Ep. 138 Pain Without Lesion, What’s that? Important Historical Perspectives on Chronic Pain

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In this episode Dr. Michael Lenz  explores the historical understanding of chronic pain that lacks visible physical symptoms. He discusses stigma against sufferers, hypochondria, historical sex bias in pain understanding, and the transition in recognizing non-visible pain as real with the advent of functional MRIs. Dr. Lenz makes a case for the necessity of understanding the complexity of pain beyond the classic biomedical model and acknowledging the historical roots of current attitudes towards pain for better pain management in the present .

00:00 Introduction to Chronic Pain and Stigma
01:06 Understanding the Host's Background
01:58 Exploring the Concept of Pain
02:41 The Historical Perspective of Pain
03:49 The Concept of Mechanical Objectivity
05:19 The Clinical Gaze and its Impact
08:56 The Role of Medical History in Understanding Pain
09:17 The Stigma and Misunderstanding of Chronic Pain
09:33 The Problem of Pain Without Lesion
10:33 The Role of Forensic Science in Understanding Pain
11:36 The Impact of Sex and Social Status on Pain Perception
15:06 The Impact of Stigma on Pain Perception
15:49 The Role of Modern Medical Approaches in Understanding Pain
20:39 The Role of Legal Cases in Understanding Pain
27:31 Conclusion: The Historical Impact on Current Pain Perception
29:07 Final Thoughts 

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When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

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