"Are You Telling Me It's All in My Head?" The Truth About Chronic Pain | Prof. Tasha Stanton

"When Tasha speaks about pain, everyone should listen" - Merv Travers (previous guest and pain researcher) In this episode, Professor of Clinical Pain Neuroscience, Tasha Stanton translates the current science of persistent pain into practical reasoning.Tasha explains that pain is a protective system that can become over-sensitive - in her words, "a system that's working too well." She's candid about what she's moved away from over her career — why giving the brain sole focus, and the notion that "the brain decides," are both inaccurate - and what it takes to communicate pain science without a patient hearing it's all in your head.From there it's straight into application: assessing body perception and two-point discrimination, sensorimotor and tactile discrimination retraining, what the RESOLVE trial suggests about mechanism, the role of systemic inflammation and why loading helps, and using active inference and predictive processing to drive change - including her group's VR cycling work, which improves how patients feel while they work harder.Tasha is also clear that the evidence for persistent pain points to hope rather than inevitability, and she closes with what she'd actually say to a patient in pain.If you treat people in persistent pain and want better outcomes, sharper communication, and theory you can use in clinic, this one's for you.RESOURCES- Pain Coach: Clinical tool discussed by Lachlan. Use today with a patient - click here- Prof. Tasha Stanton Research: https://researchers.adelaide.edu.au/profile/tasha.stanton- The Resolve Trial: https://jamanetwork.com/journals/jama/fullarticle/2794765- The Knee Osteoarthritis Handbook (NOIgroup) - Tasha is a co-author: https://www.noigroup.com/product/knee-osteoarthritis-handbook/KEY TOPICS 00:00 — Teaser00:59 — Why Tasha comes so highly recommended 01:31 — From an overwhelming caseload to pain science 03:40 — The mentors who shaped her clinical thinking 05:10 — When the system fails patients: lessons from her mum's care 07:22 — Lachlan's own experience of persistent pain 08:53 — Reframing pain for patients: protection, not damage 10:50 — Pain as a changeable process (bioplasticity) 13:43 — What Tasha changed her mind about — and why clinicians should too 16:06 — Language in clinic: from "brain" to "dysregulated systems" 17:44 — A clinically useful model of pain to share with patients 22:35 — "The carpentry looks good": pain after knee replacement 23:22 — Assessing body perception and post-surgical pain risk29:52 — A thoracic pain case: what two-point discrimination revealed 31:38 — Sensorimotor retraining in practice: grids, graphesthesia, dosage 33:33 — Does sensory change drive pain change? CRPS & the RESOLVE trial 41:49 — Inflammation, central sensitisation, and why loading helps 44:49 — Translating complexity into simple, actionable interventions 46:48 — A knee OA case: shifting outcomes by shifting the narrative 48:17 — Targeting lifestyle factors for the individual in front of you 49:21 — Optimising the rest–activity balance across 24 hours 51:11 — Applying active inference and predictive processing clinically 52:58 — VR cycling: engineering a prediction error to drive adaptation56:55 — What to say to a patient who's in pain right now 58:03 — Framing prognosis: hope over inevitability 59:21 — Clinician resources: Pain Plans and where to learn moreDisclaimer: Not personalised medical advice, consult a health professional.