The Brain on Fire: Chronic Pain Science with Dr. Adriaan Louw

Chronic pain affects one in four people worldwide — and most of us don't understand why. In this episode, Dr. Brent Anderson sits down with Dr. Adriaan Louw, physical therapist, author, and co-founder of Evidence in Motion, to break down the science of pain in plain language. Dr. Louw explains the three types of pain — nociceptive, neuropathic, and nociplastic — and why understanding the difference matters for treatment. Together, they explore why pain exists as a protective mechanism, why tissue damage and pain intensity don't always correlate, and how the nervous system can become sensitized over time, leading to persistent and widespread pain conditions like fibromyalgia. The conversation covers the role of movement, sleep, nutrition, and education in managing chronic pain, the science of neuroplasticity and desensitization, and how positive movement experiences can literally rewire the brain's pain response. Dr. Louw also shares his thoughts on the current pharmacological options with the strongest evidence behind them and leaves listeners with an important message: chronic pain can get better. Introduction and Guest Introduction - 0:09 Understanding Chronic Pain - 1:30 Types of Pain Explained - 2:04 The Role of Pain in Protection - 6:08 Pain and Tissue Damage - 8:06 Neuroplasticity and Pain - 10:38 Successful Movement Experiences - 18:11 Fibromyalgia Discussion - 36:24 Final Thoughts and Resources - 47:27 Subscribe for more conversations on movement, health, and the science of living well. Learn more about Dr. Brent’s work: drbrentanderson.com Resources mentioned: whyyouhurt.com — free patient education videos and provider directory Evidence in Motion — evidenceinmotion.com