For decades, pain care has run on a simple question: what's wrong with you? Risk factors, deficits, pathology, problems. It's well-intentioned but could the deficits focus being making things worse?

In this episode of Pain Coach, Lachlan sits down with Dr Niamh Moloney and PhD candidate Barry Moore from Curtin University to unpack a quietly radical reframe in persistent pain research: stop leading with what's wrong, and start asking what's right.

Niamh shares the the beachside journaling session that flipped her thinking. Barry walks through his newly published scoping review in the European Journal of Pain, surfacing 79 studies on protective factors like self-efficacy, optimism, resilience and social connection, that help people live well with pain.

Crucially, this isn't toxic positivity. It's not about ignoring pathology or dismissing what hurts. It's about refusing to reduce a person to a list of their risk factors and building care around the resources they already carry.

If you've ever walked out of an appointment feeling smaller than when you walked in (or  unintentionally sent a patient home that way) this conversation will change how you think about pain care.

One problem in, a couple of solutions out. That's the goal.

RESOURCES:

 * Free trial of Pain Coach: https://paincoach.co?utm_src=podB&N [https://paincoach.co/?utm_src=podB&N]
 * Dr Niamh Moloney on X: https://x.com/drniamhmoloney
 * Barry E. Moore LinkedIn: https://www.linkedin.com/in/barry-moore-006a24145/
 * 📄 Moore, B. E., Schleidgen, L., Hang, C. P., et al. (2026). "Protection from Chronic Musculoskeletal Pain: A Scoping Review." European Journal of Pain, 30(4): e70273. → https://doi.org/10.1002/ejp.70273 [https://onlinelibrary.wiley.com/doi/10.1002/ejp.70273]
 * 📄 Rabey, M. & Moloney, N. (2022). "I Don't Know Why I've Got this Pain!" Allostasis as a Possible Explanatory Model. Physical Therapy, 102(5), pzac017. → https://doi.org/10.1093/ptj/pzac017 [https://academic.oup.com/ptj/article/102/5/pzac017/6535131]

KEY TOPICS

00:00 — Intro

00:43 — Disclaimer & welcome

01:22 — Meet Dr Niamh Moloney & Barry — paths crossing at Curtin

03:05 — What is chronic / persistent pain?

05:18 — Why pain persists: the multifactorial picture

09:35 — Central sensitisation in lay terms

12:47 — Why "central sensitisation" grinds Niamh's gears

15:36 — How to know if your nervous system is involved

18:43 — Niamh's lived experience of persistent pain

20:34 — The "why" behind the wider project

24:46 — The allostatic load paper: "I don't know why I've got this pain"

26:14 — Confronting her own risk factors

27:55 — The beach notebook: writing down what kept her well

29:44 — CliftonStrengths and the leadership lightbulb

31:39 — From deficits to strengths: a research pivot

33:09 — Antonovsky, Holocaust survivors & the salutogenic model

36:16 — Barry's scoping review (European Journal of Pain) — 79 studies

38:25 — Strengths aren't just the opposite of risk factors

40:04 — What surprised the researchers

43:30 — Lived experience: how people actually use their strengths

46:13 — Strengths ≠ toxic positivity: validating patients first

48:56 — Why disability (not pain) was the chosen outcome

51:22 — Pain intensity work is coming next

52:43 — The decade-long wider project & future studies

56:58 — Building hope, not despair

58:18 — Advice for someone at their low point

1:04:04 — Where to follow Niamh and Barry

The Strengths-Based Shift: Why Pain Researchers Are Asking "What's Right With You?" Instead of "What's Wrong?" | Prof. Niamh Moloney & Barry Moore

Dr Millie Mardon is a pelvic pain researcher at Western Sydney University with her own lived experience of the condition. Diagnosed with endometriosis at 14 after years of debilitating period pain, Millie navigated surgeries and a complex healthcare system — and is now happy to say she is pain-free. That experience became the foundation of her entire research career.

