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 advocated as a model of function to conceptualize physical therapist practice. Among its advances, the WHO-ICF model explicitly recognizes the existence of social factors that could 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. This paper calls for a more intentional and sustained dialogue between clinical practice and sociology to help elucidate the nature, characteristics, complexities and clinical implications of one particular element of the WHO-ICF model, environmental factors. The aim of this review is to advocate for the continued adoption of a sociological lens to assist physical therapists in better understanding the broader networks of people, ideologies and practices in which people ‘in pain’ are woven into and the historical, geographical and cultural spaces in which they operate. This review discusses 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. Pain worlds is designed to complement the WHO-ICF model and assist in developing interdisciplinary research agendas that clarify and investigate the role, significance and clinical implications of sociocultural and environmental dimensions of pain. The study concludes with a brief set of suggestions for the development of such translational research agendas and call for the incorporation of pain worlds in clinical practice.