Can Pain Education Lessen Chronic Pain with Adriaan Louw, DPT? (Ep 156)

Physical therapist and pain scientist Adriaan Louw explains Pain Neuroscience Education (PNE): teaching that pain is a protective output of the nervous system influenced by threat, context, stress, sleep, mood, immune/autonomic activity and prior experiences—not merely a direct readout of tissue damage. He reviews evidence that PNE reduces fear, catastrophizing and disability and works best when paired with graded activity/exercise, pacing and flare-up planning rather than as a standalone “lecture.” Key clinical points include using reassuring, non-nocebo language; avoiding overreliance on scary imaging labels; setting functional goals; and integrating sleep, stress regulation and gradual exposure to movement. Central sensitization/nociplastic pain concepts are highlighted and are particularly relevant for patients with EDS (widespread pain, joint instability, kinesiophobia), POTS (autonomic hyperarousal, fatigue, exercise intolerance) and MCAS (neuroimmune sensitivity). Practical takeaways: learn how pain works (education handouts/metaphors), start very gentle graded movement within tolerance, pace activities, address sleep and stress, and create a personalized flare-up plan. For clinicians, Louw outlines brief, repeatable PNE conversations embedded into usual care to improve buy-in, function and quality of life even when full pain elimination isn’t immediately possible.