Adriaan Louw is a self-described introvert, but you wouldn’t know it by talking to him. That’s because the South Africa native speaks a mile a minute and has made it his life’s work to spread the message about Pain Neuroscience Education (PNE), which he speaks about often and enthusiastically.
Physiotherapy: An Accidental ProfessionDr. Louw’s introduction to his area of specialty was almost as accidental as his introduction to physiotherapy. As an undergraduate student at the University of Stellenbosch in Cape Town, he had a strong interest in medicine and sports but struggled with some of the chemistry classes required for med school. After a school counselor suggested physiotherapy, which Dr. Louw didn’t even know about at the time, he enrolled in a physio class and was immediately hooked by the idea of gaining the skills and knowledge to help people in pain. He completed both his bachelor’s and master’s degrees in physiotherapy before beginning his career in a hospital outpatient department in Cape Town.
After practicing traditional physiotherapy for many years, Dr. Louw was introduced to PNE when his manual therapy skills didn’t seem to do enough for some of his patients. “Manual therapy is nice because you can often see the result immediately, but the reason I got interested in pain neuroscience is because manual therapy is limited when it comes to treating people with chronic pain,” he says. “I had been practicing for a long time, so people started sending me the more difficult patients and I got to a point where I felt like, ‘I don’t know what to do with them anymore.’ I needed a new paradigm, I needed a new way of helping people,” he says.
This roadblock led him to other notable physiotherapists and leaders in the pain science movement: Dr. David Butler and Dr. Lorimer Moseley. “These guys were super nice to me,” says Dr. Louw. “And I worked with them for many, many years on the whole pain science movement before we started doing more of our own work individually.” In addition to becoming a mentor and friend, Dr. Butler encouraged him to enroll in a PhD program in therapeutic neuroscience education and spinal disorders, which Dr. Louw completed in 2014.
Pain Neuroscience Education—A New Way of ThinkingThe PhD program at the University of Stellenbosch solidified Dr. Louw’s belief in the PNE movement which is contrary to the common way of thinking about pain. “The old-school thought was we always tied injury to pain. If you have an injury, you’re going to hurt. I mean, if you hurt you must have an injury,” says Dr. Louw. “And we now know that 30% of people experience pain with no injury. There are emotional times in our lives when our nervous system will protect us by producing pain, for example. So, we've taken on the concept that we separate the health of our tissues from the experience of pain.”
“It’s just the concept that we’re treating human beings, we’re not treating a joint or a muscle,” Dr. Louw added. “You know we always say, ‘Every joint has a brain. Every joint has a family.’ In the past I treated the joint—all I cared about was this joint in front of me. But we forget that that joint has a person attached to it—that there’s a human being we’re treating and we’re so into the joint or the muscle, we forget about the person. And what pain science has done for me, is it’s humanized the pain experience. It’s a human being here that we have to help,” says Dr. Louw.
Sharing his Knowledge Through BooksDr. Louw’s research resulted in his first book, Your Nerves are Having Back Surgery, which he wrote as a pre-operative pain program for individuals preparing for spinal surgery. The publication of that book resulted in letters from people requesting a book for those who weren’t preparing for surgery, which led to the publication of the book Why Do I Hurt?. This resulted in requests for more books that addressed other types of pain. Dr. Louw feels the success of the series—which now includes twelve patient books, as well as a clinical text and teaching system—is because the books are short, inexpensive, and provide a quick route to understanding and treating pain. “I think we also found a nice voice for clinicians who were looking for the right words to use with patients in the clinic,” he says.
In addition to writing books and research papers, Dr. Louw travels all over the world teaching classes and speaking at conferences. He’s also building post-graduate programs in pain science and working with a lot of students. He and his wife, Colleen Louw, who is also a physical therapist, own the Ortho Spine and Pain Clinic in Story City, Iowa, where they provide PT services to members of the community.
Adriaan Louw teaches a class about pain neuroscience.
A Movement with a MessageDr. Louw’s goal as a physical therapist is to make the world a better place by teaching people who are in pain about their pain. “When I work in the clinic, I may see 15 patients; I can impact 15 people that day,” he says. “But through my teaching, writing and speaking in front of thousands of people—maybe I can be part of a movement that can mobilize to take this message out to more people. That’s probably the biggest thing we’re doing: can we get the next generation trained to train the next generation about PNE, and help more people who are hurting?”
“Therapists and healthcare providers can get down really quickly,” Dr. Louw says. “You know, there’s the opioid epidemic, and people are struggling—the doctors are getting frustrated—there’s a lot of negative out there. But when I do commencement speeches, I tell students all the time, ‘The future looks bright. There’s a lot of good happening in this world. I know we’re faced with some serious challenges right now, but there’s so much good happening and we’ve got an incredible opportunity to make this world a better place, including for people in pain.’”
Fortunately, this self-described introvert who discovered physiotherapy by accident has found his voice and is willing to use it, because the pain epidemic is a global challenge and his message could help some of the millions of people who are affected by it.