Podcast
Unpacking Pain
Hosted by Holly Osborne and Megan Steele · EN
Unpacking Pain is a podcast about chronic pain - what causes it, how it affects our lives, and what we can do about it. Hosted by a pain scientist and a pain sufferer, it blends evidence-based science with lived experience to offer support, education, and empowerment.
If you’ve ever felt unseen in your pain journey, know that you are not alone. Join us on Unpacking Pain as we peel back the layers of the chronic pain experience - where science meets story, and where knowledge opens doors to healing.
Each week, Dr. Megan Steele, PT, DPT, PhD(c), and Holly Osborne, a chronic pain sufferer, sit down to explore the “three-legged stool” of chronic pain: the biological, psychological, and social. Together they demystify the science, share personal stories, and engage in candid conversations about the mind-body connection, treatment approaches, and the realities of living with and managing pain.
What makes Unpacking Pain different is its unique yin-yang approach: Megan brings deep expertise in pain research and clinical practice, while Holly offers the raw honesty of 26 years of lived experience navigating chronic pain. Together, they create a space that is empathetic, candid, and enlightening.
Topics include:
- The neuroscience of pain and why it isn’t “all in your head”
- Evidence-based pain management strategies that work in daily life
- Practical strategies for coping and thriving with chronic pain
- How stress, trauma, and emotions shape our pain journey
- Stories of resilience, breakthroughs, and hope
Whether you are living with chronic pain, supporting someone who is, or working as a health professional, this podcast offers insights that validate, educate, and inspire. Our goal is not just to explain chronic pain but to reframe it - making room for understanding, empowerment, and possibility.
Your voice matters, we would love for you to send us your questions or share your story with us at unpackingpain@gmail.com. Together we can shed light on the realities of chronic pain, unpack the issues, and discover new ways forward.
https://unpackingpainpodcast.com
10episodes
Episodes
Newest firstAll episodes
Unpacking: Your Chronic Pain Questions
Apr 2000:56:09Tap to summarizePain can show up even when scans look “fine,” and severe arthritis can exist with little to no pain - so what should you do when the usual explanations don’t add up?Holly puts Dr. Megan on the hot seat for a listener-driven lightning round, tackling five common questions people ask when they’re trying to make sense of chronic pain. Learn how to think about medication as a tool (and when it may be a bridge rather than the full plan), why “pain doesn’t equal damage” matters for recovery, and how to talk with partners, friends, or clinicians who focus only on the body when you’re trying to address the whole picture.The conversation also covers aging and pain - what’s normal, what’s not inevitable, and how to decide between continuing to pursue solutions versus practicing acceptance. To make the biopsychosocial approach more practical, Dr. Megan shares a simple place to start: tracking flare-ups with context (stress, thoughts, people, situations) to spot patterns your nervous system may be reacting to.Season one wraps with key takeaways and a preview of what’s coming next.Links to interesting things from this episode:Joshua Pate’s Research on Pain “You Can Heal Your life” by Louise HayBessel van der Kolk books“The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain” by Alan Gordon and Alon ZivJohn E. Sarno books
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Unpacking: Surgery Day
Mar 2500:56:10Tap to summarizeIf you’ve ever wondered why surgery can “fix” the structure but not always fix the pain, you’re not alone.Dr. Megan Steele and Holly Osborne explore what really influences surgical outcomes, especially for people living with chronic pain. Join them as they break down why pain isn’t purely mechanical, how your nervous system’s threat detection can shape recovery (even under anesthesia), and why scar tissue, stress, and past medical experiences can change the healing process.You’ll also hear practical ways to prepare before surgery - like prehab, planning for the hospital experience, and using calming strategies to dial down stress - plus realistic post-op considerations many people aren’t warned about, including digestion issues, brain fog, and why early movement matters. Along the way, they share a simple framework for evaluating newer procedures and what to ask a surgeon before agreeing to an approach that may not have a long track record.Helpful for anyone weighing surgery, supporting someone through it, or trying to make sense of why “successful” operations don’t always lead to relief.Links to interesting things from this episode:Waddell Signs
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Unpacking: Trust First, Treatment Second
Mar 1601:07:01Tap to summarizeIn this episode, we discuss a personal experience involving violent assault, injury, and subsequent surgeries. Listener discretion is advised. If these topics are difficult for you, you may wish to skip this episode or listen when you feel supported.If you’ve had pain for years, you’ve probably been asked to summarize your whole story in minutes, and then felt the conversation rush straight to tests, protocols, and a “game plan.” That’s often where trust breaks, important details get missed, and you walk out feeling unseen.Here, you’ll hear what changes when the first goal isn’t to solve everything, but to create enough safety for the real story to emerge. Holly shares what it’s like to carry a long medical history alongside trauma, shame, and the pressure to “hold it together” in clinical settings. Dr. Megan Steele explains why open-ended questions, uninterrupted storytelling, and clear validation can be the difference between symptom management and meaningful progress - especially with persistent pain.You’ll come away with practical ways to:Prepare for appointments when your history feels complicated or hard to tellAsk for what you need (privacy, time, clarity) without it feeling difficultNotice when a provider is building trust or performing expertiseUnderstand how trauma, stress, and beliefs can amplify pain over timeThink about care as a partnership, not a performance or a test you can failLinks to interesting things from this episode:Marc R. Safran, MD“You Can Heal Your Life” by Louise Hay
