Pianese Luigi, Bordoni Bruno
Physical Medicine and Rehabilitation, 3C+A Health and Rehabilitation, Roma, ITA.
Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA.
Cureus. 2025 Jun 10;17(6):e85717. doi: 10.7759/cureus.85717. eCollection 2025 Jun.
Chronic pain represents one of the most complex challenges of contemporary medicine. This narrative review critically analyzes the limitations of the traditional biomedical model in addressing chronic pain, highlighting how its reductionist vision is inadequate to effectively understand and treat this condition. The conceptual evolution of pain from a simple symptom to a codified "disease" is examined, highlighting the incongruities of this approach. The contribution of the bio-psycho-social model is discussed, recognizing its merits but also its applicative limits. Finally, the integration of the functional model, derived from functional medicine, is proposed as a complementary element that could fill the existing gaps, paying greater attention to nutritional and environmental factors and to the mesenchymal matrix as the biological "terrain" of chronic painful diseases. This review suggests the evolution towards a "bio-psycho-functional and social" model for a more complete understanding and management of chronic pain.
慢性疼痛是当代医学最复杂的挑战之一。这篇叙述性综述批判性地分析了传统生物医学模式在应对慢性疼痛方面的局限性,强调其还原论观点不足以有效理解和治疗这种病症。文中考察了疼痛从简单症状到被编纂为一种“疾病”的概念演变,突出了这种方法的不协调之处。讨论了生物心理社会模式的贡献,既认可其优点,也指出其应用局限性。最后,提出源自功能医学的功能模式作为一种补充要素,以填补现有空白,更加关注营养和环境因素以及间充质基质,将其视为慢性疼痛性疾病的生物学“土壤”。本综述建议朝着“生物心理功能和社会”模式发展,以便更全面地理解和管理慢性疼痛。
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