Episode 22: Preventative Pain Science with Josh Bellingham, MPT

In this episode, we dive deep into pain science how-to’s with Josh Bellingham, MPT. As a physio, Josh is passionate about providing accessible resources to people with persistent pain. He believes that the relationship between a patient and provider is the vehicle for changing limiting beliefs, which ultimately are the reason people make progress. 

Josh is an advocate for using current pain science with ALL people experiencing pain, at any point along their journey. We explore how this looks for different populations and how to tell if someone is willing to "go there". He shares how the Loeser “onion ring” model of pain helps us see the various layers of inputs that facilitate or inhibit pain. We also discuss how to handle imaging and “diagnosis seeking” in a pain-science-informed, patient-centered way. 

Josh shares metaphors for describing pain as an alarm, the development of pain sensitivity, and contextual factors which create physiological responses such as muscle guarding. He’s also an advocate of adding pain science to people’s lives outside of the clinic, through social media, apps, and Netflix. This episode is an easy listen to review pain science concepts and come away with new clinical pearls!

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Josh holds a Bachelor's degree in Kinesiology and a Master’s degree in physiotherapy from the University of Manitoba. Josh began his career with a focus on exercise and sports performance, but over the years developed a passion for understanding and managing complex pain. Josh has completed a variety of courses in pain management through "Pain BC" and regularly participates in their weekly clinical discussions. In addition to working full time in private practice, Josh is also active on his website, chronicpainphysio.ca as well as Instagram to advocate for and support people living with chronic pain. When he’s not in the clinic or working on content for "Chronic Pain Physio", you’ll find Josh hiking in the mountains of beautiful British Columbia.

Highlights from our conversation in Episode 22

• (0:34) Josh’s background and current projects
• (6:03) Pain science for acute care / chronicity prevention
• (10:35) Metaphors for explaining pain 
• (20:09) Loeser’s “onion ring” model of pain in clinical practice 
• (24:26) Listening vs special tests for understanding pain 
• (27:01) How diagnostic imaging contributes to uncertainty, feeling out of control, and lack of information
• (33:35) Responding to people who’re seeking a diagnosis
• (42:46) How to meet people where they’re at for pain science 
• (49:20) The overlap between psychology and physical rehab for pain 
• (55:54) Josh’s Lightning Round

Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 

Resources from Episode 22

• Check out Josh’s Website - https://www.chronicpainphysio.ca/ and follow him on IG @chronicpainphysio
• Loeser’s “onion ring” model of pain
• Burnout & How To Complete The Stress Cycle (Podcast)
• Headspace - Guide To Meditation (Netflix)
• Headspace - Guide to Sleep (Netflix)
• Tame The Beast - Rethinking Persistent Pain (Youtube)
• OA Optimism with Greg Lehman (Youtube) 

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