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Unpacking: Pediatric Pain
Mar 900:55:05Tap to summarizeDid you know researchers are teaching kids about pain before they experience it - and it might prevent chronic pain in adulthood?Between 20-25% of children with acute injuries develop chronic pain, but they're not just small adults. Their brains are more plastic, more vulnerable, and remarkably more responsive to intervention. Dr. Megan Steele and Holly Osborne explore what makes pediatric pain different, why some kids get stuck in chronic pain cycles, and what parents and caregivers can do about it.You'll learn about the two critical periods in childhood brain development (ages 2-3 and 12-13) when kids are most vulnerable to pain becoming chronic, and why hormone shifts during puberty play a bigger role than we thought. Discover how sensory sensitivity in childhood predicts widespread pain later, and why having just two caring adults outside the home can buffer kids against developing chronic pain.Holly and Dr. Megan discuss practical strategies for parents - including how to talk about your own chronic pain with your children without passing patterns along, when to normalize pain versus when to take it seriously, and why pain literacy education in schools shows remarkable promise.Whether you're a parent, work with children, or experienced chronic pain as a kid yourself, this conversation offers hope and actionable insights for breaking the cycle before it starts.Links to interesting things from this episode:Joshua W. Pate, website - with links to the book series mentioned by Dr. MeganAdriaan Louw's website, "Why you hurt"ACEs Aware - organization educating about and screening for Adverse Childhood Experiences"Adolescence"
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Unpacking: How Your Brain Can Change Your Pain
Mar 201:01:07Tap to summarizeAnyone selling you a magic bullet for chronic pain is either lying or doesn't understand how pain actually works. But here's what does work: your brain's ability to literally rewire itself.Holly and Dr. Megan Steele explore the growing body of research showing that mindfulness, breathwork, and visualization aren't just "woo-woo" practices - they create measurable changes in your brain that reduce pain. You'll discover why chronic pain is more about threat detection than tissue damage, and how shifting your nervous system into a state of safety can provide real relief.Dr. Megan breaks down the science behind techniques that actually work, including:Why breathwork is the easiest place to start (and how it stimulates your vagus nerve)What happens in your brain during meditation (hint: different areas light up on MRI scans)How to use "associative learning" to trigger safety responses in your bodyWhy suppressing pain sensations backfires and what to do insteadThe surprising connection between completing stress cycles and pain reliefNo false promises here. These practices take commitment - but the side effect profile is zero, and the science backs them up. Whether you're frustrated with traditional approaches or looking to add evidence-based tools to your pain management toolkit, this conversation offers practical starting points.As Holly reminds us: as long as you're breathing, you can change your brain. Therefore, you can change your pain.Links to interesting things from this episode:Fadel Zeidan, UC San Diego
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Unpacking: Gender Differences and the Impact of Hormones on Pain
Feb 2300:48:45Tap to summarizeWhy do women make up 70% of chronic pain sufferers? The answer involves more than just biology. Dr. Megan and Holly examine how hormones, pain thresholds, and social conditioning create vastly different pain experiences for men and women.You'll discover:Why pain thresholds change dramatically at puberty and menopauseHow testosterone acts as a buffer and estrogen fluctuations trigger painInsights about that viral study where men couldn't last through simulated labor painWhy menstrual pain is chronically underreported (and how that leads to worse outcomes)How memory and pain are linked through estrogen receptors in the brainWhat happens to transgender individuals' pain perception during hormone therapyHolly and Dr. Megan also tackle the social costs of pain - from women hesitating to report debilitating cramps to men feeling pressured to "gut it out" - and why finding a practitioner who asks about your full pain experience matters.The good news? Pain is malleable, and there are evidence-based approaches that can help.Links to interesting things from this episode:Dr. Jen Gunter, website
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Unpacking: How Social Factors Shape Chronic Pain Journeys
