Pain Education Is Stuck — And We Know It
There’s a new paper out from Moseley and team.
They’ve renamed Pain Neuroscience Education (PNE) to Pain Science Education (PSE).
Same message, but now with comics, VR, and some storytelling added in.
They’re trying to freshen it up.
But anyone paying attention knows… it’s still the same old stuff.
Pain is a brain output.
Pain doesn’t mean damage.
If you change how you think about pain, your pain might go away.
That’s the pitch. It always has been.
But Let’s Be Real
The model hasn’t changed. Just the wrapping paper.
Still focused on explaining.
Still preaching from the top down.
Still acting like pain is a belief problem — and they’ve got the belief correction manual.
But does it actually work for most people?
The research says... not really.
And in clinic? It misses the mark more often than it hits.
The Neuromatrix: Useful Once. Now Just in the Way.
The whole thing is built on the neuromatrix model.
That pain comes from the brain, and we just need to update the software.
It sounded smart 20 years ago. But now?
It feels more like a belief system than actual science.
And yet, it’s treated as fact.
Taught in courses. Sold to patients. Backed by authority.
And if it doesn’t help someone? That’s their fault.
“They didn’t get it.” “They weren’t ready.” “You didn’t teach it well enough.”
But no one stops to ask:
What if the model itself is the problem?
A Different View
Bud Craig’s work shows us something deeper.
Pain isn’t just a brain trick.
It’s a homeostatic emotion — like hunger or thirst.
It comes from the body when things are out of balance.
Inflammation
Acidic tissue
Nervous system overload
Fatigue
Low energy
Disconnection
You don’t fix those things with metaphors.
You fix them with movement, rhythm, breath, food, recovery, trust.
You don’t talk the body out of pain.
You help it feel safe again.
It’s Time to Say It Plainly
The problem with PNE isn’t just the method.
It’s the mindset.
It’s the attitude that “we know better.”
That the brain is the answer to everything.
That patients need to be re-educated.
And that if the education fails — it’s on them.
That’s not science.
That’s sales.
And the worst part? It’s delivered with a smile, a TED Talk, and a research grant.
The Brain Took Over the Room
Let’s call it what it is.
Neuroscience didn’t just join the conversation — it took over.
The conductor became the soloist.
And now everything revolves around the brain.
Pain is no longer in the tissue. Not in the immune system. Not in the gut.
Nope — just a misfiring prediction machine that we need to talk into calmness.
We’ve lost the whole person by obsessing over one organ.
Taleb Saw This Coming
As Nassim Taleb wrote in Antifragile:
“When it comes to narratives, the brain seems to be the last province of the theoretician-charlatan... Add neurosomething to a field, and it suddenly sounds scientific — even when it’s just psycho-neuro-babble.”
The brain-based model gives the illusion of control.
But it hasn’t delivered the outcomes it promised.
So Here’s the Truth
We don’t need more education.
We don’t need another metaphor.
We don’t need another cartoon or animation explaining how pain is a brain output.
We need a new path. One that starts in the body.
One that:
Builds real capacity
Resets balance
Teaches through experience, not slideshows
Trusts the body's signals, not overrides them
Thanks for the Input. We’ll Take It From Here.
Neuroscience had its moment. It gave us some tools.
But it’s not the whole answer.
It’s time physios, coaches, patients, and people doing the real work reclaimed the space.
We’re not here to be educated.
We’re here to heal.
And that starts by turning down the noise — and tuning back into the body.
Let’s move forward.
With honesty. With humility. With both feet on the ground.