When pain medicine meets health coaching – my collaboration with Dr Deepak Ravindran

Some professional collaborations are built around a job description. Some happen almost by accident. Others begin with a moment of recognition, you know when you come across someone's work and think, this makes sense to me. That is how my work with Professor Dr Deepak Ravindran began.

I first came across Deepak while working as UK Director for a e-health company back in 2019 and then by chance again while studying for my health coaching degree. He had given a lecture on nociplastic pain and I was struck by the way he talked about the topic of persistent pain: the science, the education, the whole-person perspective and the way he communicated complex ideas in a way that felt both knowledgeable and incredibly approachable. I was a chronic pain sufferer myself so I then read his book, The Pain M.I.N.D.S.E.T. (twice! It’s great, because it is practical!) and became even more convinced that his approach was closely aligned with the way I wanted to work in my specialisation as a health coach.

What is nociplastic pain?

Pain is generally understood in three broad categories. Nociceptive pain occurs when actual or threatened damage to body tissues activates pain-sensing nerve endings—for example, after an injury, surgery or inflammation. Neuropathic pain results from a lesion or disease affecting the somatosensory nervous system, such as nerve damage caused by diabetes or shingles. Nociplastic pain is different: it arises from altered nociception, where the nervous system's processing of pain signals has changed, without clear evidence of ongoing tissue damage or a lesion of the somatosensory nervous system that can fully explain the pain. It is a recognised pain mechanism, and importantly, the pain is real even when conventional investigations do not reveal an obvious structural cause.

What particularly caught my attention was his recognition that health coaching could be the “missing link” for many people living with nociplastic pain. That there is so much evidence that food, movement, interaction and connection help with pain relief, and coaching can concentrate on those aspects so new “actions” can turn down the volume of pain perception. Here was a pain specialist who understood that explaining pain scientifically and treating pain are only part of the journey. People still have to take that knowledge into their everyday lives and work out how to change what they do, think and feel around their pain. Also, I contacted him because I could see the potential for something very complementary. Deepak brings decades of clinical experience and expertise in pain and lifestyle medicine. I bring the behaviour-change coaching expertise: helping people turn knowledge into action, work through the barriers that appear in everyday life and build the confidence and habits needed to make change sustainable. We seemed to be coming from slightly different

professional backgrounds but our thinking was remarkably aligned.

I remember thinking: we could make a very good team.

And we do!

Working together through his From Hurting to Healing programme since January 2026, has shown me just how powerful that combination can be for people when clinical expertise and behavioural support genuinely understand and respect each other.

Deepak has spent more than two decades working with people in pain. He is a professor, a Consultant in Pain Medicine at Royal Berkshire NHS Foundation Trust and clinical lead for specialist pain services in West Berkshire, author, public speaker and much more. His training and clinical work span anaesthesia, pain medicine, interventional pain practice, musculoskeletal medicine and lifestyle medicine.

What I find particularly interesting is where his thinking has taken him.

The longer you work with persistent pain, the harder it becomes to see it as a problem that can be solved simply by finding the right physical structure and treating it. Pain is an experience involving the nervous system, the endocrine system, the gut, the body’s sensations, previous experience, expectations and the circumstances in which a person is living.

That complexity can be intellectually fascinating. For someone who has been in pain for years, it can also be exhausting. I know that because I lived it myself.

Understanding the science is therefore only part of the journey and this is where I have come to appreciate the role of coaching in a completely different way.

Knowing is not the same as living

One of the things I have noticed repeatedly in health coaching is that people can understand an idea very quickly and still struggle enormously to put it into practice.

Pain makes this especially visible.

Someone may learn that persistent pain does not necessarily mean ongoing damage. They may understand that several body’s systems can become protective, drawn to predict “pain”. They may begin to recognise the relationship between fear, movement and avoidance too.

They can leave a session thinking, That finally makes sense.

Then they wake up the next morning.

The knowledge is still there.

So is the pain and now there is a gap between the two.

This is the space where I work.

I hear people in pain, I empathise deeply because I know what it means, I lived it myself and I worked my way through and I can happily say that this method works. It is possible to live life fully despite it all.

The person may need time and support to notice what they “do” when pain increases. They may need to rebuild trust in a movement they have avoided. They may need to understand why a carefully planned routine works beautifully for two weeks and disappears during a stressful period. They may need to find a way of responding to a flare that doesn't immediately send them back into fear.

There is something wonderfully clean about explaining pain in a consultation.

Real life is considerably messier. Deepak and I keep that at the forefront of our minds and work.

