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Its Not In Your Head | Chronic Pain Podcast

@iniyhpodcast

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Pain education and resources for patients and clinicians. 🎙️ We've come together to find better ways to treat complex pain. Listen to episodes 👇

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Dr Dan Bates: “It’s not in your head. The amount of times I’ve said that to patients and they tear up, just because someone believes them… Sure, you can think about your pain differently. But no one imagines themselves into a life where you lose everything you love. No one’s imagining their pain. It’s real.”

Joshua Pate: “One of my favourite answers came from @mycuppajo … She said your pain is real and you are believed”

Barry Moore: “You are more than just your risks, your weaknesses and your pathology. Find someone who’s going to help you realise that, someone who really tries to understand you and gets you doing more of the things that fill your cup.”

Merv Travers: “People’s pain is real and it’s not in their heads. We have new treatments that have been developed, tested and are showing real promise. I certainly have more tools in my toolkit than I had in 2020. There’s absolutely no doubt about it.”

Prof Mark Hutchinson: “There are hundreds of thousands of brilliant minds around the world literally working through the night, coming up with new ways to recognise the pain state, diagnose the pain state and intervene… Our view of pain is changing so much faster than it ever has.”

🎧 Full episodes on the Pain Coach podcast 👇

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"If you're confused, the patient is sensitized."

My @iniyhpodcast partner Dr. Dan Bates says this, and for clinicians it's less a tidy aphorism than a practical cue or trigger.

You know the moment. A complex pain patient is in front of you and you cannot make it add up. The pain has gone from proportional to disproportional, focal to widespread, intermittent to constant. Fatigue, brain fog, nausea, disrupted sleep, dysautonomia, etc. all layered on. And you feel that flick of confusion and frustration.

▶️ Here's the shift: that confusion is not a dead end. It's a clue. Used well, it's the prompt to stop and ask "is this central sensitization?", instead of letting the harder slide take over. The one where confusion becomes feeling stuck, stuck becomes the shame of not having an answer, and that shame quietly lands as blame on the patient. "A lot of things affect pain." What they hear is: "it's you, not what we treat."

Most clinicians aren't dismissive. They're working inside real diagnostic limits and a system not built for dynamic, multi-system presentations like sensitization, or nervous system dysfunction. The cue gives that confusion utility, and somewhere constructive to go.

➡️ The way Dan and I break apart complex pain and central sensitization gives it structure: drivers, amplification, and the downstream symptom "buckets," so you can separate the core diagnoses from the amplifiers and link symptoms to treatment.

💻️ I'm teaching a live masterclass on this: The Sensitization Script. It's built for patients first, but if you work with complex pain, you'll leave with a framework for turning that stuck feeling into recognition.

⏰️ Friday, July 17, 2026 · 4pm PST / 7pm EST · Just $27.

🔗 Register at my link in bio or go directly to resilientwarriorcoachingllc.com/tss

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Sensory sensitization is a piece of complex pain that is common with CRPS, hypermobility, fibromyalgia, and sensitization or nervous system dysfunction. 🔥

A common example is with allodynia with touch, but it is so much more. 👇️

▶️ Sensory sensitization is the intense, intrusive amplification of things like:
◾️ Touch
◾️ Light:
◾️ Sound
◾️ Temperature
◾️ Smell
◾️ Taste/Food

⬅️ Swipe through the carousel to see how they present, and where to start addressing each as a patient.

🎙️To dive deeper, listen to episode 37 of @iniyhpodcast.

📚 For support in managing complex pain with a community that actually gets it, check out the Complex Pain Program (CPP) from @resilientwarriorcoaching.

🔗 The program interest list is currently open at Juz's link in bio!

👉️ When you add yourself, you'll get the Desensitization Guide immediately sent directly to you so you can a head start on decreasing sensitization. 📑

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The treatment options for CRPS, central sensitization, and related diagnosis can be daunting and difficult to manage – especially when it’s all newer.

The world of complex pain is not one you understand until you’re in it. Like playing a new sport, it takes time for things to slow down and be able to really understand the landscape.

➡️ The goal is not to throw the kitchen sink at patients and overwhelm them, but to have a clinician who can offer or help you access all the different options from a therapeutic perspective, while working through them systematically and as effectively as possible given your specific presentation.

It is also crucial that they take your wishes into account with regards to what you’re comfortable with. THAT is evidence-based medicine: the best available science, with the experience of the clinician, AND the desires of the patient.

🧠 In my case, coming of a brain injury where I was heavily medicated for 9 years, I did not want to be on a ton of medications that would again threaten the physical and cognitive independence I had worked so hard to achieve. Thus, I leaned heavier on procedures earlier.

