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 the story of a student on his last clinical rotation who was so locked into test clusters and technique that he nearly missed a patient in visible distress, until one question about coping unlocked what she actually needed. Ben shares how a NICE-guideline question about cultural influence on pain has changed his intake conversations, plus the patient whose neck pain flared after an election result.

They also dig into why "subjective" is the wrong word for a patient's story (it's not less-than the objective findings, it often predicts outcome better), how systemic biology shows up even when imaging and labs look "controlled," and why social and cultural context can make or break a treatment plan that's otherwise textbook-perfect.

If you want a structured way to hold all of this in a session without turning it into another checklist, Mark and Ben mention the free Whole Person Reasoning guide, link below.

LINKS
Free Whole Person Reasoning guide
Join Modern Pain Pro
More from Modern Pain Care

#PhysicalTherapy #PainScience #BiopsychosocialModel

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

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 philosophy, epistemics, and clinical practice. He asks uncomfortable questions about what physical therapy actually is and where it's going.
In this episode:
Why rigid guideline adherence can be an ethical problem, not a clinical safety net (SIJ fusion as a concrete case)
How value-based care's four pillars create friction rather than harmony in practice
What AI is already doing to MSK services right now (Cambridge UK is procuring AI for MSK management today)
Why ambient documentation tools change more than just note-taking
The contextual architect: what the PT role looks like when AI handles algorithmic pathways
What decentering the human in PT curriculum would actually mean in practice
Resources mentioned:
Chad Cook's paper on value-based care in MSK practice
Dave Nicholls' work on the future of physiotherapy
Deleuze and Guattari (rhizome concept applied to clinical thinking)
Part 1 of this conversation
Want to keep developing this kind of reasoning? Modern Pain Pro is the community where clinicians work through exactly this.
--> Trial for 15 days
If this episode was useful, leaving a review helps more clinicians find it.

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

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 knowledge apply directly to clinical reasoning, and why the biopsychosocial model functions better as an analytical tool than a practice guide.
 We also dig into the Back Cafe — a 3-arm RCT on lumbar spinal fusion rehab that compared a progressive training program, a video program, and a social cafe setting run by a senior physiotherapist. At the 2-year follow-up, the back-cafe group outperformed the training group on pain and beat both other groups on daily task performance. The study raises hard questions about what the active ingredient in rehabilitation actually is. 
This is Part 1 of 2. 
LINKS 
Join Modern Pain Pro
Matt Low's blog
Back Cafe study (PubMed)
CauseHealth (Matt's network)

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Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

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 takeaways:

-  What the Misdirected Problem Solving Model reveals about chronic pain care
-  Why patients still separate the "body problem" from the "mind thing" even when seeing both PT and a psychologist
-  How incoherent clinical narratives keep patients locked in biomedical thinking
-  What true interdisciplinary care actually looks like vs. parallel care happening in silos
-  How PTs can bring the psychosocial in -- and why psychology needs to bring the body back into the conversation
-  What a unified clinical story sounds like in practice

A free webinar is coming up focused on building this framework in your own practice. Registration HERE

If this episode hit home, subscribe and check out Modern Pain Pro -- where clinicians go deep on exactly this kind of work together. - https://modernpaincare.com

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🎙️ - Listen to our Podcast - https://www.modernpaincare.com

____________________________________
Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness

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 themselves, and create space for the patient’s story to guide care.
This conversation dives into practical ways to show up more human, grounded, and effective when treating messy cases that don’t fit the textbook.
In this episode, you’ll learn:
Why you don’t need to be “the expert” in the room
How clinician nervous system regulation changes patient outcomes
What trauma-informed care actually looks like during treatment
How curiosity improves clinical reasoning in complex pain cases
Why acknowledging a patient’s story can transform rehabilitation
How to integrate psychological awareness without abandoning physical treatment
If you treat persistent pain, pelvic health conditions, or complex chronic cases, this conversation will change how you approach patient care.
Subscribe for more conversations on modern pain care, clinical reasoning, and treating complexity.
Explore the resources and programs mentioned in the links below.

Link:
Sondermind
Complex PTSD Book
Holistically Treating Complex PTSD Book
IG Post on Veterans  Stress and Suicide

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📸 - Follow us on Instagram  -  https://www.instagram.com/modernpaincare/

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🎙️ - Listen to our Podcast - https://www.modernpaincare.com

____________________________________
Modern Pain Care is a company dedicated to spreading evidence-based and person-centered information about pain, prevention, and overall fitness and wellness