Part 2 goes from definitions to implications.

Bottom-up pain does not mean “it’s in the tissues.”

This episode is a recording of a live interview with pain researcher and clinician Asaf Weissman. If you haven’t watched Part 1, start there—we laid the foundation: why pain semantics matter, how mixed messages harm patients, and why “nothing is wrong with your body” is an overreach.

In Part 2, we dig into:

• What “always bottom up” actually means (and what it doesn’t)
• Structural paradigm vs pathophysiology: why imaging often fails us
• Why stress, fear, and emotions are usually modulators, not causes
• Threshold models: when trajectories may (and may not) be changeable
• The case for neuroimmune mechanisms in chronic pain states
• Where diagnostics and biologics may take chronic pain care next
• What role physios may play as case managers and guides

This is the second half of a two-part series. Part 1 builds the framework. Part 2 challenges how we interpret evidence, scope, and clinical uncertainty—while staying anchored to what helps the patient in front of you.

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Chronic pain care is stuck—and definitions may be the reason.

In Part 1 of this two-part series, we reset how clinicians talk about nociception and pain.

This episode is a recording of a live interview with pain researcher and clinician Asaf Weissman, whose work explores the relationship between nociception and pain—and why confusion in the field creates real-world harm for patients.

In this episode, you’ll learn:

• Why “just semantics” becomes a patient trust problem
• How mixed messages (“all in your head” vs “tissue damage”) derail care
• Why “nothing is wrong with your body” is an overreach
• Where neuroimmune processes may fit in chronic pain biology
• Why psychological interventions tend to show only modest effects on pain intensity
• How clearer definitions could move research and practice forward

This is Part 1 of a two-part conversation. Here, we focus on the foundations—definitions, clinical frustration, and the biological plausibility behind what patients feel. Part 2 will go deeper into implications for treatment and the direction pain care needs next.

Subscribe for Part 2.

Join the Modern Pain Pro community.

Enroll in Pain Practice OS.

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Enrolling our next cohort of Pain Practice OS soon - JOIN US!

Most back pain improves – but how we guide recovery makes all the difference.

In this part 2 conversation with Dr. Jim Eubanks, we dig into:

• First-line care for acute low back pain
• Why rest is often the worst advice
• The role (and limits) of hands-on care
• When and how pain procedures fit into a plan
• Clear guidance on when to refer to a physiatrist
• Navigating complex cases that stall in recovery
• Future potential (and current pitfalls) of regenerative medicine

This episode brings clarity and clinical confidence to some of the most debated decisions in spine care.

Subscribe for more evidence-aware guidance, and check the links below for show notes, resources, and clinician tools.

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

In this episode, Dr. Jim Eubanks, physiatrist and spine specialist, breaks down the most harmful back pain myths patients encounter online-and what clinicians can say instead. If you've ever struggled to help a patient move past catastrophic thinking or scary MRI language, this conversation will give you the tools to reframe pain, imaging, and recovery.

What you'll learn:

• Why "pain equals damage" keeps patients stuck in fear and avoidance
• How to translate radiology reports into plain language that empowers movement
• When imaging is actually necessary (and when it's not)
• The role of lifestyle, sleep, stress, and psychological factors in back pain recovery
• Why rehabilitation should almost always come first-even before imaging

This is part one of a two-part series. Part two dives into first-line care, injections, procedures, and when to involve a specialist.

🎧 Listen to the full podcast 

💬 Join Modern Pain Pro for mentorship, case discussions, and clinical resources → modernpaincare.com

📘 Learn about Pain Practice OS → Our flagship program for clinicians building local pain programs

Your work matters-let's build modern pain care together.

#BackPain #PhysicalTherapy #ChronicPain #PainScience #Physiatry #RehabFirst

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

In this episode, I sit down with Mark Shepherd, fellowship program director, to tackle a controversial question: Is the "manual therapy" label holding back our profession? We explore whether orthopedic manual physical therapy should rebrand itself as the research evolves and public perception shifts.

What we cover:

• Why fellowship training is about reasoning, not just technique
• The disconnect between what OMPT actually is vs. how it's perceived
• How branding affects patient expectations and clinician identity
• Whether the manual therapy name limits our ability to attract new fellows
• The role of touch in modern pain care—and why it shouldn't define us

This is a nuanced conversation between two fellows who deeply respect the training but question whether our messaging matches our methods in 2025.

🎧 Modern Pain Care Resources:

• Join the Modern Pain Pro community 
• Learn about Pain Practice OS 

#PhysicalTherapy #ManualTherapy #OMPT #PainCare #Fellowship #PainScience #Physio

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Try Pain Coach 

Connect with Lachlan on LinkedIn

Struggling to turn complex chronic pain into simple, actionable care plans your patients can follow?