RESOURCES: 

 * Try Pain Coach for free [https://paincoach.online/?utm_src=MMpod]
 * Millie's Research "I Wish I Knew Then What I Know Now"  [https://journals.lww.com/pain/abstract/2023/06000/i_wish_i_knew_then_what_i_know_now___pain_science.25.aspx]
 * Millie's Instagram [https://www.instagram.com/pelvicpain_researcher/] 
 * Millie's researcher profile [https://researchers.westernsydney.edu.au/en/persons/millie-mardon]

KEY TOPICS:

0:00 — Introduction & trailer
1:25 — Why Millie devoted her life to pelvic pain research
3:12 — Millie's personal story: endometriosis from her first period
3:36 — The 7–9 year diagnosis delay in Australia — and why it matters
7:23 — The role of parental advocacy in getting answers
9:26 — Is a diagnosis the be-all and end-all?
12:55 — Pain-free for over 10 years
14:06 — What Millie thinks made the difference in her recovery
16:17 — "I Wish I Knew Then What I Know Now" — her landmark research study
18:05 — The 4 pain science education concepts that actually help people with pelvic pain
22:34 — Where lifestyle fits into pain: sleep, stress, diet & exercise
25:40 — How a medical scientist ended up in pain research
27:24 — The influence of Lorimer Moseley, David Butler & Explain Pain
29:45 — What actually is endometriosis?
33:20 — Prevalence: 1 in 7 women, 1 in 5 with persistent pelvic pain
34:48 — Why is endometriosis still so underfunded?
40:09 — Surgery for endometriosis: what does the research actually say?
40:43 — The Melbourne surgery scandal (ABC Four Corners: Scarred)
42:05 — The real numbers: 50% improve, 25% stay the same, 25% get worse
43:26 — Ablation vs excision: which works better and why
48:38 — The danger of swinging too far — biomedical vs biopsychosocial
52:46 — Millie's current research projects
53:28 — The pelvic pain social media campaign for young people
54:39 — The EndoEd trial: pain science education before laparoscopy
56:14 — The big unanswered question: why do some people get better and others don't?
57:14 — Gut health and endometriosis: 97% of people have GI symptoms
59:50 — Millie's parting advice for anyone navigating pelvic pain



Nine Years To Be Believed: The Endometriosis Diagnosis Crisis, The Surgeon Allegedly Performing Unnecessary Endo Surgery & Why Pain Science Education Needs A Female Rewrite | Dr Millie Mardon (PhD)

If you've been told your pain is "all in your head" or that it's purely a problem with structures in your body - this episode will challenge both of those ideas.

Dr Merv Travers is a physiotherapist, PhD researcher and strength & conditioning coach based in Perth, Western Australia. He's a Senior Research Scholar at the University of Notre Dame Australia, working in the areas of low back pain, tendon pain, and exercise rehabilitation.

In this conversation, Merv explains why pain belongs to the whole person - not just the brain and not just the body. He breaks down active inference and predictive processing in plain language, shares a story of a professional athlete he treated for Achilles pain and makes a compelling case for why the RESOLVE trial may be the most important musculoskeletal pain trial we've ever had.

We also explore the common threads between some of the best research that has been done on persistent pain - Cognitive Functional Therapy, Pain Reprocessing Therapy and Graded Sensorimotor Retraining - and why Merv believes the active inference framework ties them all together.

Whether you're a clinician looking for a better way to treat persistent pain or someone living with pain who's been told nothing else can be done - this episode offers real hope backed by real science.

RESOURCES:

 * Try Pain Coach for free [https://paincoach.online/]
 * RESOLVE      Trial (Bagg et al., JAMA 2022) [https://jamanetwork.com/journals/jama/fullarticle/2794765]
 * The Fit for Purpose Model (Wand      et al., Physical Therapy 2022)  [https://doi.org/10.1093/ptj/pzac151]
 * Recognise App (for      laterality training) [https://www.noigroup.com/product/recognise/]
 * Dr Merv Travers / Optimise Rehab [https://www.optimiserehab.com/]