💊 It is well known how high the side effect profiles are for medications related to these conditions like Gabapentin (Neurontin), Lyrica (Pregabalin) or Cymbalta (Duloxetene). What is less known is the NNT, or number needed to treat, i.e. how many people trial a medication for it to give just one person at least 30% pain relief.

🎙️ Check out episode 8 of @iniyhpodcast for more on managing expectations with these drugs.

With medications, starts low. If you don’t have significant side effects, you can go up, but don’t keep going up hoping for more relief despite them. This is where folks get into trouble with the things that amplify pain and make it harder to manage.

▶️ The reality is there are no magic bullets. Different medications have different mechanisms of action and are affecting different pathways, so it is logical to end up on a few that create a stack if you can tolerate them.

👉️ For personalized support managing complex pain, DM or book a discovery call at my link in bio.

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💉 I just had an L4/5 epidural to address the disc related part of my back pain.

⬅️ Swipe through this post to learn about epidurals and how they are applied in the pain space.

The procedure went super smooth and I could watch it as they did it on x-ray which was cool. (I try to make procedures kind of fun and less stressful by tapping into the music playing in the procedure room and chatting with my doc about pain stuff). I felt much better immediately after when still numb, but it took two days for the flare from the injection itself to settle and be able to more fully evaluate. 🔥

Note: This is normal and more likely in complex patients with more nervous system wind up. A moderate vs intensely disproportionate response is usually predicted by central sensitization levels going into the procedure. 👇️

📋️ If you're a complex patient, you can check out @iniyhpodcast ep 18 on pain assessments and download/fill out the Central Sensitization Inventory (CSI) for yourself at https://www.iniyh.com/episodes/ep-18-how-to-assess-your-pain

Overall post epidural - big difference! I am able to do more with less pain and definitely dropped my baseline pain score. The goal in my case is to decrease the intrusive aching and sharp pain in my spine, so the ligaments are in a better position and the multifidus muscle can stabilize the spine better.

🏋️‍♂️ Then, the pelvis and hips are in a better position to respond and function more optimally with consistent training. That is what improves the motor patterning and mobility needed to dig out of the weakness/inhibition cycle that leads to the piece of pain output from muscle dysfunction and spasming.

👉 Ideally, I can then better overcome the ligament laxity and weakness that contributes to SIJ dysfunction, and avoid prolotherapy. That, I'll be able to properly assess after giving myself a window to rebuild.

▶️ Treating multifaceted pain takes being able to strategically assess different variables, manage expectations, stay in the moment, and also have a broader 'if-this, then-that' plan based upon the results.

✍️ What's been your experience with epidurals? Drop it in the comments!

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The transition from hospital employment to private practice is one of the biggest career moves a doctor will make. On Saturday 14th March, we helped a room full of them get a serious head start.

The Business of Medicine 2026 at W Hotel Melbourne covered everything medical training doesn't teach doctors. Tax strategy, entity structuring, medical billing, marketing, compliance, team management, personal wealth planning, and more. One attendee told us that in a single day, we covered everything he had to figure out by himself during his own transition. Exactly what we set out to do!

A huge thank you to the incredible experts who generously gave their time to make this event possible:

Guest Speakers:
· Ann-Maree Ventura and Joshua Flett | Fletcher Clarendon Lawyers
· Brendan Homann | Medbill
· Caroline Chaplin | Rooms With Style
· Leonard Sack | Profmed Medical Insurance Solutions by ProfCover

Medical Mentor Panel:
· Dr. Amber Hart | Maternal and Infant Wellbeing Melbourne
· Associate Professor Chun Yew Fong | Eastern Haematology Oncology Group
· Dr Dan Bates | Back Neck and Joint

DPM Financial Services Team:
· Sean O'Neill | Tax Principal
· Anthony Pane CA | Tax Principal
· Dino Miliotis | Tax Principal
· Karli Tsemetzis | Private Wealth Consultant
· Kyle Roberts | Insurance Consultant

Are you a doctor ready to make the leap to private practice? Or just starting to think about it? We'd love to help!

Book an appointment via the link in our bio.

During all stages of your medical career, we can help with the next step.

#DPMFinancialServices #FinanciallyEmpoweringDoctors #BusinessOfMedicine #PrivatePractice #PrivatePracticeSuccess #PrivatePracticeMarketing

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✨Ravinto ja CRPS – miten syömisellä voi vaikuttaa oloon?

CRPS (Complex Regional Pain Syndrome) on monimuotoinen kipuoireyhtymä, johon liittyy usein voimakas raajakipu, hermoston herkistyminen, turvotus ja paikallinen tulehdus. Sairauden taustalla nähdään tulehdusreaktioita ja keskushermoston herkistymistä.

Monet kroonisen kivun asiantuntijat korostavat, että ravinto voi tukea kehon perusprosesseja – kuten tulehduksen säätelyä, verensokerin tasapainoa ja hermoston toimintaa – ja siten vaikuttaa epäsuorasti oireiden hallintaan.

