Understanding Chronic Pain with Lachlan Sutton | Complete Physio Podcast

In this episode, chronic pain specialist Lachlan Sutton breaks down what chronic pain actually is, why it persists long after injury, and what you can do about it. We cover the difference between acute and persistent pain, why the "wear and tear" narrative around conditions like osteoarthritis is often more harmful than helpful, and how the nervous system plays a far bigger role in ongoing pain than most people realize. Lachlan explains the three types of pain, how to read the signs that something more complex is going on, and why movement — not rest — is almost always the answer. We also get into how physio for chronic pain actually works: from functional assessment and goal setting to graded exposure, fear of movement, and why education might be the single most powerful treatment of all.

We discuss

0:00 Introduction & What Is Pain?

1:13 What Is Chronic Pain & When Does It Start?

2:28 When Should You See a Chronic Pain Physio?

4:56 Signs Your Nervous System Has Wound Up

6:26 Acute Injury Red Flags to Watch For

8:37 Pathways Into Chronic Pain

9:32 Osteoarthritis & The "Wear and Tear" Myth

13:00 Why Movement Feels Dangerous (But Isn't)

17:02 The Body as a Garden, Not a Machine

19:47 The Three Types of Pain Explained

23:01 How to Tell If Pain Is Structural or Central

26:48 When Scans Help (And When They Mislead)

33:00 Treatment Approaches: Where to Start

36:09 Fear of Movement & How Physios Address It

39:35 The Role of Passive vs Active Treatments

46:38 Are Patients Ready for Change?

49:59 Neuroplasticity & How Pain Can Unwind

53:11 Functional Assessment in Practice

56:17 Rethinking Posture & Core Bracing

59:31 Goal Setting for Chronic Pain

1:06:00 Awareness & Access to Chronic Pain Services in the UK

1:10:32 Building Trust With Complex Patients

1:14:00 Education as the Most Powerful Intervention

1:20:14 Lachlan's Favourite Patient to Treat

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