KEY TOPICS

00:00 — Teaser & Introduction
01:05 — Merv's Mission: Helping Clinicians Help Patients
02:44 — How Do You Understand Pain?
04:13 — Predictive Processing Explained Simply
08:00 — The Teacher Who Said "Your Back Never Heals"
09:50 — Beyond Predictive Processing: Active Inference
12:02 — Pain Equals Body Damage x Nervous System Threat?
14:19 — The Wine Experiment: How Expectations Shape Experience
18:02 — Why Every Person's Pain Is Unique
21:48 — Treating Athletes: The Culture of Structural Thinking
23:28 — The Achilles Story: "I Don't Know What I'm Going to Do"
24:56 — Sensory Acuity Testing: "Foot Fetish Tinder"
27:07 — The RESOLVE Trial: The Most Important Pain Trial We've Had
30:21 — Why The Trial's Rigour Matters
31:40 — CFT, Pain Reprocessing Therapy & What's Coming Next
33:58 — The Common Threads Across All Three Treatments
37:07 — Get To Know Your Patient (Pain Coach Ad)
37:33 — Movement Experimentation & Modifying Symptoms
44:05 — Manual Therapy Isn't Excluded From This Framework
48:56 — The Fit For Purpose Model: Three Pillars
51:07 — Self-Evidencing Through Movement
54:19 — The Placebo Effect Is Not A Dirty Word
58:55 — A Universal Truth For Someone In Pain
01:01:21 — Where To Find Merv Travers

Pain Is Not In Your Brain And It's Not In Your Tissues - So Where Is It? | Dr Mervyn Travers (PhD)

Dr. Rachel Zoffness (PhD) is a pain psychologist and author who has devoted her career to understanding why we suffer with pain and what we can actually do about it.

We discuss:

 * The childhood experience with chronic pain that sparked her obsession with understanding suffering. 
 * The "biopsychosocial" truth about pain that medicine has known for 65 years but never tells patients. 
 * Why the healthcare system only treats one-third of the pain problem. 
 * The "pain dial" in your nervous system and the three factors that turn it up or down. 
 * How she learned to warm her hands to 90 degrees using only her thoughts. 
 * The difference between a "high pain recipe" and a "low pain recipe" – and how to craft yours. 
 * If there is an off switch for pain and whether you would want one. 

And much more...

Rachel's new book Tell Me Where It Hurts is out March 24th and is available for pre-order on Amazon.

RESOURCES

 * Pain Coach: Find Lifestyle Targets for Treating Pain  [https://paincoach.online?utm_src=RZpod]
 * Tell Me Where It Hurts [https://www.zoffness.com/books]
 * Rachel's Website [https://www.zoffness.com/]
 * Book an appointment to see Lachlan [https://www.physiopaincoach.com.au/]
   

KEY TOPICS

00:00 The lie medicine has sold you about pain

01:24 Why Rachel devoted her life to studying pain

03:02 Chronic pain as a child & what she wishes she'd known

05:28 What is pain? The biopsychosocial model explained

08:05 The three domains: Bio, Psych & Social

09:05 The missing two-thirds of pain treatment

11:32 Why pills and procedures aren't working

12:13 Central sensitization: How pain becomes chronic

15:01 The piano analogy: Your brain practices pain

17:50 Is there hope? Can the pain pathway shrink?

25:52 The Pain Dial: How to turn your volume up and down

26:15 Factor 1: Stress and anxiety

26:40 Factor 2: Mood and emotions

27:25 Factor 3: Attention and focus

28:16 The good news: The opposite is also true

30:18 Is there an on/off switch for pain?

32:04 Why opioids work (and it's not just physical)

33:39 Can chronic pain ever fully disappear?

35:32 The Pain Recipe: High pain vs low pain ingredients

38:35 Crafting your low pain recipe

41:51 Habit change & lasting pain relief

45:08 Biofeedback: How Rachel learned to warm her hands to 90 degrees

51:42 Your thoughts literally change your biology

53:16 Biofeedback is as effective as migraine drugs

54:16 This isn't "manifesting" – it's science

55:55 How to reduce fear during a pain flare

58:24 What surprised Rachel while writing the book

01:00:26 About "Tell Me Where It Hurts"

01:02:10 Rachel's parting advice: Write your pain recipe



The Missing Two-Thirds Of Pain Treatment + Find Your Pain Recipe | Dr. Rachel Zoffness (PhD)

Is what you eat making your pain worse? In this episode, I sit down with Chloe McLeod, founder of Verde Nutrition Co, Accredited Practising Dietitian, and Advanced Sports Dietitian with over 16 years of experience. Chloe is one of Australia's leading experts in gut health, food intolerance, and autoimmune conditions. Chloe  has been featured in Women's Health, Body & Soul, and House of Wellness. We unpack the real connection between nutrition and chronic pain, whether gut health is all hype and what you can actually do to start feeling better. If you live with fibromyalgia, rheumatoid arthritis or persistent pain, this one's for you.

