The Real Reason Pain Never Goes Away
Understanding pain, the broken system, and the medicine that actually works.
Each week, dozens of previously hopeless people walk through the doors of our clinic and get better.
People who have been in pain for a decade or longer.
It is shocking how similar the stories are, “I’ve tried it all. I’ve been to a dozen Physical Therapists, tried acupuncture, a few chiropractors, had MRI’s and X-Rays done at the hospital…”
…and the story goes on.
It is crystal clear that the current system for dealing with chronic pain is awful.
In fact, I don’t think a system for eliminating chronic pain exists at all.
Physical Therapists, schooled in recovery from injuries and surgeries are utterly helpless when it comes to idiopathic pain (pain of unknown origin). It’s not their fault. They weren’t trained for this.
Doctors weren’t either. Physicians have isolated themselves to one single part of the body and are fixing their eyes on that spot alone. They mean well, but they aren’t seeing the complete picture.
The current system relies on procedures that address symptoms rather than sources. A nerve ablation procedure literally burns off the tip of the nerve so it stops firing the pain signal. But why was their pain in the first place?
Pharmaceuticals and injection are all attacking the symptom and not the source.
I’ve even had a few clients come in telling me that their surgeon is recommending that they do a “diagnostic surgery.” In other words, they can’t find anything wrong, so they’re going to cut you open to get a better look and MAYBE we’ll find something.
That’s tragic!
What’s even more tragic is the insurance-based system in which the entire medical industry relies on.
In an insurance-based medical system, clinicians often must choose diagnosis codes and treatment plans that fit what insurance will reimburse. This doesn’t always align with what makes the most sense for the human body. Many effective interventions — including personalized movement strategies, nervous system regulation, and foundational physiology — are not reimbursable, which means clinics are financially discouraged from prioritizing them. As a result, the system tends to incentivize volume and billing compliance over deep, individualized healing.
Chronic pain is not a mystery but it is to a medical system that is rooted in isolated, symptom-based medicine and a flawed economic model.
Saint Bartholomew was created to be real medicine.
Deep down, we all know that the model is broken. We know that truly restoring the human body requires a holistic approach that covers more than just the focusing on the symptoms. We know a healthy, thriving body consists of a fully-functioning mind, body and soul and it’s time someone acknowledges that.
At Saint Bartholomew, we’re not here to manage pain — we’re here to end it.
What is Pain?
Lorimer Moseley, the great pain scientist, tells the his story of hiking through the Australian Outback when he stepped on a stick.
“Ouch,” he mumbled to himself but didn’t think much of it.
A few minutes later, he noticed that his ankle was starting to hurt.
The pain grew and his ankle started to swell.
That’s when he looked down and noticed the unmistakable bite marks of one of the most venomous snakes in the world.
What followed was one of the most traumatic experiences of his life. He was helicoptered out of the outback and rushed to the hospital just in the nick of time to save his life.
Fast forward a few years and he was walking through his backyard and he actually did step on a stick. This time, his body exploded with pain.
Why? Because the brain remembered what happened the last time he felt that sensation and wanted to make sure that he was not so careless this time around.
Pain is just a signal.
It is not the sign of an actual injury, it’s just an alarm bell from the brain that is trying to get your attention.
For many people with chronic pain, that alarm bell has been ringing for so long, that the alarm itself has broken. It just won’t turn off! No matter how many clamshells you do with your Physical Therapist, if your brain EXPECTS pain, pain won’t go away.
A better approach is needed.
When I Worked in the NBA
…anytime a player got injured, he was rushed back into the training room and an immediate “meeting of the minds” commenced.
Gathered around the table were all the specialists on staff. I was there, the physical therapist was there, the massage therapist, athletic trainer, strength and conditioning coach, orthopedic surgeon, neurologist, and sport psychologist were all there.
Each would give their opinion and a multi-disciplinary plan was formed.
I would do his corrective exercises, the massage therapist would work on specific muscles, the strength coach would strengthen certain areas, the orthos would decide if any imaging or procedures were needed and each day, the athlete would show up and go through the entire plan.
