It's Not in Your Head

No matter what type of chronic pain a patient has, certain lifestyle foundations are non-negotiable starting points - particularly with sensitization or complex presentations. This episode walks through the core elements of Justine's MARS Method, with specific, actionable recommendations around:

• Protein intake and fiber consumption
• Hydration
• Sleep quality
• Movement

Patients leave with steps they can implement immediately. Clinicians gain a time-efficient framework for communicating lifestyle essentials in a way that complements and enhances the impact of their medical interventions.

Resources:

www.iniyh.com

www.resilientwarriorcoachingllc.com/cpp

www.drdanbates.com.au

Timestamps:

00:00 Official Intro

00:17 Intro

04:17 What is the MARS Method:

04:25 M is for Movement

05:56 A is for Awareness

07:46 R is for Recovery

08:25 S is for Stress

09:10 Why these matter?

12:43 Metabolic Changes

17:11 Effects on your Nervous System

18:02 Sedentary Lifestyle

19:43 Why is Protein Important?

21:52 Muscle Loss & Protein

24:16 How much Protein?

27:12 Upgrading Your Protein

34:18 How do you choose?

38:43 Why Fiber?

42:55 Types of Fiber

44:54 Hydration

48:28 Sleep

55:55 Exercise/ Movement

01:03:07 Ligament Laxity and flares

01:06:12 Wrap-up & What's Next on the Pod

01:09:33 Disclaimer

This episode reviews validated assessment tools that help identify pain types, amplifying factors, and functional impact — and introduces the hosts' own sensitization questionnaire for viewing results through the central sensitization lens. The discussion closes with an examination of how patient mindset affects the ability to improve over time. All questionnaires discussed in this episode are linked on the podcast's website page so you can fill them out and bring them to your next appointment.

Resources:

www.iniyh.com

Timestamps:

00:00 Official Intro

00:17 Intro

03:56 Pain Detect

06:45 Central Sensitization Inventory: 25 Questions

12:37 Central Sensitization Inventory: Part B

13:39 Bodily Distress Syndrome Checklist

14:49 Our Central Sensitization Assessment

19:47 DAS 21

24:25 Oswestry Disability Index

28:41 Pain Analog Scale

35:36 Growth vs Fixed Mindset in Patients & Wrap-up

40:06 Disclaimer

This episode walks through the neuropathic pain treatment algorithm from first to fourth line, giving both patients and providers a structured, evidence-based roadmap. Topics covered include:

• First-line oral medications and how to trial them
• Topical agents for localized nerve pain
• Interventional options including nerve blocks and neuromodulation
• Spinal cord stimulators and intrathecal pain pumps

A link to download the full algorithm paper is available on the episode page. Primary care physicians and specialists alike will find this a practical guide for working through neuropathic presentations more efficiently.

Resources:

www.iniyh.com

Timestamps:

00:00 Official Intro

00:17 Intro

03:51 Why Did Dan Develop this Algorithm?

06:45 Starting Point - Is It Neuropathic Pain?

09:53 How to Draw Your Pain Diagram (KEY)

12:23 Consequences for Neuropathic Pain

19:04 Medication Perspective

25:09 How to Prescribe Medications

26:26 Second Line Combination Therapy

31:08 Topical Focal Treatments

36:05 Specialist Referral

40:15 Pulsed Radiofrequency

43:43 Adhesiolysis

46:49 Thermal Radiofrequency

47:59 STIM Interventions - Neuromodulation

56:09 Making Difficult Choices

01:01:50 Complications

01:04:30 SCS Pocket Pain

01:08:18 Opioids

01:15:20 Targeted Drug Therapy

01:16:56 Wrap Up

01:19:44 Disclaimer

Pain diagrams are a widely underused clinical tool — not because they don't work, but because they're often done incorrectly. This episode explains how structured pain body diagrams, drawn with a clear and consistent key, can make invisible symptoms visible and help clinicians identify nociceptive, neuropathic, and nociplastic components at a glance. The hosts walk through examples covering back, leg, and neck pain, demonstrating how this simple tool can improve diagnosis, goal setting, and progress tracking for both patients and providers.

Resources:

www.iniyh.com/newsletter

Timestamps:

00:00 Official Intro

00:17 Intro to How to Draw Pain Diagrams

03:03 Where is it? What does it feel like? What's made it worse?

04:26 Turn the Invisible, Visible

06:11 Useless Pain Drawings

07:17 Pain Key

08:51 Plain Neuropathy

09:32 Patient that's Sensitized

12:36 Five Major Causes of Lower Back Pain

17:11 Overlap - Medical Blocks & Other pain

20:15 How do we draw backs? 

