#39 MORE GOOD DAYS - Modern Approaches to Pain Management with Nel Fulia

Understanding Chronic Pain: Misconceptions and Effective Management Strategies

Chronic pain affects millions of people, yet it’s still widely misunderstood. In this episode, we unpack what pain actually is, why chronic pain can persist even when scans appear “normal,” and why treating pain isn’t as simple as fixing damaged tissue.

We explore pain as a protective alarm system—one designed to keep us safe—but discuss how, in chronic pain, that system can become overprotective. The conversation challenges the common belief that ongoing pain always equals ongoing injury, highlighting research showing that many people with structural changes on scans experience no pain at all.

A key focus of the episode is the role of the nervous system and central sensitization, where pain signals become amplified over time. Using simple, relatable analogies, we explain how pain can be driven by sensitivity rather than damage—and why understanding this can be both empowering and relieving for patients.

We also dive into the thinking behind More Good Days, an initiative created to bridge the gap between evidence-based pain science and what many patients are actually offered in clinical care. The discussion highlights the importance of education, movement, psychology, and human connection in helping people rebuild confidence in their bodies.

Ultimately, this episode reinforces a critical message: effective chronic pain management requires a multidisciplinary approach that treats the whole person—not just the site of pain.

Episode Chapters / Timestamps

00:00 – Understanding Chronic Pain
What pain really is, why it exists as a protective mechanism, and how chronic pain differs from acute injury.

00:51 – Rethinking Pain and Damage
Challenging the assumption that pain always equals physical damage, and why scans don’t always tell the full story.

04:49 – The Journey to More Good Days
How the idea for More Good Days emerged and the gap it aims to close in chronic pain care.

10:29 – Explaining Pain to Patients
Why education matters, how understanding pain reduces fear, and the role of language in recovery.

16:40 – Recognizing Central Sensitization
How the nervous system can amplify pain signals and what this means for chronic pain sufferers.

22:09 – Engaging Patients in Their Recovery
Movement, confidence-building, and tailoring approaches to individual patients.

24:50 – Clinicians as Patients: Common Patterns
Shared behaviours clinicians fall into when experiencing pain themselves—and what we can learn from it.