Glossary of Key Terms

When you come to sessions with the Persistent Physical Symptoms Service, you will begin learning to manage your symptoms in new ways. This may mean hearing some new words, which can quickly become confusing. We hope that this list will help you to understand what these words mean.

Acceptance & Commitment Therapy (ACT)

ACT is an approach which aims to help people live rich, full and meaningful lives whilst managing the pain and distress that life can bring. It is based on the idea that, often, dwelling on our symptoms (which is what we are doing when we try to get rid of them!) can in fact make them worse. Instead, ACT helps us to make room for the symptoms to be there, without struggling against them, which leaves us with more time and energy for the things that are important to us. ACT is a form of Cognitive Behavioural Therapy (CBT; see below).

Biopsychosocial Model

The biopsychosocial model means that rather than just looking at illness or diagnosis (as in the medical model), we look at other things which we know affect people's health and well-being - this includes psychological factors like their mood, personality and behaviour, as well as social factors such as their family, financial situation and home environment. When we consider all of these things together, we can get a better idea of what things are like for an individual, and how we may be able to help.

Biopsychosocial Model Venn Diagram Physical Symptoms
The Biopsychosocial Model

Cognitive Behavioural Therapy (CBT)

CBT provides a way of understanding the links between our thoughts, feelings, physical sensations and the things we do, and helps to explain why people can experience the same situation in very different ways. Understanding these links can help us to make changes and move forwards with our lives.


Gabapentinoids are a type of medication which includes Gabapentin (sometimes called Neurontin) and Pregabalin (sometimes called Lyrica). These types of drugs are sometimes used to treat Neuropathic Pain. Research shows that they are not very helpful for other types of persistent pain.

Graded Activity

Activities are selected, adapted and graded for therapeutic purposes to promote health and well being. PPSS therapy is goal directed and uses activity analysis and graded activity to enable people to restore and/or maintain their function and well-being.

Graded Excercise

A graded approach to increasing physical activity to improve fitness and slowly build up the amount of excercise as fitness increases. The first step is to set a sustainable baseline of physical activity. This is then followed by progression when a person is able,  taking into account their prefferences and objectives, current activity and sleep patterns, setbacks and emotional factors.

Neuropathic Pain

Neuropathic pain is a pain that comes from problems with signals from the nerves. Neuropathic pain is often described as burning but can also feel like shooting, stabbing, tingling, tightness, numbness or electric shocks or pins and needles. You can find out more about Neuropathic pain here.


Opioids are a type of medication which are used as painkillers. Drugs such as Codeine, Oromorph, Methadone, Fentanyl, Oxycodone and Morphine are opioids, but there are others. Opioids can be very useful for managing short-term (acute) pain, but research shows that they aren't very effective for persistent pain. Research also shows that they can actually be harmful if used over a long period of time. This is why health professionals are developing other ways to manage persistent pain, such as the PPSS.


Pacing is a skill that enables you to consistently carry out activities.

Primary and Secondary Suffering

Living with persistent symptoms is difficult enough, but is made harder by everything that goes along with them - from the effect on your mood, sleep, and relationships, to your ability to do the things you want to do. We sometimes call the symptoms "primary suffering", and the other things they affect in your life "secondary suffering". This secondary suffering is what we hope to change through the PPSS.

Sleep Hygiene

Difficulty with sleep is common with people who have persistent symptoms. Some people find they are getting too much sleep, and others may struggle to sleep, or find that sleep is unrefreshing for them. The PPSS sessions will help you understand why sleep is so important, and how you can develop a more helpful sleeping pattern.

Other Words & Phrases

If there are any other words or phrases that you are not sure about, please get in touch so we can add them to this list!

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