20:26 Facet joint pain

21:40 SI Joint Inflammatory

23:10 SIJ Osteoarthritis

24:05 SI Joint Dysfunction

27:48 S1 Nerve Compression

28:09 L5 Nerve Root

28:49 L4 Nerve Root

29:04 L3 Nerve Root

32:04 C4 Nerve Root

32:26 C5 Nerve Root

32:45 C6 Nerve Root

33:14 C7 Nerve Root

33:46 C8 Nerve Root

34:57 C1 - 2 Facet

35:13 C2 - 3 Facet

35:49 C3 - 4 Facet

36:02 C4 - 5 Facet

36:12 C5 -6 Facet

36:44 C6 - 7 Facet

37:17 C2 - 3 & C5 - 6 Whiplash

37:38 Pathologies of Neuropathic Pain

37:59 Focal Nerve Entrapment

38:28 Peripheral Nerve - Superficial Peroneal

39:22 Diabetic Peripheral Neuropathy

40:28 Myofascial Triggers

41:57 Multiple Diagnoses

44:39 Multiple Sites

46:24 When Patients come back with Pain

48:24 Cervical Instability

49:42 Recap

53:55 Disclaimer

Pain flares are an inevitable part of chronic pain — but they don't have to feel unmanageable. This episode breaks down the phases of a flare and offers concrete strategies for each stage, from early recognition to recovery. Patients learn how to identify their personal flare patterns earlier, spend less time in crisis, and navigate their way out more effectively. For providers, the episode offers a framework for educating patients proactively, so they are equipped to manage what they can control and know when to seek additional support.

Resources:

www.iniyh.com

https://www.instagram.com/iniyhpodcast/

Timestamps:

00:00 Official Intro

00:17 Intro - Flare Management

02:38 Reasons for this episode

03:55 Justine's Most Recent Flare

05:34  Breaking Down the 5 phases

05:43 1st Phase - Trigger or Stressor

09:27 2nd Phase - Loss of Routine

12:05 3rd Phase - Worsening Pain

15:03 4th Phase - The Hole

17:55 5th Phase - Digging Yourself Out

19:35 Phase 1 Strategies

23:34 Phase 2 Strategies

25:30 Phase 3 Strategies

30:43 Why not Opioids?

32:10 Communicating with your provider

34:44 Phase 4 Strategies

38:27 Phase 5 Strategies - The Reach Out

43:08 Pain Flares have a Cycle

46:58 WrapUp

48:54 Disclaimer

Effective goal setting in chronic pain care requires more than tracking metrics — it requires connecting purpose to action. This episode breaks down how both a pain specialist and a pain coach approach goal setting with their respective patients, covering how to identify a patient's "why," build discipline, cultivate motivation, and develop confidence. Patients leave with tools to make their clinical appointments more productive, while providers gain strategies to link interventions to patient goals in a way that improves adherence and long-term outcomes.

Resources:

www.iniyh.com

https://www.instagram.com/iniyhpodcast/

Timestamps:

00:17 Intro

02:39 Having a Great Why

04:24 Your why matters because this takes time

06:18 Connect your Purpose and your Plan together

08:35 Developing Discipline with a Morning Routine

11:13 Connecting Habits to Discipline to Motivation

12:42 Timeframe - how long will this take?

14:26 How do you identify purpose?

20:47 Finding confidence experiences

27:23 Pain is about loss

30:25 How to talk to your Doctor about this

32:33 Patients need to bring in what they need from Doctors

36:37 Expectation Management

38:38 Disclaimer

This episode introduces the Central Sensitization Algorithm — a clinical tool designed to help providers more quickly and accurately diagnose and treat central sensitization and related neuroinflammatory disorders. By organizing symptoms into distinct categories of nervous system dysfunction, the algorithm creates a clearer picture from what is often a confusing clinical presentation. For patients, it offers a framework for better understanding and communicating what they are experiencing, reducing diagnostic frustration and improving care outcomes.

References:

www.iniyh.com/newsletter

www.resilientwarriorcoachingllc.com/cpp

www.drdanbates.com.au

Timestamps:

00:00 Official Intro

00:17 Intro - How you start to think about it

01:31 Initial Presentation

03:25 Neuropathic / Nociceptive

04:01 Central Sensitization (Other side)

04:45 What is Sensitization?