In this episode of the Modern Pain Podcast, Mark sits down with physiotherapist and Pain Coach founder Lachlan Townend to unpack how lifestyle data, clinical reasoning, and tech can finally work together instead of against each other.

Lachlan shares his own journey with persistent groin pain, why the traditional biopsychosocial model often becomes “woo-woo” and unmeasured, and how he built Pain Coach to help clinicians track sleep, exercise, social connection, nutrition, and psychological distress in a way that actually guides treatment.

You’ll hear us dive into:

• How Lachlan’s personal pain story shaped his empathy and practice
• Why patients don’t want “complexity” – they want simple, actionable steps
• The limitations of manual therapy and short-term fixes (without throwing them out entirely)
• How to use lifestyle tracking as a clinical support tool, not a replacement for reasoning
• Using data to test-treat-retest lifestyle changes over time
• The tension between research, incentives, and real-world outcomes
• How AI could help clinicians ask better questions of their patients’ data

If you’re a physio, PT, chiro, OT, pain coach, or any clinician working with persistent pain, this conversation will give you a concrete way to move beyond the “magic hands” model and into measurable, whole-person care.

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

In this episode, Mark sits down with Richard McIlmoyle, a chiropractor from British Columbia who went through a profound professional transformation after discovering modern pain science. Richard shares his journey from biomechanical certainty to embracing uncertainty, and how that shift has made him a better clinician and mentor.

In this conversation, you'll discover:

• How to mentor students without destroying their foundational confidence
• Why intellectual humility is your greatest clinical asset
• The tension between what we're taught in school and what science actually shows
• How Richard approaches manual therapy from a macro-down perspective
• Why he audited UBC's medical school pain curriculum (and what he found)

Richard's story is a masterclass in professional evolution. From attending the San Diego Pain Summit in 2015 to now influencing medical education in British Columbia, he demonstrates what's possible when clinicians choose curiosity over certainty.

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Pain management requires psychological flexibility—not just for patients, but for clinicians too. Bronnie Lennox Thompson reveals why embracing uncertainty builds better therapeutic relationships than projecting false certainty ever could.

What you'll learn:

→ Why the biopsychosocial model gets lip service but fails in practice

→ How to redirect your certainty from treatments to relationships

→ Guided discovery techniques for hands-on and active care

→ Why saying "I don't know" strengthens trust (not weakens it)

→ Essential skills: Motivational Interviewing + ACT for pain coaching

→ How to help patients discover freedom in their own world (not just your clinic)

Bronnie explains her shift from "biopsychosocial" to a multifactorial model, shares how clinicians struggle with uncertainty just like patients do, and breaks down the practical communication skills that transform you from expert-fixer to collaborative guide.

Whether you're struggling with big emotions in sessions, feeling stuck in the "certainty peddling" culture of CE courses, or ready to deepen your psychologically informed practice—this conversation offers permission, wisdom, and actionable strategies.

Perfect for: Physical therapists, occupational therapists, chiropractors, and any clinician working with people in chronic pain who want to practice with more authenticity, confidence, and human connection.

🔗 Interested in coaching and mentorship? Learn more about Modern Pain Care programs at modernpaincare.com

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____________________________________
Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

Chronic pain doesn’t have to steal your purpose.

In this episode, Benjamin shares how he’s navigated life with cluster headaches—and how he’s turning his journey into a mission to help others.

Key takeaways

• How Benjamin first experienced his illness and what followed
• Why acceptance became a turning point—not surrender
• Daily rhythms and small rituals that anchor him
• Relationship dynamics: the role of honest, nonjudgmental communication
• How lived experience shapes credibility in pain work
• Integrating mind and body: why they can’t be separated in chronic illness
• What Benjamin’s next steps look like (coaching, writing, building community)

If you’re a clinician, coach, or person in pain interested in bridging lived experience and evidence-based practice, this one’s for you.

🎯 Subscribe for more conversations with pain leaders.

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

You’re not powerless to fix the system — you can lead change right where you are.
In this episode, Mark Kargela walks you through 5 actionable steps any clinician can take now to transform how pain is treated in your community.

What you’ll learn:
 • Why waiting for the system to change is a trap
 • How to build a financial model that supports sustainable care
 • Ethical, value‑driven marketing—not selling out
 • The power of community, mentorship, and accountability
 • How to deliver truly psychologically informed care in practice

Want to do more than just “talk about” whole person care? This is your roadmap to doing it — in your clinic, in your region, with real patients.

🛠️ Subscribe and turn on notifications
📚 Links below for our community, resources, and the Pain Practice OS program

Pain Practice OS 

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____________________________________
Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness