Category: Biopsychosocial

Social Medicine

16/10/2023

By Duke Autret, Myotherapist

As healthcare professionals, we understand that physical health is not solely determined by medical treatments or therapies. There are a variety of social determinants of health that influence a person's well-being, including access to healthcare, education, employment, housing, and more. In this article, we will explore some of the common considerations regarding the social determinants of health and how they apply to physical health and myotherapy.

Access to Healthcare
Access to healthcare is a crucial social determinant of health that affects a person's physical health outcomes. Lack of access to healthcare can lead to untreated chronic conditions and injuries, which can result in more severe health problems down the line.
At Simple Wellness Myotherapy, we prioritise accessibility by accepting private health insurance plans and offering affordable pricing options.
We also ensure that we provide a treatment plan that is inclusive of low cost or free at home care advice, such as exercises that can be completed at home without expensive equipment or subscriptions, and other home care or lifestyle modification advice that helps your manual therapy treatment become even more effective.

Housing
Housing quality and stability have a significant impact on physical health. Poor living conditions, such as mould or pests, can exacerbate chronic conditions such as inflammatory and autoimmune diseases, respiratory conditions like asthma, and allergies. We understand that living in an environment that causes a chronic condition to flare up can also lead to an increase of physical symptoms including pain, fatigue and restlessness.
Additionally, unstable housing situations can lead to stress and anxiety, which can negatively impact physical health.
As part of our myotherapy practice, we ask our patients about their life circumstances and work to provide them with resources to improve their living conditions or to find modifications that can help reduce the impact of those influences.

Education
Education level and access to educational opportunities can also affect physical health outcomes. People with lower levels of education are more likely to engage in unhealthy behaviours, such as smoking or unhealthy diets, which can lead to chronic conditions.
We also recognise that health education is somewhat lacking generally, from early childhood through to adulthood, and that there are a lot of outdated health beliefs that are no longer supported by evidence.
At Simple Wellness Myotherapy, we aim to educate our patients about healthy lifestyle choices and offer resources for further education and skill-building.

Employment
Unemployment or underemployment can lead to financial stress and inadequate access to healthcare, both of which can negatively impact physical health. As part of our myotherapy practice, we encourage our patients to prioritise their physical health, even if it might mean taking time off work or seeking alternative employment options that allow for better work-life balance.
We can also help advocate for a better ergonomic work environment by providing a letter to your employer with suggested modifications that will help you prevent injury and pain, and prevent them from having a WorkCover case - this might include the suggestion of having an official ergonomic assessment completed, or small modifications like switching a handheld phone for a headset; providing a chair with better lumbar support; or requesting that your employer allocate you lighter duties while you are being treated for an injury.

Community
Social isolation and lack of social support can lead to depression, anxiety, and other mental health issues that can also very much affect physical health.
Our myotherapy practice focuses on creating a supportive community for our patients, providing a safe and welcoming space for them to discuss their physical and mental health concerns.
We prioritise creating meaningful connections and therapeutic relationships with our patients. If you like to chat and socialise throughout your treatment, we’re here for that! If you prefer a quiet, peaceful treatment we will respectfully keep our discussion purely to the essentials of your treatment. Our therapists are empathetic and compassionate, and we can often tell if you’re feeling “not quite right”.
Where its needed, we can help refer you to additional support and our team are always happy to write up a letter to your GP or other healthcare professionals to make accessing care as simple as possible for you.

At Simple Wellness Myotherapy we understand the importance of addressing social determinants of health to improve physical health outcomes. We encourage our patients to communicate with us about their social situations and offer resources and support to help address any challenges they may face. We also aim to provide affordable, accessible, and high-quality care to all of our patients. By including the ‘bigger picture’ of our social factors to health, we can work towards creating a healthier and more equitable society.

pain can be influenced by more than just your muscles and joints

11/9/2023

By Duke Autret, Myotherapist

It’s important to recognise and understand that musculoskeletal health and pain is highly influenced by the overall health, function and condition of the body and its context or environment it lives within.
The Biopsychosocial (BPS) Model is a holistic and interdisciplinary approach to understanding health and illness that considers the biological, psychological, and social factors that influence our well-being. One key component of the BPS Model is the concept of "predisposing and perpetuating factors" that can lead to the development of conditions or worsen existing ones, making it harder to recover. In this article, we will explore the most common perpetuating factors and their relation to the BPS Model.

These determinant factors of pain can be classified into different categories such as metabolic, social, and physical factors. Let's take a closer look at these factors:

Metabolic Factors

Hormonal imbalances, poor nutrition, and chronic diseases can contribute to the onset and perpetuation of pain.

Sleep: Insomnia, lack of sleep, or poor sleep quality can have a significant impact on our physical and mental health. Sleep is essential for our bodies to repair, recover and regenerate, and inadequate sleep has been linked to a wide range of health problems, including obesity, diabetes, heart disease, and depression. The importance of sleep in maintaining good health and encouraging patients to address sleep problems is part of a comprehensive treatment plan.

Inflammation: Although a natural response of the body to injuries or infections, persistent or chronic inflammation can contribute to a range of health problems, including autoimmune disorders, cardiovascular disease, and cancer, as well as maintaining irritation of joint structures, muscles, and nerves. Persistent Inflammatory processes can be the result of all metabolic, psychosocial, and physical factors. The BPS Model acknowledges the role of longstanding inflammation in the development and progression of many chronic conditions and encourages finding ways to reduce inflammation through lifestyle changes such as, in particular, diet and exercise.

