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Review Pain The Biopsychosocial Model of the Assessment, Prevention, and Treatment of Chronic Pain Kelley Bevers, 1 Lynette Watts, 1 Nancy D Kishino, 2 Robert J Gatchel 1 1. The University of Texas at Arlington, Texas, US; 2. West Coast Spine Restoration Center, Riverside, California, US T he biopsychosocial model has been demonstrated to be the most heuristic approach to chronic pain assessment, prevention, and treatment. Currently, this model also provides the best foundation for tailoring the most comprehensive pain management program for each specific patient. Chronic pain patients have an increased risk for developing deficits in physical functioning, emotional reactivity, and cognition. Interdisciplinary treatment, based on the biopsychosocial model, is vital to address these multifaceted issues facing chronic pain sufferers. These interdisciplinary pain management strategies have progressed with advancements in science and technology in an attempt to provide the best possible outcomes for pain patients. However, while research has made enormous advances, there are still some clinical research gaps to be addressed. This article will begin with a historical overview of pain management in order to demonstrate the evolution in theory from ancient practices to the modern biopsychosocial model. Additionally, functional restoration and other early interdisciplinary intervention programs will be highlighted for their importance and effectiveness in chronic pain management, assessment, and prevention. Keywords Pain, chronic, biopsychosocial, diathesis-stress, interdisciplinary, temporomandibular joint and muscle disorder (TMJMD), biomedical model, stress, chronic low back pain (CLBP), early intervention, prevention. Disclosure: Kelley Bevers, Lynette Watts, Nancy D Kishino and Robert J Gatchel have nothing to disclose in relation to this article. No funding was received for the publication of this article. This manuscript is based in part upon an invited presentation at the 8th World Congress of the World Institute of Pain (WIP), New York City, May, 2016. Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. Received: July 18, 2016 Accepted: August 15, 2016 Citation: US Neurology, 2016;12(2):98–104 Corresponding Author: Robert J Gatchel, Department of Psychology, College of Science, The University of Texas at Arlington, Box 19528, 1225 West Mitchell, Arlington, Texas 76019. E: gatchel@uta.edu Chronic pain is a widespread, debilitating condition shared by millions worldwide. In 2015, more than 25 million Americans reported suffering from consistent daily pain. 1 The Center for Disease Control (CDC) reported 15.6% of American adults experience consistent headaches or migraines, 29% have consistent low back pain, and 14.9% suffer consistent neck pain. With pain conditions accounting for approximately 80% of doctor visits, effective pain management and prevention methods are essential to use in order to effectively deal with issues such as emotional distress, loss of work- productivity, and quality of life in these patients. 2 The US spends roughly $625 billion annually for medical treatment and lost productivity related to the pain conditions. 2,3 The prevalence of chronic pain stimulated the US Congress to designate that the 2000s would be the decade of pain control and research, 3 by passing “The 2010 Patient Protections and Affordable Care Act.” Moreover, the National Institutes of Health (NIH) supported the Department of Health and Human Services (HHS), in collaboration with the Institute of Medicine (IOM), highlighted the importance to examine pain as a public health issue. 2 The IOM’s role was to assess the state of science regarding education, care, and research of pain, to make recommendations about how to proceed forward in the best interest of the public. The IOM presented their findings and recommendations in the US in a publication entitled “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research”. 4 The IOM recommendations were: to shift the view of pain from a patient perspective to one of a major public health issue; increase awareness of the problem of pain; focus on the prevention of pain; improve pain assessment techniques; address disparities among sufferers; and foster both treatment centers and cohesive research among scientists and healthcare providers. Interdisciplinary research is essential to better understanding complex, multifaceted issues of pain in order to address these recommendations. 5 Individuals experience pain in a multitude of ways, often seeming subjective to the individual based on their perceptions and descriptions of their condition. The variations in how patients perceive and relay this information can influence physician interpretation and treatment strategies. Unfortunately, difficulties in assessing and treating pain have led to an enormous proportion of sufferers to be treated with opioid medications, which manage pain but do not resolve the condition. Opioids tend to be highly addictive, and are often misused. In 2014, The National Institute on Drug Abuse (NIDA) estimated 26–36 million people would abuse opioids globally in the next year. 6 Opioid medications cause changes in brain chemistry that can lead to mood and 98 TOUCH ME D ICA L ME D IA