You may have heard of the placebo and nocebo effects, but I suspect you may not appreciate how powerful they can be.

In this episode, your hosts, Bob Allen, an osteopath since 2011, and Clare Elsby, a therapy coach, explore these fascinating and often misunderstood concepts and how they might already be influencing your health.

You’ll find out how the placebo effect can produce genuine changes in pain, mood, and function, even when there’s no active medical ingredient involved. From sugar pills to sham surgery, Bob shares clinical examples and surprising research that reveal just how powerful belief and expectation can be in the healing process. You’ll also learn about “open-label” placebos — where people know they’re taking a placebo and still feel better!

We then explore the nocebo effect — the lesser-known but equally powerful negative side of this phenomenon. Clare and Bob highlight how medical language and fear-based messaging (“bone on bone,” “degenerative disc disease”) can actually make your pain worse, slow down recovery, and increase anxiety.

They share real-life experiences where people were told to expect the worst — and then lived down to it.

Clare brings in the mental health perspective, including a critical look at antidepressants and the “chemical imbalance” theory, as explored in the work of psychiatrist Professor Joanna Moncrieff.

This is a must-listen episode if you’ve ever wondered how your mind and expectations affect your body and what you can do to harness that for better health.

• The placebo effect can trigger real, measurable changes in the brain, even when you know you’re taking a placebo.
• 97% of UK GPs have used placebo-based strategies to support their patients.
• The nocebo effect happens when negative suggestions or beliefs cause real symptoms and can block recovery.
• Language matters: terms like “bone on bone” or “degenerative disc disease” can reinforce your pain and fear.
• Understanding the placebo and nocebo effects helps you become a better advocate for your own health so you can receive better care and improve your health outcomes.

Links & Further Reading

🎥 The knee surgery placebo video https://www.youtube.com/watch?v=HqGSeFOUsLI&t=5s

🎥 How to get the most from your medical appointment https://youtu.be/vuHm7gYxHWo

📚 Find the book on SSRIs here https://www.waterstones.com/book/chemically-imbalanced/joanna-moncrieff/9781804291246

📊 The Statins study https://www.ndph.ox.ac.uk/news/new-study-muscle-pain

🌿 Find out more about Clare’s therapy work: clareelsby.com

📖 Read Bob’s story and why he became an osteopath: bit.ly/BobsOsteoStory

📨 Sign up for Bob’s popular Pain Free Living newsletter: bit.ly/PFL_newsletter_signup

📱 Follow Bob on social media and podcast updates: linktr.ee/Painfreeliving

Breathing is something we do around 20,000 times a day, but most of us never stop to consider how it might be affecting our health.

In this episode of the Pain Free Living podcast, your hosts, Bob Allen, an osteopath since 2011, and Claire Elsby, a therapy coach, take a deep dive into the science and simple power of how you breathe, not just how often. You’ll find out why nasal breathing is so important for being at your best, from improving oxygen uptake and supporting your immune system to boosting sleep quality and protecting oral health.

We explore the many issues linked to chronic mouth breathing — including fatigue, brain fog, poor posture, dental problems, and even behavioural changes in children. If you’ve been breathing through your mouth without thinking about it, don’t worry — awareness is the first step, and change is possible.

Claire discusses the link between breathing and mental health. She shares easy-to-use breathwork techniques that will help calm your nervous system, lower stress levels, and improve your emotional resilience. These tools are ideal for anyone dealing with anxiety or simply looking for more calm in a busy world.

This is a must-listen for anyone curious about how such a basic function can have such a wide-reaching effect on your body and mind. Whether you're new to breathwork or keen to optimise your daily routine, this episode will leave you breathing easier — literally.

Key Takeaways:

1. Nasal breathing boosts oxygen absorption, filters allergens, and supports the immune system.
2. Mouth breathing is linked to fatigue, poor sleep, and long-term health issues.
3. Diaphragmatic breathing is key to efficient and relaxed respiration.
4. Mindful breathwork helps regulate the nervous system and reduce anxiety.
5. You can retrain your breathing habits — and your health will thank you for it.

If you want to find out more about your nervous system, this is the place to look https://youtu.be/WUesY4Zx6oM

This link will take you to more on Jeff Craig, the Breathwork expert that Clare referred to in this podcast https://euthymia.uk/

A bit more info on Bob and Clare

You can find out more about Clare here https://www.clareelsby.com/

This is the place to find out more about Bob and why he became an osteopath https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media, this is the place for you https://linktr.ee/Painfreeliving

In this hectic 24/7 always switched-on world that we live in, stress is often seen as the price that must be paid until we inevitably gain fame and fortune "later"!

