I’m honored to be speaking at ThinkNext 2025, where I’ll deliver a lecture on the Neuroscience of Pain. This presentation will explore how modern pain science is revolutionizing our understanding of pain and unlocking powerful, non-pharmacologic strategies to improve patient care.

The Pain Crisis: Time for a Paradigm Shift

The pain epidemic and its devastating link to the opioid crisis is well-documented. As a health care community, we must do better. Our patients deserve it. Fortunately, the last two to three decades have ushered in a “pain revolution,” dramatically expanding our understanding of the human pain experience. Gone are the days when pain was simply equated with tissue damage. The outdated formula of “injury = pain” no longer holds. We now recognize pain as a complex, multifactorial experience involving:

• Sensitization of peripheral and central nervous systems
• Functional and structural changes in the brain
• Psychosocial influences
• Neuroplasticity and bioplasticity
• Immune system alterations
• And much more

Part I: The Latest in Pain Neuroscience

At ThinkNext, I'll introduce an overview of cutting-edge pain neuroscience and its implications for clinical practice. We’ll explore pain phenotyping, outline a precision medicine approach and examine the mechanisms behind:

• Nociceptive-driven pain
• Peripheral neuropathic pain
• Central sensitization (nociplastic pain)

This research will challenge outdated models and highlight how evolving science can reshape our response to pain and the opioid epidemic.

Part II: Translating Science into Non-Pharmacologic Care

In light of the opioid crisis and in alignment with global guidelines, pharmacologic interventions must no longer be the default approach to chronic pain. At ThinkNext, I’ll also delve into how advances in neuroscience now support a range of evidence-based, non-pharmacologic treatments that activate endogenous pain-relief mechanisms and reduce reliance on medication.

You’ll learn about the three key domains that we must address to truly transform lives affected by persistent pain:

• Cognitive: Therapeutic cognitive strategies can reduce fear-avoidance, catastrophizing, depression and anxiety. Changing pain behavior begins with changing beliefs.
• Movement: Once fear is addressed, movement becomes one of the most potent tools for pain relief, whether through aerobic exercise, resistance training or recreational activity.
• Nervous System Down-Regulation: Persistent pain often stems from a hypervigilant nervous system. Calming it, preferably through non-pharmacologic means, is essential. Techniques include relaxation, sleep hygiene, nutrition, breathing exercises and more.

The Power of Words

Pain is a normal, necessary human experience. Chronic pain is not. Pain that is understood is pain that need not be feared. Every health care provider communicates with patients and as Rudyard Kipling once said in a 1923 address to the Royal College of Surgeons: “Words are, of course, the most powerful drug used by mankind.”

This October, join me as we journey from tissues through C-fibers, into the dorsal horn, second-order neurons and the brain’s distributed neuromatrix. Let’s deepen our understanding of pain and use this knowledge to engage meaningfully with every patient we meet, transforming their experience of pain and suffering.