Miksi ravinnolla voi olla merkitystä?

👉 Tulehdus ja kipu
Tulehdus voi voimistaa kipukokemusta. Ravintoaine-rikas, vähän prosessoitu ruokavalio voi tukea tulehdustasapainoa.

👉 Hermoston toiminta
Hermosto tarvitsee rasvahappoja, proteiinia, vitamiineja ja kivennäisaineita toimiakseen optimaalisesti. Esimerkiksi omega-3-rasvahapot ja laadukas riittävä proteiini tukevat solujen toimintaa.

👉 Energia ja palautuminen
Tasainen ateriarytmi auttaa pitämään verensokerin tasaisena. Tämä on tärkeää, koska CRPS:ään liittyy usein uupumusta, aivosumua ja herkkyyttä stressille. Kivunhallinnassa korostetaan kokonaisuutta: ravinto, uni, liike ja stressinsäätely kulkevat käsi kädessä.

🍽️ Käytännön vinkkejä CRPS-arkeen

🟢 Lisää:
• Kasviksia ja marjoja
• Rasvaista kalaa
• Pähkinöitä ja siemeniä
• Hyviä rasvoja
• Laadukasta proteiinia

🟢 Vähennä:
• Runsasta sokeria
• Erittäin prosessoituja tuotteita
• Pitkiä ateriavälejä

🟢 Muista nesteytys.

Jokaisen keho reagoi yksilöllisesti. Ruokapäiväkirja voi auttaa tunnistamaan yhteyksiä ruokavalion ja oireiden välillä.

Ravinto ei paranna CRPS:ää eikä korvaa hoitoa. Mutta se voi olla yksi tärkeä pala kokonaisuudessa, joka tukee kehoa ja arjessa jaksamista.

🌿 Mikä ravintoon liittyvä muutos on vaikuttanut eniten sinun oloosi?

💬 Kerro kommenteissa ja jaa postaus vertaiselle, jolle tästä voisi olla hyötyä.

#CRPS #ravinto #krooninenkipu #crpselämää #crpslife

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Navigating "Scan Anxiety": Refocusing When You Can’t Control the Outcome⁣. 👇⁣
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I’m currently in a waiting period that many of my patients know too well — waiting on MRI results.⁣
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It’s something I haven’t been able to do for years because of my spinal cord stimulator, and while I’m glad to finally have access to this imaging, the waiting brings its own challenges. ⁣
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👉 "Scanxiety" is that uneasy limbo between taking action and facing uncertainty. Your mind runs through a worst case scenario of “what ifs,” almost preparing you for potential emotions to come.⁣
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For me, much of the buildup centered around trying to tease out the different parts of my back pain that can come from hips, discs, nerves, facets, or SIJ.⁣
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My SIJ dysfunction from hypermobility I know about, I've addressed the nerve and sensitization component, and it's not driven from my hips, though they do need to get stronger...so what is left? Discs and facets, or multifidus wasting/fatty infiltration potentially as a result of things.
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⚠️ Scans have to match your presentation to be relevant. Spinal degeneration does not mean you are doomed - and we can build a more resilient back with better motor patterning to support and improve living with these issues. But it's still easy to feel sad and tired of dealing with things.⁣
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➡️ What’s helped me most is refocusing on what I can control. I can’t change what’s already on the scan, but I can focus on how I show up for myself - how I care for my body and use my time. From there, I prioritize and execute, refocusing on just the next indicated step, rather than the entire process.
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▶️ I choose one main goal to focus on that most moves the needle, and one that helps that goal. For me, movement supported by nutrition. These intentional actions help me stay grounded and stop overthinking into too much problem solving.⁣
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Waiting doesn’t have to mean feeling helpless and knowledge is always power - we just have to be able to navigate these moments.

🎙️ Listen to @iniyhpodcast ep 31 'Dealing with Being Overwhelmed' and ep 20 'Managing Low Back Pain for more on these topics.

