This recent paper, “Neuroimmune interactions in musculoskeletal conditions: an introduction for clinicians”, has me thinking about how we package information about pain for patients. sciencedirect.com/science/ar… Here are five educational Pain Science lenses 🔎 that may help structure conversations & help patient understand their pain and, importantly, take action from a persistent pain perspective. These are covered in depth on our residential BACK to Health Programme, but can also be used selectively in one-to-one settings. They offer different ways of understanding pain, depending on which lens and how deeply a patient wishes to engage. 🔎 1. Risk factors Why me, maybe? Examples include menopause, concurrent health conditions, smoking, obesity, and high or monotonous occupational activity. 🔎 2. Initial triggers How did this start? Sometimes historical, sometimes related to a traumatic event. These can help people connect the dots and make sense of what kicked things off, although they are not always relevant to the current situation and are often not modifiable. 🔎 3. Sustaining stuff What is happening now that may be stifling recovery, quality of life, function, distress: Over-protection, reduced activity, stress, crappy sleep, beliefs, lack of social support, framing, and tissues with issues. 🔎 4. Underlying physiology e.g Blood flow, acute inflammation, chronic inflammation, pressure, neuroimmune interplay, central processes. Neuroimmune mechanisms are explored in this paper. In clinic these should be broken down into simple, relatable ideas that can be integrated or lightly alluded to. 🔎 5. Pain philosophy The meaning of pain to the individual and to humans more broadly. Hurt versus harm, over-protection, discordance between structure and pain, concordance between structure and pain, management philosophies, prognosis, how pain changes over time, the multifaceted nature of pain, and general health as a pain barometer. A few clinical pointers: ✅️Avoid painsplaining. Allude to concepts and ask what level of understanding the patient wants. ✅️ Link explanations to the patient’s life and story. ✅️Use underlying physiology judiciously and only where it meaningfully relates to one or more of the five lenses.