RESOURCES

 * Pain Coach: Find Lifestyle Targets for Treating Chronic Pain  [https://paincoach.online?utm_src=pcpchloe]
 * Verde Nutrition [https://verdenutrition.co/] 

KEY TOPICS & TIME STAMPS

00:00:53 — Introduction to Chloe McLeod & Verde Nutrition

02:02 — The connection between pain and what we eat

03:37 — Nutrition's impact on fibromyalgia & rheumatoid arthritis

05:19 — Is gut health just a craze?

05:49 — The gut-brain axis explained

07:04 — Case study: How 7 days of fast food changed a man's microbiome

09:20 — How to know if your gut is healthy

11:25 — Microbiome testing: Is it worth it?

16:42 — Big ticket items for improving gut health (water & fibre)

18:39 — Resistant starch hack: Cook, cool, and reheat pasta/potatoes

20:32 — Meat, dairy, and gluten: Do you need to eliminate them?

22:26 — Intermittent fasting and chronic pain

25:38 — Processed meat: No safe level of consumption

27:25 — Food chemical sensitivity and pain

29:22 — Added sugar: How much is too much?

31:07 — Omega-3s and extra virgin olive oil as "liquid gold"

32:03 — Working with fibromyalgia, rheumatoid arthritis & osteoarthritis

33:11 — Plants for Joints study and plant-based eating

36:34 — Navigating nutrition with eating disorder history

39:57 — Case study: Fibromyalgia client success with multidisciplinary care

45:36 — The research connecting gut health and fibromyalgia

47:10 — Excitotoxins (artificial sweeteners, MSG) and fibromyalgia

49:05 — The role of supplements in pain management

50:14 — Supplements are "sprinkles on the icing on the cake"

52:23 — Top supplements: Omega-3s, collagen, magnesium

54:40 — Curcumin, probiotics, glucosamine: Second-tier supplements

56:49 — Supplement quality and contamination risks

58:33 — How to screen for quality supplements (Informed Sport, HASTA)

01:00:36 — Final advice for someone struggling with chronic pain


You Don't Know How Good You Can Feel (Until You Do This) | Chloe McLeod 

Dr. Dan Bates, is a sports and exercise medicine specialist, director of the Back, Neck and Joint Clinic in Melbourne, and former head doctor for both Melbourne and North Melbourne AFL teams. Dr. Bates has developed an innovative, algorithmic approach to chronic pain that's helping patients reclaim their lives.

In this episode, we tackle one of the most controversial topics in pain management: what happens when patients are told their pain is "in their head." Dr. Bates reveals why this messaging - even when well-intentioned - can drive hopelessness, helplessness, and suicidal ideation. He shares the simple phrase that makes his patients tear up with relief and teaches the powerful two-word question that gives patients their power back.

You'll learn practical strategies for managing pain amplifiers within your control: how catastrophizing language physically amplifies pain, why depression and anxiety are normal responses to chronic pain (and how they make it worse), and the importance of taking ownership. Dr. Bates reveals his clinical algorithm to determine how he treats his pain patients. 

 Dr. Bates offers hope for those in despair: your pain is real, you're not imagining it, and just because we can't find the cause doesn't mean there isn't one.