Have you ever noticed that when a professional athlete gets injured, the team releases a statement that says something like, “Kobe Bryant will be out 4-6 weeks,” and then, like clockwork, 4-6 weeks later, here comes Kobe Bryant back to the court!?
But how come it’s taking months, or worse yet, YEARS for your chronic pain to go away?
In the NBA, the system is built for results. I never had to worry about client retention, the lifetime value of my customer or whether the exercises I chose would be approved for reimbursement.
My only job was to get results…period.
This is not the system that the average person has access to.
Not even close.
The Four Levers of Chronic Pain
We designed Saint Bartholomew using the professional sports system as our model. We wanted a comprehensive approach that addressed every major system of the body and we wanted to design the organization to ensure the clinician and client were aligned in their motivations. It had to be results-based.
We came up with the Four Levers of Chronic Pain. These are the four systems of the body that contribute significantly to pain.
Posture & Breathing
20,000 breaths every day, if this isn’t working well, nothing else will be.
Static posture must allow proper breathing mechanics. Overly tight or overly weak muscles will influence how you breath.
This is your core.
Can you keep your ribs perfectly stacked on top of your pelvis?
Strength
Now assuming you have a good “stack” (posture & breathing), can you maintain it under stress?
Do you have adequate strength to maintain your core?
Energy Production
Can you hold proper breathing mechanics long enough?
Many people feel good when they wake up, but by 2pm, the pain is back. This is your ability to produce long sustaining energy.
Nutrition and sleep play a major role here also.
Central Nervous System Regulation
Are you quietly activating your fight-or-flight response without even knowing it?
The moment fight-or-flight is activated, your body stiffens up and prevents you from becoming pain free. This must be trained.
This is the gatekeeper to your chronic pain
Our philosophy is simple, if you train all four systems, you will eventually return the body to a high-functioning state.
With a body functioning at such a high level, what are the odds that you are still in pain?
This process effectively reduces the likelihood of you being in pain to nearly zero.
And that is our mission at Saint Bartholomew.
Breakthroughs are Happening Every Day at Saint Bartholomew
Tears are not uncommon in this clinic.
People who were running out of hope or thought this was just a part of the aging process are now staring down a pain-free, active, vibrant, exciting future.
Some people experience it on the very first day others breakthrough a few months in. But this is the place where it happens.
One of my favorite examples was a young man, 24 years old, who came to me with chronic lower back pain.
We went through the entire program and he got no relief. Every technique I tried came up empty.
At the time, I was still “workshopping” our CNS strategies and I wasn’t confident enough in them to bring them into the clinic but since we were having no success, I asked him if he would be open to giving them a test-drive.
One week later, his symptoms were 60% improved.
By two weeks, he was playing basketball and soccer again.
By week three, well, I don’t know because he just stopped coming in!
After this breakthrough, I knew our CNS strategies were the missing link and the final piece of our puzzle.
YOU CAN SEE MORE SUCCESS STORIES HERE
The Light at the End of the Tunnel
Every time we hire someone new, we tell them that whenever a new client comes in, they are going to tell us their story.
They will highlight the complexities and the challenges they’ve faced.
They will make it seem like their case is uniquely complex.
Then we tell them that it rarely is.
You are not in pain for one singular reason or event.
You are in pain because collectively, your four levers are not operating as well as they could be. Maybe you let your diet slowly slip. Maybe you don’t sleep as well as you once did. Maybe you’re only focusing on strength in the gym and never do any cardio.
Chances are, it is a collection of factors that have led you to this point and it’s now time to get everything moving in the same direction again.
There is a great image from the book, Essentialism, that I like to show our clients.
Most of our clients come in with their energies and resources being aimlessly scattered about. But we know that success will come from channeling each of your systems all in the same direction.
This is how progress is made.
This is how breakthroughs happen.
Medicine by Saint Bartholomew - The Weekly Newsletter
I am writing this newsletter to give you the tools.
To teach you the science.
To show you the strategies.
To keep you up to date with new things I’m learning and experiences that happen in our clinic.
Our mission is to effectively solve chronic pain for as many people as we can and if you’d like to take this journey with us, please consider subscribing to this newsletter.
Further Reading:
If you want to see how this framework is actually applied, I’ve documented it in my book. I’ll send you a complimentary copy here.
spot on!