For clinicians ready to see the whole picture
Your patients aren't failing.
Your framework might be.
Pain lives across biology, psychology, and life context — all at once. Modern Pain Pro gives you the clinical reasoning system to see the whole person and know exactly where to work.
The Whole Person Reasoning Framework is a clinical-reasoning model for persistent and chronic pain. It guides clinicians to assess a patient across four interacting domains — local tissue, system biology, psychological processes, and life context — instead of searching for one biomedical cause.
What is the Whole Person Reasoning Framework?
It is a structured way to reason about complex pain presentations. Developed by physical therapist and educator Mark Kargela, the framework treats pain as something that emerges from several interacting systems at once. Rather than reducing a patient to a single tissue or diagnosis, clinicians use it to organize history, examination, and treatment across four domains and the connections between them.
What are the four domains?
The four domains are local tissue (structures, movement, and load tolerance), system biology (autonomic, immune, endocrine, and gut-brain signals), psychological processes (threat, avoidance, fusion, and values), and life context (work, relationships, sleep, and meaning). Each domain carries its own clinical signals and tools, and each one shapes the others.
In Progress
The full framework is coming.
I'm building out a complete walkthrough of the Whole Person Reasoning Framework — the four-domain model I use to think through persistent pain with clinicians: local tissue, system biology, psychological processes, and the life context around the patient.
The pillar page will break down each domain, the connections between them, and what it actually looks like to reason across all four in a real clinical session.
It's not live yet. But if you want it in your inbox the moment it drops, leave your email below.
The Four Domains
Pain emerges from four interacting domains — not one.
A preview of what the full framework will cover. Each domain has its own clinical signals, its own tools, and its own influence on the others.
Local Tissue
The structures, the movement, the load tolerance — where most clinicians start and get stuck.
System Biology
Autonomic, immune, endocrine, gut-brain — the slower signals that shape how pain actually behaves.
Psychological Processes
Threat, avoidance, fusion, values — what the mind is doing with the pain, not in the pain.
Life Context
Work, relationships, sleep, meaning — the ecosystem the patient and the pain live inside.
Common questions
Questions clinicians ask.
Short answers to what the framework is, who it serves, and how it differs from a single-diagnosis approach.
Who is the Whole Person Reasoning Framework for?
It is built for clinicians treating chronic and persistent pain who want a structured way to reason through complex presentations instead of forcing a single biomedical model.
Who developed the framework?
Physical therapist and educator Mark Kargela developed it after more than 20 years working in chronic pain practice and teaching.
How is it different from a single-diagnosis approach?
Instead of reducing a patient to one tissue or diagnosis, the framework treats pain as something that emerges from several interacting systems at once, so clinicians organize history, examination, and treatment across four domains and the connections between them.
Is the framework a treatment protocol?
No. It is a reasoning structure, not a protocol. It helps a clinician weigh how the four domains interact for an individual patient and decide where to focus.
How do clinicians learn the framework?
Modern Pain Care teaches it through evidence-informed education, a peer community, and mentorship, including the Modern Pain Pro membership and the Modern Pain Podcast. A full framework walkthrough is in progress.
Early Access
Get the framework when it's ready.
I send a weekly email to clinicians working in persistent pain — clinical reasoning notes, patient scenarios, and the research I'm pulling from. When the full framework page goes live, you'll be the first to see it.
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Not ready for email?
Start with the podcast.
Modern Pain Podcast — where I unpack clinical reasoning in persistent pain one conversation at a time.