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Science & Evidence:

The approach to practice we offer is informed by science and grounded in evidence, the basis of which is outlined on this page. However the science is so extensive (and complex!), it is impossible to include it all in detail.

Biopsychosocial Model For Pain:

The Biopsychosocial model was first outlined by Dr George Engel in 1977 as a response to the cold and clinical 'reductionist' medical model. A diagnosis and treatment based entirely on clinical tests ignores the person and how they are coping generally. Engel conceptualised symptoms as arising from a dynamic interaction between psychological, social and biomedical factors.

The Biopsychosocial model informed the New Zealand Guidelines for the Management of Acute Low Back Pain published in 1997 (Dr Penney was a member of the Expert Panel which produced these guidelines).

In 2003 The Australian Acute Musculoskeletal Pain Guidelines Group produced extensive Clinical Practice Guidelines; again Dr Penney was a member of both steering group and the Expert Panel on Low Back Pain. These guidelines were produced in part as a response to the 'over-medicalisation' of musculoskeletal pain, in particular the use of x-rays and CT scans which are often unnecessary.

In recognition of the growing evidence base supporting the Biopsychosocial approach to pain, the Royal North Shore Hospital in conjunction with Sydney University also introduced the Master of Science in Medicine (Pain Management), now widely recognised as one of the world's leading evidence-based degrees in pain management.

Biopsychosocial Interactions:

The neuroscience of mind/body integration comes from a variety of sources and authors.

Mindsight is the work of Daniel Siegel MD an eminent neuroscientist, which helps us understand how the brain processes information and why we tend to react rather than respond to stressful events (including pain).

Teaching us to stop and respond, rather than just react is the concept and practice of Mindfulness, and Mindfulness Based Stress Reduction (of which Dr Penney conducts regular courses, see This is originally the work of Jon Kabat-Zinn. Mindfulness, as an approach is supported by rapidly growing evidence for use in chronic pain, depression, anxiety, eating disorders and general wellbeing (including immune function).