The Modern Pain Podcast

Is "whole person reasoning" just biopsychosocial with new branding, or does it change how you actually run a session? Mark Kargela and Ben Whybrow break down why treating pain by tissue alone misses most of what's driving a patient's experience, and why that applies from day one of an acute injury, not just after the 91-day mark that turns pain "chronic." Mark tells t...

What if following the clinical guideline is sometimes the wrong call? Not occasionally. In the kinds of MSK situations that come up regularly. That's the argument physiotherapy researcher Matt Low makes in Part 2 of this conversation, and it's worth sitting with. About Matt: Matt Low is a physiotherapy clinician and researcher based in the UK whose work sits at the intersection of philos...

Evidence-based practice has a blind spot: not in the research itself, but in how we rank one form of knowledge above all others.  In this episode, I sit down with physiotherapist and PhD candidate Matt Low to unpack what he calls epistemic fluency, the ability to move between different forms of clinical knowledge depending on what the situation actually requires. We cover why population-based rese...

Most chronic pain patients aren't failing to improve because they aren't trying. They're failing because no one in their care has helped them see what they're actually up against. In this solo episode, Mark breaks down why even well-intentioned biopsychosocial care often falls apart in practice -- and why the fix isn't just adding more disciplines to the team. Key takeaway...

What if the best thing you could bring to a complex pain case… is curiosity instead of certainty? In this episode, Mark Kargela sits down with physical therapist and pelvic health specialist Faith Stokes to explore what trauma-informed, psychologically informed care actually looks like in practice. When patients present with persistent pain, grief, trauma, or complex comorbidities, rigid clinical...

What if biomechanics isn’t the reason your patients improve? And what if your best “tool” isn’t a tool at all? In this episode, I sit down with exercise physiologist Samuel Bulten to unpack the identity shift many clinicians face when persistent pain doesn’t respond to traditional care. We discuss: Why biomechanics has a weaker link to pain than we were taught The ego trap of being the “fixer” in...

What if the guideline isn’t wrong—but incomplete? And what if your patient isn’t “non-compliant”—just complex? In this episode, I’m joined by Joost Van Wijchen to explore the tension between clinical guidelines and the messy reality of practice. We unpack the concept of mindlines —the experience-shaped frameworks that actually guide what we do—and why uncertainty isn’t a flaw in care, but part of...

Mindfulness for pain isn’t candles and breathing apps. It’s measurable, mechanism-based analgesia. In this episode, we break down what the neuroscience actually shows about mindfulness and pain modulation—and why it works through pathways completely independent of opioids. You’ll learn: How mindfulness decouples sensation from suffering (insula vs. prefrontal activity) Why “trying to relax” can ba...

What do you do when a patient says, “I don’t care about goals—I just want less pain”? This moment shows up every day in pain care—and how you respond can either reinforce stuckness or help someone get their life back. In this episode, Mark Kargela breaks down why pain reduction isn’t wrong—but often incomplete—and how clinicians can navigate this conversation without invalidating the patient or ta...

🎙️ What happens when a clinician becomes the patient—and almost doesn’t survive?  💥 HLH. ICU. Life support. Then… powerlifting again. In this powerful episode, strength coach and physio Jared Maynard shares his shocking journey through a life-threatening diagnosis of HLH, his fight to stay alive, and what he learned about healthcare, humanity, and healing. You’ll learn: What HLH is—and how it nea...

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 d...

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 epis...

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 p...

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...

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 discon...

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...

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...

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...

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...

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...

Rethinking pain changes outcomes. Treating tissues alone leaves people behind. In this clinician-focused conversation, Mark Kargela flips the script with Pete Moore (Pain Toolkit) to unpack what modern, human-centered pain care looks like in real clinics. You’ll learn: Why a tissue-only approach misses 10–30% of cases—and what to do instead Practical ways to “shut up and listen” to the story benea...

What happens when “fix me” fails—and you still hurt every day? Keith Meldrum shares how validation and willingness replaced a decades-long fight with pain to rebuild a meaningful life. What you’ll learn  • Why pain is always biological—but rarely only biomedical  • How stigma, dismissal, and “it’s in your head” worsen outcomes  • The pivotal power of “We believe you” in the clinic  • Practical ref...

When pain makes life small, fighting harder isn’t always the answer. Former firefighter Joletta Belton shares how she stopped “going to war” with pain and rebuilt a bigger life around it.   What you’ll learn:  • Why the “fix pain first, live later” plan keeps people stuck  • How acceptance/willingness differs from “just live with it”  • Practical ways to reconnect with values when activity is lim...

Compassion is not just being “nice”—it’s a clinical superpower. Learn how inner compassion can transform both patient care and your resilience as a clinician. What You’ll Learn in This Episode:  • Why compassion is a contextual wisdom, not just basic kindness.  • How self‑compassion supports your regulation, quality of care, and longevity.  • Real-world client story: a chronic pain patient’s break...

Fighting pain made things worse. Acceptance gave him his life back. Tom's Facebook Group In this powerful episode, Tom Bowen shares how chasing a cure for chronic pain left him anxious, depressed, and stuck. Only when he shifted focus—from fixing pain to living well—did real change begin. • How endless referrals and surgeries fueled hopelessness • The mental shift that helped him reclaim cont...