Unpacking Pain

Unpacking: Your Chronic Pain Questions

Pain can show up even when scans look “fine,” and severe arthritis can exist with little to no pain - so what should you do when the usual explanations don’t add up? Holly puts Dr. Megan on the hot seat for a listener-driven lightning round, tackling five common questions people ask when they’re trying to make sense of chronic pain. Learn how to think about medication as a tool (and when it may be a bridge rather than the full plan), why “pain doesn’t equal damage” matters for recovery, and how to talk with partners, friends, or clinicians who focus only on the body when you’re trying to address the whole picture. The conversation also covers aging and pain - what’s normal, what’s not inevitable, and how to decide between continuing to pursue solutions versus practicing acceptance. To make the biopsychosocial approach more practical, Dr. Megan shares a simple place to start: tracking flare-ups with context (stress, thoughts, people, situations) to spot patterns your nervous system may be reacting to. Season one wraps with key takeaways and a preview of what’s coming next. Links to interesting things from this episode: * Joshua Pate’s Research on Pain [https://joshuawpate.com/research/] * “You Can Heal Your life” by Louise Hay [https://www.amazon.com/You-Can-Heal-Your-Life/dp/0937611018] * Bessel van der Kolk books [https://www.amazon.com/stores/author/B00OTHN2FA/allbooks?_encoding=UTF8&ref_=aufs_ap_ahdr_dsk_ab&pd_rd_w=YZKep&content-id=amzn1.sym.7e190e19-9f6f-4df8-807a-5a7608594741&pf_rd_p=7e190e19-9f6f-4df8-807a-5a7608594741&pf_rd_r=141-7620194-7024805&pd_rd_wg=b4glB&pd_rd_r=782a5d08-c9ff-4be0-84d1-588407d705b6] * “The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain” by Alan Gordon and Alon Ziv [https://www.amazon.com/Way-Out-Revolutionary-Scientifically-Approach-ebook/dp/B07TRY3L9S?ref_=ast_author_dp_rw&th=1&psc=1&dib=eyJ2IjoiMSJ9.DfES5R5LYHSNDZco5wUNqawAm3KxivR3AegIV2VJDiIb4Ujsv4M2KBdnK3DO3RRimoWlWf0XJuUqWe005psPHKQoJvcrDKWIRyu-lBF5LZ8.AKHI4UgEijIiNDaWpMln98WH3gfK6PD1smFN0hlPuX8&dib_tag=AUTHOR] * John E. Sarno books [https://www.amazon.com/stores/author/B001IOBML8/allbooks?ingress=0&visitId=ff88594e-1944-4614-ab73-dce8b0f2c477]

Unpacking: Surgery Day

If you’ve ever wondered why surgery can “fix” the structure but not always fix the pain, you’re not alone. Dr. Megan Steele and Holly Osborne explore what really influences surgical outcomes, especially for people living with chronic pain. Join them as they break down why pain isn’t purely mechanical, how your nervous system’s threat detection can shape recovery (even under anesthesia), and why scar tissue, stress, and past medical experiences can change the healing process. You’ll also hear practical ways to prepare before surgery - like prehab, planning for the hospital experience, and using calming strategies to dial down stress - plus realistic post-op considerations many people aren’t warned about, including digestion issues, brain fog, and why early movement matters. Along the way, they share a simple framework for evaluating newer procedures and what to ask a surgeon before agreeing to an approach that may not have a long track record. Helpful for anyone weighing surgery, supporting someone through it, or trying to make sense of why “successful” operations don’t always lead to relief. Links to interesting things from this episode: 1. Waddell Signs [https://www.physio-pedia.com/Waddell_Sign]

