Chronic Pain

Chronic Pain (3)

Monday, 17 February 2020 22:35

Metaphors as means to reframe chronic pain

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Dealing with persistent pain is not easy!! There are no quick fixes. This much we all seem to agree on. There are so many different approaches, so many different tools and so many different explanations of pain and its causes, that in their journey of trying out the variety of interventions that patients do, they can become confused and maybe left with greater anxiety as to what is the cause for their pain.

Friday, 28 February 2020 07:03

Onion Rings Model of Chronic Pain

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In a previous article, I have written about how physiotherapists use metaphors and analogies to explain chronic pain. As discussed in that article, chronic pain is a complex affair and we as physiotherapists have to use these metaphors, analogies and models to understand the complexity as well as make patients realise the multiple factors influencing their pain patterns. In this article, I discuss the onion rings model of chronic pain which I have found to be an excellent metaphor to discuss the complexity of chronic pain.


Multi-dimensional approach has been shown to be effective in management of chronic pain. It usually involves a self management program along with combination of other interventions. Despite this success, a significant number of referrals fail to complete treatment or achieve improved clinical outcomes. One of the factors which may influence these outcomes is a patient's readiness for change. One of the means of defining the readiness of patients to engage with rehabilitation and self-management is through adaptation of the stages of change trans-theoretical model (Prochaska & DiClemente 1983).


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