RESOURCES 

 * Back, Neck and Joint clinic [https://www.backneckandjoint.com.au/]
 * Dr. Bates' podcast: "It's Not In Your Head" [https://www.iniyh.com/]
 * Free Trial of Pain Coach  [https://paincoach.online/?utm_src=drdanpod]

KEY TOPICS & TIME STAMPS

00:00 - 03:02 Dr. Bates' Journey into Chronic Pain Medicine

03:52 - 07:26 The "It's In Your Head" Problem

07:26 - 13:18 Medical History of Blaming Patients

13:34 - 21:30 Understanding Pain Mechanisms

21:30 - 27:25 Pain Amplifiers You Can Control

27:25 - 32:09 The Two-Word Power Move

32:09 - 37:44 Why Doctors Struggle to Say "I Don't Know"

38:05 - 42:47 The Shocking Truth About Medication Effectiveness

42:47 - 49:36 Getting More Specific with Diagnosis

49:36 - 56:45 The Algorithmic Approach to Treatment

56:45 - 59:59 Final Words for Those in Despair



Why This Doctor's Patients Cry: Two Words That Change Everything | Dr Dan Bates

In this episode, Lachlan Townend sits down with world-renowned pain researcher and clinician Professor Peter O’Sullivan - a man whose work has completely reshaped how we understand and treat back pain. 

If you’ve ever been told your spine is fragile, your core is weak, or your pain always means damage - this episode will change the way you see back pain forever. 

Peter’s research and clinical leadership led to the creation of Cognitive Functional Therapy (CFT) - a revolutionary approach that helps people break free from fear, overprotection, and the belief that pain always equals damage.

Together, Lachlan and Peter explore:

 * Why so many of us have been taught to fear movement and “protect” our backs
 *  How Peter’s own experience with pain changed the way he treats patients
 * The science behind CFT and how it helps people reclaim confidence in their bodies
 *  The role of stress, sleep, exercise, social connection and nutrition
 *  Why posture, scans, and “core stability” might not be what really matters

Resources: 

 * Free trial of Pain Coach [https://paincoach.online/]
 * Book a consultation with Lachlan  [https://www.physiopaincoach.com.au/]
 * Evoolve Pain Care Academy [https://evoolvepaincare.academy/clinician-resources]
 * Cognitive Function Therapy (3 year follow-up) paper [https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00135-3/abstract]
 * Body Logic  [https://bodylogic.physio/professor-peter-osullivan/]





The Real Reason Your Back Still Hurts (It’s Not What You Think) | Professor Peter O'Sullivan

In this episode of Pain Coach, physiotherapist, researcher, and TEDx speaker Joshua Pate joins us to unpack the complexity of pain - especially how children and adults make sense of it and why our beliefs matter so much for recovery. Josh shares powerful metaphors, practical strategies, and inspiring patient stories that highlight the balance between short-term relief and long-term change.

We discuss how pain science can transform healthcare, everyday coping strategies, and even prevention - starting as early as schools. Whether you’re living with pain, supporting someone who is, or simply curious about how the brain and body work together, this conversation offers hope, validation, and tools to help you move from the backseat to the driver’s seat of your healing journey.

Resources 

 * Pain Coach: Helping Clinicians Take The Guesswork Out Of Pain Treatment [https://paincoach.online/]
 * Connect with Lachlan on LinkedIn [https://www.linkedin.com/in/lachlan-townend/]
 * Book an appointment with Lachlan  [https://www.physiopaincoach.com.au/]
 * Joshua Pate’s website & resources [https://joshuawpate.com/]
 * Zoe and Zac’s Pain Hacks children’s book series [https://joshuawpate.com/books/]
 * Josh’s TEDx: The mysterious science of pain [https://www.ted.com/talks/joshua_w_pate_the_mysterious_science_of_pain]
 * The “One Thing” Project [https://onething.painsci.org/]
   
   Key Topics & Timestamps
 * 00:00 – Introduction
 * 06:38 – Josh’s journey: From physiotherapy clinics to pain research and children’s books
 * 10:48 – Myths about pain: Why pain isn’t just about “damage”
 * 23:42 – Turning down the pain “volume”: The Lego Experiment 
 * 40:47 – Validating pain: Why “hurt ≠ harm” isn’t always helpful
 * 46:15 – Practical Tip #1: Making sense of your own pain and how others see it
 * 49:26 – Practical Tip #2: Multidisciplinary support and short vs. long-term strategies
 * 52:11 – The ladder analogy: Small wins build toward big change
 * 55:25 – Inspiring patient story: From toilet-seat struggles to the Great Wall of China
 * 58:47 – Driver’s seat vs. backseat: Balancing agency and support
 * 01:03:08 – The “One Thing” project: Messages of hope for people in pain
 * 01:05:00 – Closing reflections: The importance of curiosity, validation, and prevention
   

Why We Should Teach Every Child About Pain | Joshua Pate

In this episode, Lachlan Townend is joined by Professor Mark Hutchinson to explore the complexities of pain from the cellular level through to lived human experience.