The good news is that stress doesn't have to be a bad thing as long as we understand the causes and, more importantly, how to manage it.

This episode is a deep dive into the topic of stress, covering its dual nature as both a necessary and potentially harmful part of everyday life.

The hosts, Bob Allen, an osteopath since 2011, and Claire Elsby, a therapy coach, dissect the origins of stress and its manifestations within your body.

Stress can be a catalyst for action, as a physiological response that prepares you to face whatever challenges come your way. Bob covers how stress can enhance your performance, drawing parallels to evolutionary responses where it could help ensure your survival against predators. The aim is to show that stress is not all bad and how it can serve beneficial purposes when it remains within controllable limits.

Having said that, the conversation also looks at the darker side of stress, particularly chronic stress, which can happen with prolonged exposure to demanding situations. We highlight the physiological implications of chronic stress, looking at how it can lead to various health issues, including tension-related disorders like headaches, neck and shoulder issues and gastrointestinal disturbances.

Bob outlines the workings of the central and autonomic nervous systems, explaining the roles of the sympathetic and parasympathetic systems in regulating bodily responses to stressors. This discussion emphasises the significance of maintaining a balance between these systems to support both your physical and mental well-being.

Claire suggests a variety of techniques that can be easily be incorporated into your daily life with practical strategies to help manage your stress levels. They include simple things like breathing exercises, mindfulness practices, and somatic therapies, all of which can help you regain control over your physiological and psychological responses to stress.

Our aim is always to provide you with the knowledge and techniques that empower you to proactively move towards a pain-free and balanced life.

Takeaways:

• Stress can be both a beneficial and detrimental force in our lives, depending on its duration and intensity.
• The nervous system plays a crucial role in how stress manifests physically and mentally.
• Chronic stress can lead to various physical symptoms, including tension headaches and gastrointestinal discomfort.
• Balancing the sympathetic and parasympathetic nervous systems is essential for effective stress management and overall well-being.
• Breathing techniques and mindfulness practices can significantly aid in managing stress and promoting relaxation.

Links referenced in this episode:

Grounding techniques - https://youtu.be/1ao4xdDK9iE?si=DskqrhS8TSKoSVY6

The butterfly hug - https://youtu.be/iGGJrqscvtU?si=Lse2G7iFPKbAYaJp

Box breathing - https://youtu.be/tEmt1Znux58?si=2dQYRUCcoAT-CWTt

Tapping - https://youtu.be/TnbRcO43CD8?si=mI9XGG7itcLvcQwF

A bit more info

You can find out more about Clare here https://www.clareelsby.com/

This is the place to find out more about Bob and why he became an osteopath https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media, this is the place for you https://linktr.ee/Painfreeliving

Making it to Episode 21 of the Pain Free Living podcast means that we are now in the top 1% of all podcasts currently being produced so A HUGE THANK YOU for helping us to join that elite group.

This episode marks the start of a new era of the podcast with a change in emphasis, thanks to our new co-host, Clare Elsby.

Clare, is an experienced accountant who a few years ago made the decision to move into the mental healthcare arena.

In a change from our usual format, I'm doing the interviewing while she does the talking. During our conversation, Clare shares her journey, covering her decision to move to the UK, her career in accountancy, and how the onset of the COVID-19 pandemic led her to pivot from accountancy to become a qualified therapy coach.

Clare highlights her interest in neurodiversity and how it informs her coaching practice, providing valuable insights into the complexities of supporting clients who often feel disconnected from more traditional therapists.

The addition of Clare to the team means that we will be diving deeper into the link between physical and mental health because we share the view that you can't have good physical health without good mental health and vice versa.

We always aim to provide you with a holistic understanding of your well-being, highlighting the links between physical and mental health and supporting your journey to improved health.

In addition to our co-hosted podcasts, we will continue to bring you solo episodes and we are also planning to include some guests that we are sure you will find interesting.

We hope that you like the new format and stick with us as we hit episode 50 and beyond!

If you like the show, please share it with your family, friends, strangers, and anyone you think might benefit from listening or watching.

Reviews and comments are always welcome, and as well as being a cost-free way of supporting the show, the algorithm loves interaction and will ensure more people see it.

Feedback is always good, so let us know how we are doing, and if you have any questions, leave them in the comments and we will answer them as soon as we can.

Takeaways:

• Clare Elsby shares her transformative journey from Northern Ireland to co-founding the accounting firm, Elsby & Co Accountants.
• The pandemic prompted Clare to pivot her career from accounting to Non-Clinical Psychology Coaching, focusing on neurodivergent inclusivity.
• Clare emphasises the importance of effective communication in her coaching practice, particularly post-pandemic.
• We will be combining discussions about mental health with physical health, highlighting the connections and busting myths as we go.
• Clare discusses the different roles within the mental health spectrum, differentiating between therapy, coaching, and clinical therapy.

