We’re launching our first podcast! Our first season of Live Aligned with Dr. Brent will feature 8 episodes,
released every 2 weeks throughout 2026.
We’re launching our first podcast! Our first season of Live Aligned with Dr. Brent will feature 8 episodes,
released every 2 weeks throughout 2026.
Chronic pain affects one in four people worldwide — and most of us don’t understand why. In this episode, Dr. Brent Anderson sits down with Dr. Adriaan Louw, physical therapist, author, and co-founder of Evidence in Motion, to break down the science of pain in plain language.
Dr. Louw explains the three types of pain — nociceptive, neuropathic, and nociplastic — and why understanding the difference matters for treatment. Together, they explore why pain exists as a protective mechanism, why tissue damage and pain intensity don’t always correlate, and how the nervous system can become sensitized over time, leading to persistent and widespread pain conditions like fibromyalgia.
The conversation covers the role of movement, sleep, nutrition, and education in managing chronic pain, the science of neuroplasticity and desensitization, and how positive movement experiences can literally rewire the brain’s pain response. Dr. Louw also shares his thoughts on the current pharmacological options with the strongest evidence behind them and leaves listeners with an important message: chronic pain can get better.
In this episode:
Resources mentioned:
00:00 Intro
Pain as one of the most common — and most misunderstood — human experiences
00:19 Guest Introduction
Dr. Adriaan Louw’s background: PhD in physiotherapy, 120+ peer-reviewed articles, Director of Therapeutic Neuroscience Research Group, VP at Evidence in Motion
01:30 Episode Overview
What modern pain science tells us about chronic pain, sensitized nervous systems, and why pain does not always equal tissue damage
03:21 Conversation Begins
Dr. Brent and Adriaan connect on the intersection of pain education and movement
03:51 The Scale of Chronic Pain
1 in 4 people globally experience persistent pain — and the numbers are rising
04:34 Types of Pain Explained
Breaking down nociceptive, neuropathic (neurogenic), and nociplastic pain in plain language for patients and practitioners
08:16 Why Do We Have Pain?
Pain as a protective mechanism — and what happens when that system works too well for too long
10:07 Pain vs. Tissue Damage
Debunking the myth that pain intensity = tissue injury severity; tissue health and pain are two different things
11:16 The Lorimer Moseley Story
How past experiences, fear, and context shape the brain’s pain response — a famous case in pain neuroscience
12:36 How the Brain Processes Pain
Pain is distributed across multiple brain areas — there is no single ‘pain center.’ Memory, emotion, and movement all play a role
15:01 The Brain Departments Story
Adriaan’s patient-friendly metaphor explaining why chronic pain affects focus, memory, and movement — and why there is hope
19:23 Education + Movement as Treatment
How teaching patients about pain reduces fear, enabling better movement outcomes — the PNE+ model
24:16 Changing Pain Education in Healthcare
The pain revolution happening in PT, OT, and medical schools; CAPT and ACOTE curriculum updates; the next generation of practitioners
28:10 Advice for Patients Seeking Help
How to find the right practitioner, advocate for yourself, and shift from external to internal locus of control
32:12 Neuroplasticity & Hope
The brain can change — what this means for people who have ‘tried everything.’ A message of genuine hope backed by science
37:15 Deep Dive: Fibromyalgia
What fibromyalgia really is, the role of the immune system and widespread sensitization, and the best current evidence for treatment
42:56 Pharmacology & Chronic Pain
Membrane stabilizers and low-dose antidepressants — how they calm the nervous system and where they fit in a multidisciplinary approach
45:23 Final Thoughts from Dr. Louw
A message to patients: healthcare is getting better, there are providers who care, and your pain can shift for the better
46:34 Pilates & Successful Movement Experiences
A British Journal of Sports Medicine systematic review placing Pilates in the top 3 interventions for mechanical low back pain
47:48 Where to Find Dr. Adriaan Louw
EvidenceInMotion.com and WhyYouHurt.com — free resources, provider finder, and patient education videos
48:21 Outro
Closing remarks and reminder to Live Aligned
PT, PhD
Adriaan earned his undergraduate, master’s degree and PhD in physiotherapy from the University of Stellenbosch in Cape Town, South Africa. He is an adjunct faculty member at the University of Nevada Las Vegas, teaching pain science. Adriaan has taught throughout the US and internationally for 25 years at numerous national and international manual therapy, pain science and medical conferences. He has authored and co-authored over 120 peer-reviewed articles related to spinal disorders and pain science. Adriaan completed his Ph.D. on pain neuroscience education and is the Director of the Therapeutic Neuroscience Research Group – an independent collaborative initiative studying pain neuroscience. Adriaan is a senior faculty, pain science director and vice-president for Evidence in Motion.
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