The Modern Pain Podcast

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 research gives you a map but not your patient's territory, how Aristotle's three forms of knowle...

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 labels and quick solutions often fail. Faith shares how clinicians can step back, regulate themsel...

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 it. You’ll learn: Why guidelines are population-informed—but patients are personalHow “mindlines” ...

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 taking away hope. You’ll learn: • Why pain reduction alone can narrow a patient’s life &nbs...

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 pathoph...

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 painWhy rest is often the worst adviceThe role (and limits) of hands-on careWhen and how pain procedures fit into a planClear guidance on when to refer to a physiatristNavigating complex cases that stall in recoveryFuture potential (and current pitfalls) of r...

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 techniqueThe disconnect between what OMPT actually is vs. how it's perceivedHow branding affects patient expectations and clini...

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 confidenceWhy intellectual humility is your greatest clinical as...

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 followedWhy acceptance became a turning point—not surrenderDaily rhythms and small rituals that anchor himRelationship dynamics: the role of honest, nonjudgmental communicationHow lived experience shapes credibility in pain workIntegratin...

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 insteadPractical ways to “shut up and listen” to the story beneath the painHow stress, HPA-axis load, IBS/migraine, and sensitization intertwine with painA workab...

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 limited • Using relationships and peer support without feeling like a bur...

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 control • What “acceptance” really means (and doesn’t mean) • Practical strategies that became second ...