The E3 Rehab Podcast 227. Questioning Pain Science w/ Asaf Weisman
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Nov 18, 2025 Asaf Weisman, a physical therapist and spinal research lab manager at Tel Aviv University, explores groundbreaking insights into pain science. He critiques the IASP's definitions of nociception and pain, arguing for a broader understanding that includes neuroimmune mechanisms. The discussion dives into the complexities of phantom limb pain, sensory illusions, and the inadequacy of anecdotal evidence. Asaf emphasizes that chronic pain has biological explanations, urging clinicians to rethink assessments and focus on practical interventions like exercise and sleep.
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Aphorism Lacks Empirical Foundation
- The aphorism "nociception is neither necessary nor sufficient for pain" lacks evidence and likely originated as opinion rather than data.
- Asaf Weisman and colleagues logically refute the aphorism and trace its earliest mention to an opinion piece in 1980.
Nociception Definition Is Too Narrow
- IASP defines nociception as neural processing of noxious stimuli that requires nociceptors.
- Weisman argues this definition is too narrow because nociceptive activity can occur beyond peripheral nociceptors.
Broaden Nociception To Pathway-Level
- Nociception should include activation anywhere along the nociceptive pathway, not only peripheral nociceptors.
- Immune, spinal, and glial mechanisms can initiate similar nociceptive processing and produce pain.