A bit more info

You can find out more about Clare here https://www.clareelsby.com/

This is the place to find out more about Bob and why he became an osteopath https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media, this is the place for you https://linktr.ee/Painfreeliving

Welcome to Episode 20 of the Pain Free Living podcast.

It's a milestone because, according to the internet (so it must be true 👀🤔) 90% of podcasts never make it past episode 3, and of the remaining 10%, 90% never get past episode 20.

Episode 21 has already been recorded, so we will soon join the group of 1% of podcasts that achieve this HUGE milestone.

When I started this podcast, I didn't appreciate how much work would be involved in getting an episode out every week. With my osteopathy day job, things have been very hectic at times, including me writing these show notes at 10 pm the night before this episode is due to go out!

I can honestly say that the responses I have been getting have made it all worthwhile and I'm looking forward to hitting the next big milestone with episode 50.

In the meantime, I thought it was time to celebrate the team that has helped me put this all together and give them all the shoutout that they deserve.

Firstly a BIG thank you to producer Ashley McKenzie, who, amongst his many achievements produced his own successful podcast "How I Became" which is well worth a watch if you have the time. In addition, he runs a recording studio, a local Caribbean restaurant, and is a poetic lyricist, voiceover artist, and intuitive coach. He also supports other community projects, too numerous to mention and still finds time to support my podcast cos he is a great human being 🙏🏽

Another BIG thank you goes to my VA, Jennifer Herbert of Jen Organises Things, who manages all things social media-related, covering my podcast and newsletter. It's thanks to her that you know when things are coming out and what they are about, so if you are ever looking for a brilliant VA she is the one!

Final BIG shout out goes to the amazing Louise Gordon, who was my co-host and partner in crime. Her job was to keep me on track and prevent me from waffling too much or disappearing down pain management rabbit holes. She managed to do this admirably right up to the point where she got too busy and had to give her consultancy business the priority it deserved. My loss is the business community's gain, so if you are a business owner in need of a coach, give her a shout.

If this is your first Pain Free Living podcast, thanks for giving it a try, and I have included clips from the most popular shows to highlight what you have been missing.

The first clips are taken from Episode 2 on a question I get asked all the time regarding the difference between an osteopath, a chiropractor, and a physiotherapist. Is there a difference? You will have to watch the clips, then the whole episode, to find the answer to that one.

Next up are clips from Episode 3 on kinesiophobia (fear of movement), which is not a term many people are familiar with, but everyone can relate to.

Finally, we look at Episode 4 covering the benefits of exercise i.e. movement medicine, for everyone, especially older adults. We also discuss how keeping it simple is key and how the right exercises can reduce pain rather than make things worse.

We hope you have enjoyed this podcast episode and keep coming back as there is lots more to come.

More about the PFL team

Ashley McKenzie - Co-founder of Unity & Motion, music, video, and podcast producer, co-host of the "How I Became" podcast, owner of the Coconut...

Do your knee joints make lots of noise when you go upstairs, or your neck when you turn your head?

If the answer is yes, you are not alone and the aim of this episode of the Pain Free Living podcast is to provide you with a clear, jargon-free explanation of what causes those sounds and whether or not you should be worried.

The correct medical term for the crackling, grinding, clicking, or popping sounds when you move your joints is crepitus.

It is something that affects millions of people worldwide, particularly adults over 50, though it can occur at any age. The sound may be audible to others or just felt as a grinding sensation within the joint itself.

Joint crepitus can affect different areas of the body depending on what you are doing, with knee crepitus when climbing stairs or moving from sitting to standing, in the shoulders with overhead movements, and in your neck when turning or side-bending your head.

While occasional joint sounds are usually harmless and part of normal joint function, persistent or painful crepitus can indicate an underlying joint problem that needs to be reviewed by your favourite healthcare professional.

What Causes Joint Crepitus?

The main mechanism behind most joint sounds involves your synovial joints. When you move and stretch a synovial joint, gas bubbles can form in the fluid due to the change in pressure, causing the rapid release of dissolved gases (nitrogen, oxygen, carbon dioxide), which form bubbles. This process is called cavitation and causes the familiar and distinctive popping sounds, which are generally harmless.

Grinding sounds can indicate a more serious condition, with a recent 2024 study highlighting knee crepitus affecting 41% of the general population, occurring in 35% following ligament injury, to 81% in knee osteoarthritis patients. Osteoarthritis remains a significant cause of painful crepitus, where cartilage breakdown produces grinding sounds and inflammation leading to pain with movement.

