Pain Science Gems from Prof. Lorimer Moseley

Lorimer Moseley on Central Pain Sensitisation

If you work with chronic pain patients, or you’re dealing with persistent pain yourself, pain science education from World leading pain researcher Lorimer Moseley is worth paying attention to.

Here are some of the key lessons from Lormier, on some super important topics:

Thoughts and Quotes on
Mind & Body

“Our body is not a machine. It is a garden. We’re a single organism.”

“How you feel about a limb is intimately related to its immune function and blood flow.”

“Inflammation is a primitive form of defence that is essential to the tissue repair process. Think of the swelling, redness and pain after injury as part of your own internal repair system and be grateful for it.”

“We are fearfully and wonderfully complex.”

“You can’t separate mind and body. We’re a unified human.”

Thoughts and Quotes on
Central Sensitization

“Fear of movement, pain catastrophizing, anxiety and nervous system sensitisation appear to be the main contributors to pain and disability.”

“Once you’re sensitized, the threat doesn’t have to be about your body part. It just has to be a threat to you as a person.”


Lorimer Moseley on Central Pain Sensitization

Lorimer Moseley on Central Pain Sensitization

“The longer you have pain, the better your spinal cord gets at producing danger messages to brain, even if there is no danger in the tissue.”

“For many people in persistent pain, this is a critical issue to understand and well worth repeating. In this sensitised state, the brain is being fed information that no longer reflects the true health and abilities of the tissues at the end of the neurons.”

“Stress can contribute to nerve sensitivity or pain system sensitivity. Stress lives in the brain, and therefore the experience of people with chronic pain often is that their pain increases as they become more stressed.”

“The brain cells that produce pain get better and better at producing pain. They become more and more sensitive.”

Thoughts and Quotes on
Exercise & Movement

“If your brain concludes that your muscles are in danger (which would seem logical) and you should do something (which also seems logical) then it will hurt. The solution? Move. Just move. Any kind of movement. Random movements are best.”


“When you massage skin, you are moving tissues and also sending useful impulses to the brain. So, movement and touch are useful ways to refresh your ‘virtual’ and actual body.”


“When you massage skin, you are moving tissues and also sending useful impulses to the brain. So, movement and touch are useful ways to refresh your ‘virtual’ and actual body.”

“Some pain during activity is acceptable, but it should stay under the point of a “flare up.”’

“You just have to do it slowly enough that it doesn’t freak out your system…. We say always do more today than you did yesterday, but not much more.”

“Only two things that should be really rested: major trauma or broken bones. Everything else should be worked.”

“When exercising, remind yourself that hurt does not equal harm. And that it’s safe to be sore.”

Thoughts and Quotes on
Pain & Damage

“We no longer think of pain as a measure of tissue damage – it doesn’t actually work that way even in highly controlled experiments. We now think of pain as a complex and highly sophisticated protective mechanism.”

“The relationship between pain and the state of the tissues becomes weaker as pain persists”

“Thinking that we have a slipped disc has the potential to increase back pain. But what if this piece of knowledge we have stored is inaccurate, just like our notion of a slipped disc?”


Lorimer Moseley on Slipped Discs

“A disc is so firmly attached to its vertebrae that it can never, ever slip. Despite this, we have the language, and the pictures to go with it, and both strongly suggest it can.”

*If we could slip discs
“The evidence that tissue pathology does not explain chronic pain is overwhelming (e.g., in back pain, neck pain and knee osteoarthritis).”

“…there are probably clinicians who hang on to the idea of pain equalling tissue damage. I suspect they either don’t see complex or chronic pain patients, or, when they do, they presume that those patients are somehow faulty or psychologically fragile, or, tragically, are lying.”

“What is pain? Is it simply a symptom of tissue damage or is it something more complex? One way to approach this second question is to determine whether it’s possible to have one without the other – tissue damage without pain or pain without tissue damage.  And you can answer that one yourself – ever noticed a bruise that you have absolutely no recollection of getting?”

Thoughts and Quotes on
Treating Pain Patients

“Clinicians’ beliefs & expectations strongly influence pain outcomes.”

“Reassurance, explaining pain & explaining our treatments within a contemporary model of pain science are key.”

“Our mindset should always be, how do I facilitate recovery rather than what can I detect that’s wrong and try and correct it.”

“We tend to underestimate what our patients can understand. In face, we’ve got research to prove that we do.”

“The whole time, I want to remind the patient: I believe you. We’re in it. I know this is horrible.”

Thoughts and Quotes on
The Pain Experience

“Pain is just your brain’s opinion of what’s going on in your body.”

“You can not have pain without knowing it. Pain is produced into consciousness.”

“Pain is modulated by any evidence that implies danger.”

“There’s no such thing as a pain stimulus. Nothing has the property of pain. It’s an emergent property of the human.”

“We tend to endorse the complexity of the brain and its fundamental role in what we experience. Unless, of course, we are talking about pain.”

Lorimer Moseley's Snake Bite
Lorimer Moseley's Snake Bite

“Pain is just one part of the protective suite.”

*Lorimer has a great snake bite story. At the time of the bite, no pain was felt – only the need to shake off his leg

“Pain is an unpleasant conscious experience that emerges from the brain when the sum of all the available information suggests that you need to protect a particular part of your body”

“When you’re sick or have the flu, your old aches and pains might come back. I had a shoulder reconstruction 20 years ago. I know when I’m getting the flu, and I’ve had the flu three times since then. The first thing to happen is my shoulder scar starts to ache again. We have all of these different systems that are able to modulate nociception.”

Thank you to Lorimier and his team for all the work they’ve done to help pain patients, myself included!

I had the pleasure of meeting Lorimier when he visited London for his highly recommended course on pain and pain biology – organized by the NOI group. For more Lorimier, see the Body in Mind website.

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