Know Pain Course

I was lucky enough to attend Mike’s ‘Know Pain’ course last year through my NHS clinic. Having worked in MSK practice for 5 years I have a great understanding of pain mechanisms so was unsure if the course would teach me much I didn’t already know. From the start Mike quickly proved there is much more for me to learn on pain theory. Whilst the metaphors he taught me opened my eyes to further discussions you can have with patients as to what is causing their pain. A personal favourite is the fire alarm analogy. This explains how our body’s pain sensors are similar to a fire alarm. Whilst the alarm should set off when there is a major problem such as a fire, the alarm can also be set off by slightly burnt toast. Our body can work in a similar way. So when our pain receptors kick in it does not necessarily mean we are damaged or in danger.

Many patients think that pain means tissue damage; this could be a disc herniation or muscle tear for example. Modern medicine has proven that this is not always the case. Pain is caused by a large variety of factors rather than simply tissue damage. This was a key part of Mike’s ‘Know Pain’ teaching.

I keep the book Mike gave to me in my clinic (see picture). It contains lots of visual information I can show patients to help explain certain aspects of pain. I often find clinicians can confuse patients when educating them about a condition, as we struggle to use non-medical terminology at times. The book allows me to visually support my education in a way the patient can easily understand.

I recall one patient who was suffering with ongoing lower back pain. A recent MRI scan could not find the cause of the pain and the patient was left thinking they were ‘broken’. After completing my subjective and objective assessment I did not suspect any serious pathology. This was backed up by the MRI scan. Upon exploring the patient’s thoughts in further detail they were under the impression their pain would get worse and they would need a wheelchair at some point in the future. Over 3 sessions we addressed these concerns along with other forms of treatment. Once the patient learned movement would not cause them damage, her function gradually improved. They still write a letter to the clinic every few months to update us on their progress. I have no doubt the ‘Know Pain’ course allowed me to provide the patient with a higher quality of care.


Mike was an engaging presenter and kept me on my toes listening for the whole day. I highly recommend his course to other healthcare professionals from those beginning their practice to experts in their field. I will hope to book onto the course in the future to refresh the knowledge I learned.

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