Mark shares his personal journey with chronic back pain, including the challenges of navigating healthcare as both a patient and a pain scientist. He discusses his cutting-edge research into how blood biomarkers could transform pain diagnosis and treatment - bringing us one step closer to precision, personalised medicine for pain.

We also dive into practical strategies like sleep, nutrition, mindfulness, and cold-water therapy, connecting them to the molecular science of how pain develops and persists. With passion and authenticity, Mark sheds light on why  there’s more hope now than ever before.

Whether you’re a clinician, researcher, or someone living with pain, this conversation offers science, story, and hope in equal measure.

Links & Resources:

 * Pain Coach: Lifestyle tracker to take the guesswork out of pain relief.  [https://paincoach.online/]
 * Professor Mark Hutchinson's LinkedIn page [https://www.linkedin.com/in/drmarkhutchinson/?miniProfileUrn=urn%3Ali%3Afs_miniProfile%3AACoAAAGr4IMBwFtZjtDDKdXyvkSEnw0oMZDWUfE]
 * Book an appointment with Lachlan  [https://www.physiopaincoach.com.au/]

Precision Pain Relief Is Closer Than You Think | Prof. Mark Hutchinson

In this episode, Lachlan talks with Jerar (@thepainillusion), an Exercise Physiologist who used to deal with long-term back pain. He shares what he learned from his own struggles and why pain doesn’t always mean something is badly wrong.

They talk about why scan findings can be unnecessarily alarming, how some advice from health professionals can actually hinder recovery and why getting stronger doesn’t always mean your pain will go away.

If you’ve ever had pain that won’t go away - or want to help someone who does - this conversation will help you see pain in a new light.

What you’ll hear:

 * Why pain isn’t always a sign of damage
 * What “The Pain Illusion” really means
 * Why scans and back problems don’t always match up
 * How to think differently about strength and movement

Links & Resources:

 * Pain Coach App offer - 1 month free with an initial online consultation [https://www.physiopaincoach.com.au/book-physio-with-lachlan-townend]
 * Pain Coach app: take the guesswork out of pain relief [https://paincoach.online/]
 * The Pain Illusion  [https://www.instagram.com/thepainillusion/?hl=en]
 * Your MRI & Persistent Lower Back Pain: A Modern Day Horror Movie by Oliver Davis [https://www.chronicallyfit.co/blog/your-mri-amp-persistent-lower-back-pain-a-modern-day-horror-movie?fbclid=PAZXh0bgNhZW0CMTEAAacciTkcWzMKimKukwUWayor3sbkAaYPcMjD4tP5X1bvxldhbyMNTOHq-NG6vQ_aem_IQ9fQFWhjYqKpq4FdF3KrQ]
 * Why do ineffective treatment seem helpful? A Brief Review by Steve Hartman [https://pubmed.ncbi.nlm.nih.gov/19822008/]

Jerar Lahoud: Fighting Back Against Bad Back Pain Advice

Welcome to Pain Coach, the podcast designed to empower you to regain control of your pain treatment journey.

In each episode, Lachlan Townend shares inspiring stories from individuals who have overcome the obstacles of pain, along with insights from health professionals dedicated to helping you reclaim your life. This podcast offers practical tools and guidance for those who refuse to let pain dictate their lives or steal their dreams.

Pain Coach encourages you to find a health professional who acts as a coach—not a 'magic healer'—supporting you in your recovery journey. It’s time to step back into the driver’s seat and reclaim what pain has taken from you.

DISCLAIMER: This podcast is for educational purposes only. The views expressed in this podcast do not constitute medical advice and are general in nature. You should obtain specific advice from a qualified health professional before acting on any of the information within this podcast.

Lachlan Townend

Shows