Unpacking: Trust First, Treatment Second

In this episode, we discuss a personal experience involving violent assault, injury, and subsequent surgeries. Listener discretion is advised. If these topics are difficult for you, you may wish to skip this episode or listen when you feel supported. If you’ve had pain for years, you’ve probably been asked to summarize your whole story in minutes, and then felt the conversation rush straight to tests, protocols, and a “game plan.” That’s often where trust breaks, important details get missed, and you walk out feeling unseen. Here, you’ll hear what changes when the first goal isn’t to solve everything, but to create enough safety for the real story to emerge. Holly shares what it’s like to carry a long medical history alongside trauma, shame, and the pressure to “hold it together” in clinical settings. Dr. Megan Steele explains why open-ended questions, uninterrupted storytelling, and clear validation can be the difference between symptom management and meaningful progress - especially with persistent pain. You’ll come away with practical ways to: 1. Prepare for appointments when your history feels complicated or hard to tell 2. Ask for what you need (privacy, time, clarity) without it feeling difficult 3. Notice when a provider is building trust or performing expertise 4. Understand how trauma, stress, and beliefs can amplify pain over time 5. Think about care as a partnership, not a performance or a test you can fail Links to interesting things from this episode: 1. Marc R. Safran, MD [https://stanfordhealthcare.org/doctors/s/marc-safran.html] 2. “You Can Heal Your Life” by Louise Hay [https://www.amazon.com/You-Can-Heal-Your-Life/dp/0937611018]

Unpacking: Pediatric Pain

Did you know researchers are teaching kids about pain before they experience it - and it might prevent chronic pain in adulthood? Between 20-25% of children with acute injuries develop chronic pain, but they're not just small adults. Their brains are more plastic, more vulnerable, and remarkably more responsive to intervention. Dr. Megan Steele and Holly Osborne explore what makes pediatric pain different, why some kids get stuck in chronic pain cycles, and what parents and caregivers can do about it. You'll learn about the two critical periods in childhood brain development (ages 2-3 and 12-13) when kids are most vulnerable to pain becoming chronic, and why hormone shifts during puberty play a bigger role than we thought. Discover how sensory sensitivity in childhood predicts widespread pain later, and why having just two caring adults outside the home can buffer kids against developing chronic pain. Holly and Dr. Megan discuss practical strategies for parents - including how to talk about your own chronic pain with your children without passing patterns along, when to normalize pain versus when to take it seriously, and why pain literacy education in schools shows remarkable promise. Whether you're a parent, work with children, or experienced chronic pain as a kid yourself, this conversation offers hope and actionable insights for breaking the cycle before it starts. Links to interesting things from this episode: 1. Joshua W. Pate, website [https://joshuawpate.com/] - with links to the book series mentioned by Dr. Megan 2. Adriaan Louw's website, "Why you hurt" [https://whyyouhurt.com/] 3. ACEs Aware [https://www.acesaware.org/] - organization educating about and screening for Adverse Childhood Experiences 4. "Adolescence" [https://www.imdb.com/title/tt31806037/]

Unpacking: How Your Brain Can Change Your Pain

Anyone selling you a magic bullet for chronic pain is either lying or doesn't understand how pain actually works. But here's what does work: your brain's ability to literally rewire itself. Holly and Dr. Megan Steele explore the growing body of research showing that mindfulness, breathwork, and visualization aren't just "woo-woo" practices - they create measurable changes in your brain that reduce pain. You'll discover why chronic pain is more about threat detection than tissue damage, and how shifting your nervous system into a state of safety can provide real relief. Dr. Megan breaks down the science behind techniques that actually work, including: 1. Why breathwork is the easiest place to start (and how it stimulates your vagus nerve) 2. What happens in your brain during meditation (hint: different areas light up on MRI scans) 3. How to use "associative learning" to trigger safety responses in your body 4. Why suppressing pain sensations backfires and what to do instead 5. The surprising connection between completing stress cycles and pain relief No false promises here. These practices take commitment - but the side effect profile is zero, and the science backs them up. Whether you're frustrated with traditional approaches or looking to add evidence-based tools to your pain management toolkit, this conversation offers practical starting points. As Holly reminds us: as long as you're breathing, you can change your brain. Therefore, you can change your pain. Links to interesting things from this episode: 1. Fadel Zeidan, UC San Diego [https://profiles.ucsd.edu/fadel.zeidan]