Pain Management From a Biopsychosocial Approach Feat. Meghan Dean

In our latest podcast episode, we sat down with Meghan, an experienced pain physiotherapist who works closely with people living with arthritis and persistent pain. What unfolded was a deep, insightful conversation that challenged traditional approaches to pain and offered practical tools for those looking to live well despite it.

Here are the key lessons from our chat with Meghan — a must-read for anyone managing chronic pain, supporting a loved one, or working in the health space

Pain Isn’t Just About the Joint

Meghan began by shifting the conversation away from joints and degeneration, reminding us that pain is far more complex than we often realise. It’s not just about tissue damage — it’s about how the nervous system processes danger. Factors like sleep quality, emotional stress, past experiences, and even beliefs about pain can influence how pain is felt in the body.

She stressed that two people with the same X-ray may have very different pain experiences depending on their mental health, lifestyle, and level of support.

Movement Is Key — and It’s Safe

A common fear for people with arthritis is that movement might make things worse. Meghan addressed this head-on: movement is safe, and essential.

In fact, gradually loading the joint helps nourish cartilage, strengthen muscles, and desensitise the nervous system. She highlighted the importance of graded exposure — starting where you are, doing what you can, and slowly increasing activity. Avoiding movement entirely out of fear can lead to weakness, more stiffness, and even more pain.

Real Progress Begins With Confidence

Meghan shared a powerful story of one of her clients who, due to fear, had stopped using his painful arm. With reassurance, education, and a simple goal — reaching for a bag of rice — he was able to regain function and reported a 60% improvement in just one session.

This story reflects a key theme in Meghan’s work: success starts with changing your relationship to pain, not just chasing it away.

Flare-Ups Are Normal — and Not Always a Sign of Damage

Pain flare-ups can be alarming, but they’re a natural part of the journey. Meghan explained that flare-ups don’t necessarily mean harm has occurred. Sometimes they’re triggered by overactivity — but often, things like grief, disrupted sleep, or emotional stress are just as influential.

Rather than fearing flare-ups, Meghan encourages people to reflect:

What might have contributed?
How long did it last?
Did it settle with rest?

This type of self-inquiry builds resilience and helps people adjust their activity without falling into fear or avoidance

Learn to Pace and Push Mindfully

A critical skill in pain management is pacing — finding the balance between doing too little and overdoing it. Meghan advises people to reflect after an activity:

Was I able to stay relaxed during movement?
Was I holding my breath, clenching, or tensing up?

If you’re pushing through pain but still able to breathe calmly and stay present, that’s usually a safe zone. But when stress responses like gasping, heart racing, or muscle tension set in, it’s likely time to back off.

Understanding this boundary helps people stay active without fuelling nervous system sensitivity.

It Takes the Right Team

Not all health professionals take the same approach to pain — and that matters. Meghan encourages people to ask:

Are they asking the right questions?
Are they interested in how pain affects your function and beliefs?
Are they working with you to create shared goals?

Great care involves curiosity, collaboration, and education — not just prescriptions or passive treatments. When that’s not happening, it may be time to seek a provider better aligned with a modern understanding of pain.

Don’t Forget Sleep and Lifestyle

Pain care doesn’t stop at exercise. Meghan pointed out that lifestyle factors play a huge role in pain intensity and recovery. Poor sleep, inconsistent routines, and stress can all fuel the pain cycle.

She encourages strategies like:

Improving sleep hygiene (no screens before bed, consistent routines
Managing stress through pacing, journaling, or mindfulness
Setting up a supportive environment that fosters rest and movement

These simple changes can significantly reduce pain sensitivity and improve quality of life.

The Bigger Picture: Empowerment Over Fear

More than anything, Meghan wants people to know that living well with pain is possible. It’s about understanding pain, not fearing it — and making changes across movement, mindset, and lifestyle that support long-term health.

Her approach is grounded in evidence, compassion, and practicality — and it empowers people to take charge of their lives, even when pain is present.

Meghan shared some valuable and accessible resources to support those living with joint pain:

My Joint Pain – myjointpain.org.au
Joint Action Podcast – jointaction.info/podcast
The Arthritis Movement (Arthritis NSW) – arthritisnsw.org.au

Click the links to explore these helpful tools and information.