
I like this wheel of sorts, put out in 2009 by the International Association for the Study of Pain. I think it nicely depicts the construct that pain – as well as many other symptoms – is a multifaceted phenomenon consisting of past and present influences. For every individual some aspects carry more influence than others, like direct trauma or pathology. The impact of these elements can also vary at different times in life. When too many of the inputs exert a negative impact on an individual then problems arise. This supports the need for a balanced approach to problems, and that crediting all dysfunction to one aspect (such as emotional state) is incomplete. I believe that focusing on changing what is changeable (movement patterns, daily activities, attitudes & beliefs) then maybe those things we can’t change (genetics, previous experience) won’t be as noticeable and troublesome.