Pain worlds: towards the integration of a sociocultural perspective of pain in clinical physical therapy.

The World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF) model has been suggested as a model of function to conceptualize physical therapist practice. Among its advances, the WHO-ICF model specifically recognizes the existence of social factors that may influence patients’ and clients’ understanding of pain. However, understandings of the historical, social and cultural processes that shape the individual and collective experiences of pain and the therapeutic relationship remain limited. A more intentional and sustained dialogue between clinical practice and sociology is called for to help elucidate the nature, characteristics, complexities and clinical implications of one specific element of the WHO-ICF model, environmental factors. The purpose of this review is to advocate for the continued adoption of a sociological lens to help physical therapists better understand the broader networks of people, ideologies and practices in which people ‘in pain’ are enmeshed and the historical, geographical and cultural spaces in which they operate. In this review, existing empirical findings in sociology to introduce the concept of ‘pain worlds’ which can be applied by physical therapists to help characterize the sociocultural factors identified in the WHO-ICF model are discussed. Pain worlds is designed to complement the WHO-ICF model and assist in developing interdisciplinary research agendas that illuminate and examine the role, significance and clinical implications of sociocultural and environmental dimensions of pain.

The paper concludes with a brief set of suggestions for the development of such translational research agendas and call for the integration of pain worlds in clinical practice.