Free Clinical PDF Guide
The answer was never a better technique. It is a better process.
So many methods work because most pain improves on a similar curve. The Whole Person Reasoning Framework is the process I use underneath it. Four domains for reasoning through complex pain, with the person in charge.
Modern Pain Care · Whole Person Reasoning Framework
Whole Person
Pain Care
A Clinical Field Guide · Screen · Interview · Exam · Treat
01
Local Tissue
Aggs, eases & SINSS
02
System Biological
The amplifiers
03
Psychological
Threat, beliefs, values
04
Contextual & Social
The healing environment
Integrated by
Lived Experience & Embodied Narrative
Why This Guide
Most of pain care is built on the steep part of a curve.
A person walks in. Over a few weeks they improve. We name whatever method was in the room, and a whole tribe grows around it. A course. A credential. A new tissue to blame.
Artus and colleagues pooled the improvement curve across 118 low back pain trials. Active care, placebo, usual care, even the waiting list improved on the same curve. The size of the gain did not track to the treatment.
You do not have to throw your tools away. Hands on care, exercise, education, they can all support the curve. The shift is to stop crediting the technique and start reasoning through the whole person, with them in charge. That reasoning is what this guide gives you.
118 trials, one curve
Within-group pain improvement pooled across primary care treatments. Artus et al. 2010, Rheumatology.
What's Inside
A concise reference for reasoning through the whole person.
What to screen, ask, examine, and treat across all four domains: local tissue, system biological, psychological, and contextual/social
The lived experience and embodied narrative layer up front, the one story that reveals and drives the other four, not a fifth box to check
A printable multisystem symptom screen for the autonomic, immune, endocrine, and gut amplifiers that a mechanical interview misses
A one-page chairside reasoning map you can reach for mid-visit
Full references with evidence tiers, so you know what is well-supported and what is expert opinion
Download the Guide
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