What Is Pain Neuroscience Education?

“If there’s no bio (in biopsychosocial), why are there physios?...For a long time we said every body has a brain, meaning don’t forget there’s a brain attached, but we have to also go backwards and remember that the brain has a body”

We speak with physiotherapist Adriaan Louw (PT, PhD, CSMT) about pain neuroscience education, including layman's explanations and metaphors to help patients better understand their pain. Adriaan discusses the science behind pain education and current research in this area. He also addresses the biosychosocial model, and the importance of including the bio in a pain science approach. 

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00:24 Can you introduce yourself?

00:42 What was your PhD in?

01:21 How did you get involved with pain neuroscience education?

02:18 Can you define Pain Neuroscience Education?

03:14 Can you give us a 5 minute layman’s explanation to describe pain?

06:47 What metaphors do you use to help patients understand their pain?

07:43 How does neuroscience education actually work to change someone’s pain?

09:24 What is the latest evidence to support this as a treatment intervention? How strong is this evidence?

11:04 What are some common pitfalls when explaining pain neuroscience to patients?

12:24 How do you change your explanations to suit the patient in front of you?

14:10 How do you explain the difference between acute and chronic pain?

16:10 How do psychosocial and lifestyle factors influence pain?

17:26 How do you like to address Pain Neuroscience Education when working with patients who are highly invested in the belief that structural pathology/biomechanical flaws are the source of their pain?

20:44 If a patient is seeing other health professionals who have been given other explanations about their pain, how do educate them without undermining the other HCP’s?

23:20 Depending on where you practice, there is very limited time during a treatment session. Do you have any strategies for therapists to incorporate pain neuroscience in that kind of setting?

25:44 It seems that the pendulum has swung heavily in favor of addressing the psychosocial aspects of chronic pain. How important is the bio aspect in chronic pain?

28:44 How do you explain why you are doing manual therapy to a patient?

31:26 Are there any specific words that you feel should never be used when educating someone about their pain?

32:53 What treatment approaches do you find work best for patients with allodynia and/or strong central sensitization?

33:50 How important do you think movement and exercise is in treatment?

34:25 What research questions are you hoping that get answered in the future?

37:21 Where can people find out more about you or your work?