Super User

Super User

Friday, 28 February 2020 07:03

Onion Rings Model of Chronic Pain

In a previous article, I have written about how physiotherapists use metaphors and analogies to explain chronic pain. As discussed in that article, chronic pain is a complex affair and we as physiotherapists have to use these metaphors, analogies and models to understand the complexity as well as make patients realise the multiple factors influencing their pain patterns. In this article, I discuss the onion rings model of chronic pain which I have found to be an excellent metaphor to discuss the complexity of chronic pain.


Multi-dimensional approach has been shown to be effective in management of chronic pain. It usually involves a self management program along with combination of other interventions. Despite this success, a significant number of referrals fail to complete treatment or achieve improved clinical outcomes. One of the factors which may influence these outcomes is a patient's readiness for change. One of the means of defining the readiness of patients to engage with rehabilitation and self-management is through adaptation of the stages of change trans-theoretical model (Prochaska & DiClemente 1983).


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