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Without understanding social determinants of health, pain care becomes guesswork dressed as certainty. Monica Noy helps us separate influence from cause and shows why humility is a clinical skill.

• why private care creates privilege and access gaps
• how BPS gets narrowed and misused as causation
• influence versus cause across bio, psycho and social factors
• education gaps in neuroscience and pain mechanisms
• harms of structural narratives and “root cause” claims
• core social determinants: income, racism, education, work, sleep, access
• sex and gender biases in research and pain treatment
• racism and under treatment of pain
• practical ways to center context without blame
• building trust through transparency and uncertainty

Pain Education, no script provided, is now available for purchase on my website, thecebe.com
To listen to more of these episodes, please subscribe on your favorite podcast network
If you enjoyed this episode, please like and share to your favorite social media platforms
If you’d like to connect with me, I can be reached to my website, thecebe.com, or send me a DM through Instagram @Eric_purves_cebe
If you really like this episode and you want to support my podcast, please consider making a small donation. This can be done by clicking on the support button or heading over to buymeacoffee.com/helloob

The Massage Science Podcast and my company, The Centre for Evidence-Based Education (The CEBE), are now official partners with Noterro.

Partnering with them feels like a natural alignment with our mission to support busy clinicians.

Get Noterro free for 44 days!
Noterro makes clinic management easy with scheduling, billing, and charting all in one place

Support the show

Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
thecebe.com
Please connect with me on social media

FB: @ericpurvesrmt

IG: @eric_purves_rmt

YouTube: https://www.youtube.com/@ericpurves2502

Would you like to make a donation to help support the costs of running my podcast?

You can buy me a coffee by clicking here

Send us a text

We question whether it is ethical to cause pain during manual therapy and unpack what nociception, tissue insult, and consent truly mean. We challenge heuristics like no pain, no gain and ground decision-making in evidence, context, and patient autonomy.

• defining pain and nociception as signals of actual or potential tissue damage

• challenging bruising and discomfort as therapeutic proof

• critiquing hurt does not equal harm as a blanket rule

• considering acute movement without adding insult
• separating clinical experience from mechanisms

• identifying knowledge gaps and outcome bias

• using informed consent beyond a checklist

• acknowledging identity, change, and humility in practice

• recognizing social determinants and inequities in pain care

Pain Education NoScript Provided is now available for purchase on my website, the CEBE.com

To listen to more of these episodes, please subscribe on your favorite podcast network

If you enjoyed this episode, please like and share to your favorite social media platforms. If you'd like to connect with me directly, I can be reached through my website or send me a DM through either Facebook or Instagram at EricPurves RMT.

If you want to support my podcast, please consider making a small donation. This can be done by clicking on the support button or heading over to buymeacoffee.com/helloob

The Massage Science Podcast and my company, The Centre for Evidence-Based Education (The CEBE), are now official partners with Noterro.

Partnering with them feels like a natural alignment with our mission to support busy clinicians.

Get Noterro free for 44 days!
Noterro makes clinic management easy with scheduling, billing, and charting all in one place

Support the show

Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
thecebe.com
Please connect with me on social media

FB: @ericpurvesrmt

IG: @eric_purves_rmt

YouTube: https://www.youtube.com/@ericpurves2502

Would you like to make a donation to help support the costs of running my podcast?

You can buy me a coffee by clicking here

Send us a text

What if pain education got the fundamentals wrong by chasing tidy scripts instead of solid mechanisms? We sit down with researcher and educator Monica Noy to rethink how clinicians learn, reason, and communicate about pain. Rather than leaning on “explain pain” narratives and one-size-fits-all language, Monica anchors care in a clear premise: nociception is necessary—though not always sufficient—for pain. That single shift reframes assessment, reduces blame, and helps us speak to people with honesty and respect.

Across a candid, story-rich conversation, we explore why pain care remains under-taught across health professions despite being the top reason people seek MSK help. Monica traces the evolution of common teaching approaches, the biases that shaped them, and the real-world fallout when clinicians over-educate, over-promise, or quietly fault patients for not “thinking right.” We talk ethics, too: if pain is associated with actual or potential tissue damage, what does it mean to create pain during treatment? When does intensity cross into harm, and how do we decide with patients rather than for them?

You’ll hear a grounded way to use the biopsychosocial lens without turning it into a moving target that justifies endless chasing. We discuss definitions, semantics, and why shared language matters; how better mechanism literacy leads to fewer words and better questions; and what Monica’s new course, Pain Education, No Script Provided, offers clinicians who want to be less wrong and more helpful. Expect fewer scripts, more clarity, and a renewed respect for autonomy—yours and your patients’.

Enjoyed the conversation? Subscribe, share with a colleague who teaches or treats pain, and leave a review to help others find the show.

The Massage Science Podcast and my company, The Centre for Evidence-Based Education (The CEBE), are now official partners with Noterro.