A person doesn't experience their nervous system in a laboratory. They experience it while rushing to work, after a poor night's sleep, during an argument, when their pain suddenly increases or when they are wondering whether they have made things worse again.

This is why Dr Ravindran and I think coaching works particularly well alongside pain medicine.

The medical conversation can change someone's understanding of what is happening, and in “From hurting to healing” programme that is expressed beautifully in useful videos, open clinics/Q&A and learning modules.

Coaching gives them somewhere to explore what that new understanding means when life carries on.

Deepak doesn't need to spend his clinical time helping someone redesign their Tuesday morning and I don't need to diagnose their pain.

That separation is not a limitation. It is the strength of the collaboration.

The person in the middle matters more than anything else

Healthcare can sometimes divide a person into problems.

Pain belongs over here. Sleep belongs somewhere else. Weight is discussed in another appointment. Stress is dealt with separately. Movement becomes the responsibility of physiotherapy.

The person goes home as one person.

Their sleep affects how they cope with pain. Pain affects how much they move. Movement affects confidence. Confidence affects what they attempt. Their environment affects what is realistic. Food is fundamental. Stress changes the whole picture.

This is one big reason lifestyle medicine has become such an important part of the conversation around persistent pain.

It isn't about suggesting that someone can cure their pain by eating perfectly or thinking positively but finally recognising that the human being experiencing pain is more complicated than the painful body part, it’s paramount.

Deepak's approach reflects that broader holistic view, combining pain medicine with lifestyle medicine and a strong emphasis on helping people stay accountable, understand and participate in their own recovery.

What I see from my side

The most rewarding part of my work isn't a dramatic transformation from one week to the next, it’s frankly much quieter than that.

I consider success, when I see someone who used to interpret every increase in pain as a warning begins to pause before reacting, someone who had stopped moving starts experimenting with movement again, someone notices that a difficult week doesn't have to erase everything they have built, someone stops measuring progress solely by whether the pain is present.

Those changes can be easy to miss, if we only measure the final outcome in isolation, but working together that is what people appreciate the most of being coached and give them a vital jump-start for a new healthier life.

I strongly believe those new approaches matter because they change the person's relationship with what is happening within them and that is one of the reasons I believe coaching belongs in this conversation as a useful healing tool.

A coach has the time and the space to stay with the ongoing process.

There is no expectation that the person should understand everything immediately or get it right the first time. We can look at what happened, work out what made something difficult and adjust the approach until it is completely personalised.

The person remains at the centre of the work.

That is the thinking behind From Hurting to Healing.

From Hurting to Healing

To summarise, Deepak's role is to bring his clinical expertise and his understanding of pain to the programme. My role is to support members with the behavioural side of the journey.

The combination is more powerful than either of us working in isolation because it recognises something that is easy to overlook in healthcare.

For me, this is one of the clearest examples of what Ciao Change does: I don't want to sit between a patient and their healthcare professional. I want to help connect the two for the greater good of the person we care for.

The clinician brings expertise about the condition and the appropriate clinical pathway. The person brings their own experience, circumstances and goals. Coaching creates a space in which the two can meet in everyday life, have skilful conversations and that is where improvement happens.

A collaboration I value enormously

Working with Deepak has reinforced something I already believed when I started Ciao Change: good healthcare advice is only the beginning.

The person still has to take it home.

They have to live with it on the good days and the difficult ones. They have to make decisions when they are tired. They have to find out what works for them and learn what to do when it doesn't.

When I started my role as health coach, I imagined a world where people can have a professional support system and stop feeling alone and desperate trying to solve their pain. With “From hurting to Healing” I can say that people can now have it under one multidisciplinary umbrella. With a simple and affordable membership people in pain can have a safe place where to find all the best help possible. I could not recommend it enough.

I feel very fortunate to have found a professional relationship in which we can tackle that reality from different directions, with the same “person-centred approach at heart.

Medicine can help people understand what is happening. Coaching can help them discover what they can do with that understanding in a way that fit seamlessly into they real lives.

That, for me, is where From Hurting to Healing becomes much more than a pain management programme. It is a unique, useful collaboration for real people and it is one I am genuinely proud to be part of.

Sources and further reading

For Deepak's professional background and current approach to pain management: Prof. Dr Deepak Ravindran — About 

For the From Hurting to Healing programme and its stated approach: From Hurting to Healing 

For Deepak's discussion of moving towards a broader, whole-person approach to pain management: The Rise of the Upstreamist 

For his book and approach to pain science: The Pain-Free Mindset