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.

In this episode:

• The difference between acute, neuropathic, and nociplastic pain
• Why pain is a protection mechanism — not a punishment
• How the nervous system becomes sensitized in chronic pain
• Fibromyalgia, central sensitization, and what actually helps
• The role of movement (including Pilates) in pain rehabilitation
• Finding hope and qualified providers in the chronic pain space

Resources mentioned:

• whyyouhurt.com — free patient education videos and provider directory
• Evidence in Motion — evidenceinmotion.com

Hosted by Dr. Brent Anderson, this podcast draws on more than 35 years of clinical practice, research, and teaching. He is a doctor of physical therapy, professor, founder of Polestar Pilates, and pathokinesiologist. Dr. Brent has long been fascinated by the dynamic relationship between movement and pathology, and how understanding that relationship can help people move better, feel better, and live more aligned lives.

Each episode features conversations with special guests, colleagues, and friends who are making meaningful contributions across healthcare, movement science, wellness, and education. Together, we explore how movement shapes not only our bodies, but how we relate to ourselves, to others, and to the world.

Live Aligned is about curiosity, compassion, and clarity, inviting practitioners, students, and lifelong movers alike to think more deeply, move more intentionally, and be kind along the way.

More info at: https://drbrentanderson.com/podcast/