Partnering with them feels like a natural alignment with our mission to support busy clinicians.

Get Noterro free for 44 days!
Noterro makes clinic management easy with scheduling, billing, and charting all in one place

Support the show

Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
thecebe.com
Please connect with me on social media

FB: @ericpurvesrmt

IG: @eric_purves_rmt

YouTube: https://www.youtube.com/@ericpurves2502

Would you like to make a donation to help support the costs of running my podcast?

You can buy me a coffee by clicking here

Send us a text

The Massage Science Podcast and my company, The Centre for Evidence-Based Education (The CEBE), are now official partners with Noterro.

Partnering with them feels like a natural alignment with our mission to support busy clinicians.

Get Noterro free for 44 days!
Noterro makes clinic management easy with scheduling, billing, and charting all in one place

Support the show

Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
thecebe.com
Please connect with me on social media

FB: @ericpurvesrmt

IG: @eric_purves_rmt

YouTube: https://www.youtube.com/@ericpurves2502

Would you like to make a donation to help support the costs of running my podcast?

You can buy me a coffee by clicking here

Send us a text

Sarah MacAulay, an RMT from Stewiacke, Nova Scotia, brings a fresh perspective on dual relationships in massage therapy, challenging the profession's traditional ethical guidelines that don't reflect rural practice realities. Living in a town of approximately 1,800 people, Sarah shares her journey of navigating professional relationships that inevitably overlap with personal ones, revealing how urban-centric ethics create unnecessary burdens for rural practitioners.

• Dual relationships occur when professional therapeutic relationships overlap with personal connections
• Traditional ethics teaching instructs therapists to "avoid dual relationships" without providing context for rural practitioners
• The abstinence approach to dual relationships is unrealistic in small communities where practitioners know most patients
• Research from other healthcare professions shows risks of dual relationships are often overstated
• Patients in small communities often prefer being treated by someone they know and trust
• The burden of reconciling practice reality with traditional ethics creates unnecessary guilt for rural practitioners
• Successful management of dual relationships involves honesty, communication, and co-created boundaries
• Current ethical frameworks derived from urban institutional settings don't translate to rural practice
• Practitioners need education on managing dual relationships rather than simply being told to avoid them
• Sarah is developing guidelines to support therapists navigating dual relationships in small communities

Join Sarah at the upcoming Knowledge Summit on Sunday, October 5th, where she'll present "A Closer Look at Dual Relationships in Research and Practice" – offering research-informed approaches for practitioners working in small communities.

The Massage Science Podcast and my company, The Centre for Evidence-Based Education (The CEBE), are now official partners with Noterro.

Partnering with them feels like a natural alignment with our mission to support busy clinicians.

Get Noterro free for 44 days!
Noterro makes clinic management easy with scheduling, billing, and charting all in one place

Support the show

Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
thecebe.com
Please connect with me on social media

FB: @ericpurvesrmt

IG: @eric_purves_rmt

YouTube: https://www.youtube.com/@ericpurves2502

Would you like to make a donation to help support the costs of running my podcast?

You can buy me a coffee by clicking here

Send us a text

The Massage Science Podcast and my company, The Centre for Evidence-Based Education (The CEBE), are now official partners with Noterro.

Partnering with them feels like a natural alignment with our mission to support busy clinicians.

Get Noterro free for 44 days!
Noterro makes clinic management easy with scheduling, billing, and charting all in one place

Support the show

Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
thecebe.com
Please connect with me on social media

FB: @ericpurvesrmt

IG: @eric_purves_rmt

YouTube: https://www.youtube.com/@ericpurves2502

Would you like to make a donation to help support the costs of running my podcast?

You can buy me a coffee by clicking here

Send us a text

The Massage Science Podcast and my company, The Centre for Evidence-Based Education (The CEBE), are now official partners with Noterro.

Partnering with them feels like a natural alignment with our mission to support busy clinicians.

Get Noterro free for 44 days!
Noterro makes clinic management easy with scheduling, billing, and charting all in one place

Support the show

Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
thecebe.com
Please connect with me on social media

FB: @ericpurvesrmt

IG: @eric_purves_rmt

YouTube: https://www.youtube.com/@ericpurves2502

Would you like to make a donation to help support the costs of running my podcast?

You can buy me a coffee by clicking here

Send us a text

The Massage Science Podcast and my company, The Centre for Evidence-Based Education (The CEBE), are now official partners with Noterro.

Partnering with them feels like a natural alignment with our mission to support busy clinicians.

Get Noterro free for 44 days!
Noterro makes clinic management easy with scheduling, billing, and charting all in one place

Support the show

Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
thecebe.com
Please connect with me on social media

FB: @ericpurvesrmt

IG: @eric_purves_rmt

YouTube: https://www.youtube.com/@ericpurves2502

Would you like to make a donation to help support the costs of running my podcast?

You can buy me a coffee by clicking here