05:56 How Dan Got Into Hypermobility

08:44 3 Components of Hypermobile EDS

09:18 Two Sides of Central Sensitization

11:03 Justine's Path to Central Sensitization

16:04 Dan's Frown of Frustration

18:57 Looking at the Literature

20:32 7 Main Categories of CS

22:14 Pre-existing Diagnoses 

22:37 Disproportionate, prolonged pain

24:24 Symptoms

25:30 Sensory Hypersensitivity

30:22 Sleep Disturbance

34:38 Fatigue

36:47 Cognitive Impairment

40:02 Mood Disturbance

42:46 Motor Dysfunction

45:33 Dysautonomia - Cardiovascular

47:42 Dysautonomia - Gastrointestinal System

48:34 Dysautonomia - Urinary System

49:47 Dysautonomia - Secretor Motor System

50:49 Dysautonomia - Reproductive System

52:22 Assessment

54:31 What do we do as Doctors? What is driving this patient's CS?

57:57 Final Points

01:00:13 Disclaimer

This episode moves from the problem to the solution — offering specific, evidence-informed language that providers can use to communicate about pain without dismissing or inadvertently shaming patients. The discussion emphasizes that pain is a complex interplay of physiological and psychological factors, not purely one or the other. Both patients and providers are given tools to work collaboratively, address the real drivers of pain, and approach difficult conversations with empathy and clinical accuracy. Mental health crisis resources are provided for listeners who need support.

Resources:

www.iniyh.com/newsletter

Timestamps:

00:00 Official Intro

00:17 Intro

04:27 Patient Example - Suicidal thoughts

07:33 What do we do?

08:50 Mosley & Butler's Pain Neuroscience

10:11 Asher Perspective

10:57 Pain Neuroscience Messages - Good Side

13:47 The Downside

17:11 Blue Sky Effect

18:40 Pain Scales and Shifting Pain

24:26 Words That Are Misinterpreted

28:23 How to Get Around it?

31:08 4 Part Series, Step 1 - Find & Fix

32:29 Step 2 - Filtering

33:47 Step 3 - Turn Down the Amplifiers

36:14 Step 4 - Rewire

38:25 Summarize It

40:32 From The Patient Side

44:01 Disclaimer

Trigger warning: This episode discusses suicide.

Chronic pain patients carry a 25% likelihood of having suicidal thoughts in the preceding two weeks — and research suggests that being told pain is "in your head" may increase that risk by 500–1,200%. This episode bridges the gap between what patients experience when dismissed and what providers often fail to recognize about the impact of their language. The hosts frame this as a patient safety issue, comparing the risk to what would be accepted from any other medical intervention. Crisis resources are included in the show notes below.

Resources:

www.iniyh.com/newsletter

Suicide support lines:

Australia - Lifeline 13 11 14 or call 000

USA & Canada - Suicide Crisis and Lifeline 988, or The Crisis text line 741 741

United Kingdom -Suicide Prevention Helpline 0800 689 5652 or Emergency services on 999 or the NHS on 111

Finland - MIELI Crisis Helpline 09 2525 0116

Timestamps:

0:00 Official Intro

00:17 Intro

02:30 Dan's side

05:04 Iatrogenic Psychological Harm

08:28 Young vs Older Patients

09:57 Chronic Fatigue Syndrom

13:16 Obvious to patients, not to providers

16:26 Illness Behavior

21:38 The harm - suicide risk

22:08 Patrick Ryan

27:37 Matthew Burke

31:19 Somatic symptoms and hopelessness

34:03 Bring it together

40:33 Pain Neuroscience

45:09 Wrap Up

47:28 Disclaimer

From the uterus to witchcraft to hypnotism, this episode traces the long and often troubling history of how unexplainable symptoms have been labeled and dismissed. The discussion moves through historical classifications — including Briquet's syndrome, somatoform, conversion, and functional disorders — to show how deep-rooted biases have carried into modern medicine. This episode offers a lighter change of pace while delivering important context for why patients with difficult-to-explain presentations have struggled to be taken seriously throughout history.

Resources:

www.iniyh.com/newsletter

Timestamps:

0:00 Official Intro

00:17 Intro

01:56 Diagnostic Limitations

05:30 Doctor Side

08:57 Patient Side

11:07 Juxtaposed position

15:08 Understanding things given the time

17:31 I don't know comes with caveats

20:27 Diagnosing History

29:55 Scientific Regions

33:36 The Enlightenment

42:12 Unconcious component of the mind

51:39 Same time as Charco - Briquette

01:04:04 Symptoms Briquette starts to recognize

01:09:20 Thurbrandt - end of 1800s

01:10:56 Sigmund Freud

01:14:41 Second WW

01:17:08 Looking closer at the DSM 1

01:25:02 Unintended Consequences

01:31:25 Conversion Disorders

01:35:29 DSM 5

01:42:04 International Classification of Diseases

01:43:30 How to think about this

01:50:35 Disclaimer