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A huge issue in the pain space is the disconnect and lack of understanding between patients and doctors.⁣
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What's special about @iniyhpodcast is not just that we are a patient and physician, but that we are actually friends. Despite the distance, we've developed a relationship built on trust and mutual respect over the last 2.5 years since we first met - and finally got to see each other again in person!
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We've spent hundreds of hours on zoom working through challenges that affect pain care and communication, coming from a mutual desire to create change beyond the people we work with and leave a larger impact.
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➡️ How can we genuinely understand the other sides perspective, solve challenges better, and mitigate inadvertent harm that comes from patients feeling misunderstood and judged, and clinicians being frustrated and overwhelmed?⁣
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➡️ How can we improve patient agency and self-efficacy, but not remove the responsibility medical professionals have in guiding care and prioritizing treatment?⁣
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Expecting medical professionals to save us, unfortunately is not the answer with chronic pain. Patients may need to realistically do most of the work, but if you are not heard, can’t get access to treatments, and don’t have a physician who is collaborative and works as a team, the ceiling is also typically too low.⁣
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"I don’t know” can’t be filled with blame the patient.⁣
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“I’m overwhelmed and this is unfair” can’t be filled with all doctors suck.⁣
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▶️ If we can increase understanding and empathy from both sides, we can come together, instead of feeling like we’re on different teams with a huge divide between.
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Doctors are just people too, and patients are not making stuff up. Nobody wants a life of pain, scratching and clawing to maintain their lives.⁣
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👉 If you've struggled with understanding your body and managing complex pain, or are a clinician in this space, we've developed tools to more effectively sort through complicated histories and confusing presentations so you can get better outcomes.⁣
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🎙️ Check out 'It’s Not in Your Head' with Juz and Dan - available on all podcast players, YouTube, or our website at www.iniyh.com.
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#iniyh #painpodcast

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⁣Why is it important to understand chronic pain? ⁣
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So you can see what pieces of it various conservative or interventive treatments address. ⁣
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No one thing fixes everything - especially when you are a complex patient, years down the track, with everything more wound up.⁣
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💉 Procedures like stellate ganglion blocks, sympathetic lumbar injections etc impact the piece of the pain output that is driven by sympathetic outflow.⁣
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If you have Complex Regional Pain Syndrome, you know what I'm talking about...
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🔥 The symptoms that include involve this "fight or flight" system malfunction, where abnormal nerve signals trigger prolonged inflammation, intense pain (burning, allodynia), swelling, and skin changes (color, temperature, sweating) in an injured limb, essentially keeping the body in a heightened stress response long after the initial injury should have healed, leading to sympathetically maintained pain.⁣
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🎙️ Learn more about the procedures used in these situations on ep 48 of @iniyhpodcast. Available wherever you get your podcasts, or YouTube.

👉 Comment SGB to get additional episode education sent directly to you.
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#crps #ptsd #anxiety #stellateganglionblocks #sympatheticinjections

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✨”Onko kipu pään sisällä?” – mitä nykytutkimus oikeasti sanoo

📌 Tiivistettynä tästä videosta:

• Krooninen kipu ei ole mielenterveyden sairaus
• Se ei ole “pään sisällä”, vaikka aivot ovat mukana kivun käsittelyssä
• Kipu syntyy ja ylläpidetään keskushermostossa (selkäydin + aivot)
• Selkäydin voi vahvistaa ja ylläpitää kipua itsenäisesti
• Siksi kipu voi jatkua, vaikka kudos olisi parantunut

👉 Se, että kipu kulkee aivojen kautta, ei tee siitä psyykkistä
👉 Psyykkinen tuki on tärkeää jaksamiseen, ei siksi että kipu olisi mielenterveyden häiriö

Tällä erolla on väliä, koska kipua ei saa vähätellä tai selittää pois.
Oikea tieto = parempi hoito ja parempi kohtelu.

Opi lisää kuuntelemalla @iniyhpodcast

#kipu #krooninenkipu#crps #mielenterveys

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Have you fallen off over the holidays?⁣
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Congratulations, you are normal. This happens to all of us to a degree, including me.⁣
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Even though we know what things keep pain more at bay, the reality is we just cannot maintain them ideally all the time.⁣ We are human, and resilience comes not from never falling off, but from being able to get back on track after we have. 💪⁣
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We are all prone to different things shifting the most...Whatever is having the biggest impact on you and improving creates the most capacity, is what you want to sure up first.⁣
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▶️ You can’t fix everything at once. Pick one of those domains that is affecting your capacity the most – movement, awareness/mindfulness, recovery/nutrition, or stress – and start there. Then layer more tweaks in amongst the other domains.⁣
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I am not into New Year’s resolutions and the whole ‘new year, new me’ thing, but I do like using that point in time sometimes to commit to doing some things different moving forward.⁣
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➡️ Give yourself the grace to be human and don’t beat yourself up for putting your energy into other things over this stretch, while tapping into your self-efficacy and discipline to make a plan to decrease pain again.
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🎙️ For more tips to bring the holidays home, listen to ep. 46 from @iniyhpodcast, and check out:

◾Ep. 19 for a deeper dive into the most significant conservative pain management strategies, and
◾ Ep. 31 for how to navigate if you're feeling overwhelmed.
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Episodes are available wherever you get your podcasts or YouTube.

👉 Comment COMEBACK to get our additional episode resources directly sent to you!
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#iniyh #iniyhpodcast #painplain #resilience #conservativemanagement

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