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What if pain education got the fundamentals wrong by chasing tidy scripts instead of solid mechanisms? We sit down with researcher and educator Monica Noy to rethink how clinicians learn, reason, and communicate about pain. Rather than leaning on “explain pain” narratives and one-size-fits-all language, Monica anchors care in a clear premise: nociception is necessary—though not always sufficient—for pain. That single shift reframes assessment, reduces blame, and helps us speak to people with honesty and respect.

Across a candid, story-rich conversation, we explore why pain care remains under-taught across health professions despite being the top reason people seek MSK help. Monica traces the evolution of common teaching approaches, the biases that shaped them, and the real-world fallout when clinicians over-educate, over-promise, or quietly fault patients for not “thinking right.” We talk ethics, too: if pain is associated with actual or potential tissue damage, what does it mean to create pain during treatment? When does intensity cross into harm, and how do we decide with patients rather than for them?

You’ll hear a grounded way to use the biopsychosocial lens without turning it into a moving target that justifies endless chasing. We discuss definitions, semantics, and why shared language matters; how better mechanism literacy leads to fewer words and better questions; and what Monica’s new course, Pain Education, No Script Provided, offers clinicians who want to be less wrong and more helpful. Expect fewer scripts, more clarity, and a renewed respect for autonomy—yours and your patients’.

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