Feb 1600:57:51Tap to summarizeWhy do two people with the same injury have completely different pain journeys - and what does a zip code have to do with it?Today we dig into the often-overlooked social side of persistent pain: the way income, work conditions, food access, relationships, and even cultural expectations can ramp pain up or help dial it down.Dr. Megan and Holly explore how:Socioeconomic status and access to care change the way pain shows up and sticks aroundFood deserts, chronic stress, and unstable housing contribute to inflammation and nervous system sensitizationSocial support, community, and a sense of belonging act as real “medicine” for the brainWork satisfaction, toxic bosses, and job insecurity influence chronic low back pain and recoverySimple practices - like visualization, “spoon” or gas-tank metaphors, and clearer communication with friends, partners, and coworkers - can make it easier to live your life while living with painYou’ll come away with language to explain your limits to others, new ways to think about your own pain story, and practical, low-cost tools for building more safety, connection, and support into your everyday lifeLinks to interesting things from this episode:Dr. Megan’s Instagram“Integrating multidimensional data analytics for precision diagnosis of chronic low back pain”“Navigating the biopsychosocial landscape: A systematic review on the association between social support and chronic pain”“Radical Acceptance: Embracing Your Life With the Heart of a Buddha” by Tara BrachÉtoile
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Unpacking: The Emotional Burden of Chronic Pain
Feb 900:53:32Tap to summarizeWhat if the pain you feel long after an injury has “healed” isn’t a sign that your body is broken, but that your nervous system is stuck in protection mode?Dr. Megan and Holly break down what’s happening in the brain and body when pain lingers, scans look “normal,” and daily life starts to shrink. They explore how chronic pain and emotions are tightly linked, and why anxiety, depression, shame, and even hyper-empathy so often travel with long-term pain.You’ll hear about the shift from acute to chronic pain, how the brain’s “pain map” can smudge and spread, and why pain can move around the body even when there’s no clear structural damage. They unpack the boom-and-bust cycle of pushing hard on “good” days and crashing afterward, the heavy toll of masking and “performing okay” for others, and how shame and hopelessness can quietly take root alongside physical symptoms.Most importantly, Dr. Megan offers practical, science-backed ways to begin lightening the emotional load of chronic pain:Understanding functional vs. structural pain and why that distinction matters for your recoveryRecognizing how anxiety and depression can amplify pain - without blaming yourselfUsing small, realistic goals to build evidence that pain and depression are “lying” about what’s possibleReframing flare-ups as part of a non-linear healing path rather than proof of failureLeveraging simple tools like movement, breath work, and gratitude to gently retrain the brainIf you’ve ever felt like your scans are “fine” but your life is not, or wondered whether your emotional struggle around pain really “counts,” this conversation offers clarity, validation, and a grounded sense of hope that change is still possible.Links to interesting things from this episode:“No Mud, No Lotus: The Art of Transforming Suffering” by Thich Nhat Hanh
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Unpacking: The Psychology of Pain
Feb 200:52:12Tap to summarizeWhy does chronic pain spread from one area of your body to another? And why does it often feel worse at night when you're trying to sleep?When pain persists for months or years, your nervous system doesn't just stay the same - it changes. Your nerves lose their protective coating, your spinal cord becomes more sensitized, and your brain actually develops structural changes that keep you locked in a cycle of protection and threat detection. Dr. Megan Steele walks you through the biological transformations happening in your body when pain becomes chronic, from peripheral nerve changes to decreased gray matter in areas responsible for memory and executive function.But here's where it gets counterintuitive: the path forward might involve turning toward your pain rather than away from it. Dr. Steele explains why constantly trying to ignore or push through pain can actually make it worse, and introduces somatic tracking as a way to bring subconscious protective mechanisms into conscious awareness. You'll learn why women are 70% more likely to experience chronic pain, how hormones play a role, and why your nervous system is wired for sameness - even when that sameness includes dysfunction.Holly shares her own experience of building an identity around pain and the fear that comes with imagining life without it. Together, they explore how life shrinks when pain takes over, and how it can expand again through small, graded steps that feel safe to your nervous system.If you've ever felt like your pain has a mind of its own, this conversation will help you understand what's actually happening in your body and brain - and why there's still hope for change.
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Unpacking: The Podcast
Feb 200:12:16Tap to summarizeWhat happens when a pain researcher teams up with someone who’s lived with chronic pain for decades?In this bonus conversation, meet the voices behind Unpacking Pain. Dr. Megan Steele, a physical therapist and pain science researcher, explains why evidence-based guidance is still hard to find and what the data actually says. Holly Osborne shares the lived experience side - what helped, what didn’t, and how to keep going when progress stalls. Together, they lay out why they started the show and how they hope to serve you.Listen to learn:How research and real life fit together to make sense of persistent painWhat you can expect from future episodes: clear explanations, practical tools, and steady encouragementSimple ways to become a better observer of your pain and talk about it with your care team and your circleHow to plug into a community that understands the invisible parts of this journey
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