Other situations that can cause crepitus include ligaments snapping over bone surfaces, age-related joint changes, previous injuries, and muscle imbalances.

Takeaways

• Crepitus is the medical term for the crackling, grinding, clicking, or popping noises that synovial joints sometimes make during movement.
• Most joint sounds are caused by gas bubbles rapidly forming and collapsing within the joint and are usually harmless.
• Some joints are more prone to crepitus than others, and it usually occurs in the knees, shoulders, or neck.
• Osteoarthritis can be a major cause of problematic crepitus
• While occasional popping sounds from your joints are harmless, grinding sounds and pain indicate an issue requiring professional assessment and care.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media, this is the place for you https://linktr.ee/Painfreeliving

You know the nervous system is complicated but do you appreciate how truly complicated it is?

The aim of this episode of the Pain Free Living podcast is to provide you with a clear, jargon-free introduction to the nervous system and how it can affect your pain levels and overall health whether you are an athlete, work in an office, or are an older adult.

The nervous system is complex and is responsible for coordinating your body’s 11 systems, including cardiovascular, digestive, skeletal, and respiratory functions.

It consists of the Central Nervous System (CNS), which is the brain and spinal cord, and the Peripheral Nervous System (PNS), which includes the somatic and autonomic systems.

The somatic nervous system (SNS) manages your muscles and sensory receptors in the skin, while your autonomic nervous system (ANS) controls vital functions like heartbeat, digestion, and stress responses.

The ANS consists of the sympathetic (SNS), parasympathetic (PNS), and enteric nervous systems (ENS) over which you have no direct control - see, I told you it was complicated!

Your SNS is the one that controls your response to stress by preparing you to either fight, flee, or freeze. Dominance of the SNS increases stress hormones like cortisol, and can contribute to problems like insomnia, digestive issues, chronic inflammation, and a weakened immune system. It can also increase your sensitivity to pain.

Your PNS & ENS work in opposition to your SNS and are responsible for your rest, digest, and repair responses, lowering your heart rate, reducing pain, improving sleep, and enhancing your rate of recovery from illness and other problems.

Takeaways:

The nervous system is a complex network that regulates many bodily functions essential for maintaining good health.

• The sympathetic nervous system prepares the body for stress, and can lead to various health issues if it's too dominant.
• Activating the parasympathetic nervous system through relaxation techniques can help manage stress-related health problems.
• Stress increases your pain sensitivity, which is why managing stress is vital for pain management.
• Carrying out activities that boost relaxation in turn increases the function of the parasympathetic nervous system and improves health.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media this is the place for you https://linktr.ee/Painfreeliving

Think of exercise as movement medicine rather than something that will leave you sweating and breathless, and you are more likely to do it.

In this episode of the Pain Free Living podcast, osteopath Bob Allen talks about the benefits of exercise but from a different perspective than the usual fitness industry conversations and he never says "No Pain, No Gain" (mostly because it's not true!).

The fitness industry always seems to prioritise how you look and aesthetic outcomes over any actual health benefits. While there is nothing wrong with having a 'Love Island' body most people just want to be able to go for a walk, play with their children or climb the stairs without getting out of breath or getting achy joints.

Thinking of movement as medicine and keeping movements simple makes exercise more palatable and accessible than the image of lying in a sweaty heap in the corner of a gym or endless hours on an exercise bike.

I like to give activities that can be done at home with no equipment but I'm equally happy providing advice on what you can do if you like the gym, swimming, running or any form of exercise. It doesn't have to be hard, and even five minutes per day can give health benefits.

Adding more physical activity into your daily routine, and most importantly, making it fu,n means you are more likely to start and carry on.

The episode ends with a reminder that the journey towards fitness is not about sticking to rigid standards, but needs to be personal and enjoyable, and it will lead to a better, healthier life.

Takeaways:

• The podcast highlights the fact that consistent exercise can significantly reduce the risk of various health issues, such as heart disease and cancer.
• Listeners are urged to reconsider their perception of exercise, recognising it as a fun, beneficial activity rather than a grind that you have to get through.
• Even five minutes per day can lead to substantial health improvements over time, and if you can't spare five minutes a day, what are you doing with your life?
• Exercise has to be fun, otherwise, you are unlikely to stick to it.
• The World Health Organisation recommends specific amounts of exercise, but any movement will be beneficial regardless of meeting those exact guidelines.
• Incorporating exercise into your daily routine, such as pairing it with existing habits like before a shower or your morning brew, will make it more achievable and feel less daunting.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media this is the place for you https://linktr.ee/Painfreeliving