Abstract
While the biomedical model is still theleading paradigm within modern medicine and healthcare, and people with generalised chronicmusculoskeletal pain are frequent users of health careservices, their diagnoses are rated as having thelowest prestige among health care personnel. Anepistemological framework for understanding relationsbetween body, emotions, mind and meaning is presented.An approach based on a phenomenological epistemologyis discussed as a supplement to actions based on thebiomedical model.Within the phenomenological frame of understanding,the body is viewed as a subject and carrier ofmeaning, and therefore chronic pain can be interpretedas a rational reaction to the totality of a person'slife situation. Search for possible hidden individualmeanings in painful muscles presupposes meeting healthpersonnel who view the person within a holistic frameof reference.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Brage S. Musculoskeletal health problems and sickness absence-an Epidemiological study of concepts, determinants and consequences (dissertation). Institute of General Practice and Community Medicine, University of Oslo, 1998.
Natvig B, Nessi?y I, Bruusgaard D, Rutle O. Musculoskeletal symptoms in a local community. Eur J Gen Practice 1995; (1): 25-28.
Borchgrevink C, Brekke T, Ygar B. Muscoloskeletal diseases in general practice. Tidsskr Nor Lægeforen 1980; 100: 439-445.
Rutle O. Patients in General Practice. Oslo. SIFF:Gruppe for helsetjenesteforskning, 1983.
Claussen B, Famm E, Nygård J. ICPN-diagnoses in 60 general practices. Tidsskr Nor Lægeforen 1994; 114: 821-824.
Album D. The prestige of diseases and medical specialties. Tidsskr Nor Lægeforen 1991; 111: 2127-2173.
Lien L. Is there a treatment for chronic pain with unclear etiology? A review study of treatment possibilities for fibromyalgia, chronic back pain and light depressions (in Norwegian). Seksjon for trygdemedisin, Universitetet i Oslo 1995: 2.
Steen E, Haugli L, Lærum E. Re-education for occupational health personnel. Tidsskr Nor Lægefor 1997; 117(19): 2765-2769.
Gamsa A. The role of psychological factors in chronic pain. II. A critical appraisal. Pain 1994; 57: 17-29.
Kabat-Zinn J, Wheeler Elisabeth, Light Timothy, Skillings Anne, Scharf Mark J, Cropley Thomas G, Hosmer David, Bernhard Jefrey D. Influence of a mindful meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosomatic Medicine 1998; 60(5): 625-632.
Damasio D. Descartes' Error-Emotion, Reason and the Human Brain. New York: Avon Books, 1994.
Leder D. The Body in Medical Thought and Practice. Boston: Kluwer Academic Publishers, 1992.
Leder D. The Absent Body. Chicago: The University of Chicago, 1990.
Chordas T. Embodiment and Experience. Cambridge: Cambridge University Press, 1996.
Engel GL. The need for a new medical model: A challenge for biomedicine. Science 1977; 196(4286): 129-136.
Foss L, Rothenberg K. The Second Medical Revolution. From Biomedicine to Infomedicine. Boston: New Science Library, 1988.
Svenaeus F. The hermeneutics of medicine and the phenomenology of health (dissertation). Department of Health and Society, Linköping University, Sweden 1999.
Schwarrz MA, Wiggins O. Science, humanism and the nature of medical practice. A phenomenological view. Perspectives in Biology and Medicine 1985; 28: 331-336.
Brown J. The I in Science. Training to Utilize Subjectivity in Research. Oslo: Scandinavian University Press, 1996.
Malterud K. Qualitative Methods in Medical Research. An Introduction (in Norwegian). Oslo: Tano Aschehoug, 1996.
Gilje N, Grimen H. Samfunnsvitenskapens Forutsetninger (Presuppositions of Social Sciences) (in Norwegian). Oslo: Universitetsforlaget, 1997.
Fay B. Contemporary Philosophy for the Social Science. Oxford: Blackwell, 1996.
Haugli L, Steen E, Lærum E, Nygård R, Finset A. Learning to have less pain-is it possible? A one year follow-up study of the effects of personal construct group-learning programme on patients with chronic musculoskeletal pain. Patient Education and Councelling (submitted).
Engel GL. The biopsychosocial model and the education of health professionals. Annals New York Academy of Sciences 1978; 310: 169-187.
Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry 1980; 137(5 May): 535-544.
Merleau-Ponty M. Phenomenology of Perception, 10th edn. London: Routledge & Kegan Paul, 1996.
Malterud K. Women's “undefined” health complaints-medical and healthpolitical challenges (in Norwegian). Tidsskr Nor Lægeforen 1999; 119(12): 1790-1793.
Johnson M. The Body in the Mind. Chicago: The University of Chicago Press, 1990.
Kepner J. Body Process-A Gestalt Approach to Working with the Body in Psychotherapy. New York: Gestalt Institute of Cleveland Press, 1987.
Leder D. Medicine and the paradigms of embodiment. The Journal of Medicine and Philosophy 1984; 9: 2943.
Csordas T. Embodiment and Experience. The Existential Ground of Culture and Self. Cambridge: Cambridge University Press, 1996.
Hydle I. Antropological Perspectives on Medicine, Social Security and the Law (in Norwegian). Oslo: Tano Achehoug, 1997.
Perls F. Gestalt Therapy Verbatim. Moab, Utah: Real People Press, 1969.
Kuhn T. The Structure of Scientific Revolutions. Chicago: University of Chicago Press, 1970.
Shapiro K. Bodily Reflective Modes. A Phenomenological Method for Psychology. Durham: Duke University Press, 1985.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Steen, E., Haugli, L. Generalised Chronic Musculoskeletal Pain as a Rational Reaction to a Life Situation?. Theor Med Bioeth 21, 581–599 (2000). https://doi.org/10.1023/A:1026530515100
Issue Date:
DOI: https://doi.org/10.1023/A:1026530515100