Nutrition: The food we eat plays a vital role in our overall health and well-being. A poor diet can lead to a range of health problems, including obesity, diabetes, and heart disease. The rise of the modern diet where a bulk of staple and accessible consumption is ultra processed foods and includes high amounts of sugars and carbs has been linked to an over 60% increase in all cause mortality! And of course, being so fundamental to overall metabolic health, clean food and good nutrition is as much a part of addressing musculoskeletal pain as it is warding away disease.

Toxicity/Pollution: Exposure to toxins and pollution can contribute to a range of health problems, including respiratory issues, cancer, neurological problems and beyond. There are many historic and current examples, one recent example of such an environmental health risk factor is the discovery of Phthalates or micro-plastics which now contaminate much of the fast foods industry. The BPS Model acknowledges the importance of reducing exposure to toxins and pollutants as part of a comprehensive treatment plan.

Psychological Factors

The breadth of psychological, cognitive and emotional health factors are beyond the scope of this article however here are some examples as food for thought.

Emotions: such as Joy, Love, and Care can be powerful antidotes which help counteract stress, anxiety, grief, depression, and other states and emotions that can overwhelm us. Emotions are a major influence on how, how much and whether you experience pain at all even if there is underlying tissue pathology or systemic disease. Traumatic events in our past, whether they be major and acute, or more subtle but repeated and cumulative, will have an effect on the personality, disposition, response and relationship we have with pain in our body. Focusing on the use and awareness of emotion is a crucial part of repair and healing at the level of the physical body including inflammatory processes and pain perception/generation.

Purpose: having a sense of purpose and meaning in life can improve overall well-being. This can come from a variety of sources, including spirituality or religion, parenting, serving/volunteering, personal growth/development and challenges. A meaning crisis can be an overlooked part of physical health but is critical for emotional/mental health and thus in turn indispensable for pain management and physical health.

Balance Material Wealth: While financial security is important, an excessive focus on material wealth can lead to dissatisfaction, addiction, negative emotions, and all the implications thereof. Likewise an instability of financial resources is obviously linked to health risk factors. This interesting study speaks to the relationship between wealth, health and happiness/satisfaction in life.

Balance of Stress: Some stress can be beneficial for health, it's what helps us build capacity and resilience (a process called Hormesis), but too much stress can be harmful. Finding a balance of stress that promotes growth and resilience without overwhelming the individual is key. Physical Exercise, Cold water immersion, and Saunas are all common ways in which people engage in building up their natural immunity to stress. There is much research on the value and effects of all such activities, here is one from 2018 on hot and cold bathing.

Nature and Beauty: Last but definitely not least, exposure to nature and beauty can improve emotional and physical health massively. This can come from spending time in natural settings, such as parks or forests, or from experiencing art and other forms of beauty. Once again the research on this is copious. One final link for those who are of nerd level interest is some hard science on the importance of ‘natural’ rhythms suited for our particular flavour of evolutionary biology.

Social Factors

Our social connections and relationships play a most significant role in our overall health and well-being. A lack of social support or unhealthy relationships can contribute to the perpetuation of pain. Our social connections and the quality of our relationships have a significant impact on our mental and physical health. A lack of social support or unhealthy relationships have also been linked to a range of health problems, including depression, anxiety, forms of dementia, and heart disease.
The social factors of health cannot be underestimated, in fact a whole host of studies have linked social isolation to being the biggest health risk today, especially for middle-aged men!
In the BPS Model we recognise the importance of strengthening social support networks as part of a comprehensive treatment plan.

Physical Factors

Physical factors such as inactivity/sedentism, load, and motor control can contribute to the perpetuation of pain. The BPS Model acknowledges the importance of addressing these factors by exploring ways to increase physical activity levels, optimising load levels, and assessing and addressing motor control issues through refining movement patterns, alignment, and body awareness.

Physical Inactivity & Sedentism: Physical activity is essential for maintaining good health, but many of us lead sedentary jobs and lifestyles that contribute to a range of health problems, including obesity, diabetes, heart disease, depression, anxiety, and loss of musculoskeletal conditioning. These guidelines show the recommended levels of physical activity that have been set out by the World Health Organisation so as to give people a good indicator of where they sit on this scale and be encouraged toward more optimal physical activity levels as part of maintaining good biological (metabolic and mechanical) and psychological (cognitive and emotional) health.

Load Management: Load refers to the amount of stress placed on the body, whether from physical activity, work, or other factors. Too much load in either frequency (overuse) or intensity (overload) can lead to injury or exacerbate existing conditions, while too little load can contribute to deconditioning and weakness. Wherever one sits on this spectrum will be an important factor to identify so as to avoid overuse injuries and promote good progressive strength and endurance building. The importance of load management in maintaining good health and encouraging exploration of ways to optimise load levels whether in work, sports, or activities of daily living is part of a comprehensive treatment plan.

Motor Control: Refers to the way in which the body moves and functions. Poor motor control can contribute to a range of health problems, including chronic pain, injury, and decreased mobility as it relates to increased loading of joints, muscles, and connective tissues where movement patterns are suboptimal. We speak of concepts and attributes such as (core) stability, alignment, proprioception, interoception, kinesthetic awareness, strength, endurance, and mobility.

By understanding the perpetuating factors of pain and their relation to the BPS Model, you can take steps to improve your overall health and well-being. Remember, pain is not just a physical symptom but can also be influenced by psychological and social factors. By addressing all aspects of your well-being, you can achieve long-term pain relief and optimal health.

If you are experiencing pain, it is essential to seek help from healthcare practitioners who take a holistic approach to your well-being. By considering the biological, psychological, and social factors that contribute to your pain, a comprehensive treatment plan can be developed that addresses the perpetuating factors and promotes your overall health and well-being. Our friendly staff here at Simple Wellness are all trained and well versed in this approach and are here to help you with your health needs.

Social Medicine

pain can be influenced by more than just your muscles and joints

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