Why it hurts

Pain: An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.


female with stiff neck

We are different from most physicians and PTs in that we analyze each patient's pain in depth.


You know how hard it is to describe a specific pain?


This is because there are six distinct types of pain, and most pains consist of a combination of two or more of the six types.


  • Peripheral nociceptive — Nerve ending pain. This is the kind of pain we are all familiar with. It happens when you cut your finger or stub your toe.
  • Peripheral neurogenic — Nerve pain. This type of pain occurs when a nerve outside of the spinal cord gets irritated or trapped. This happens when you hit your "funny bone" or your leg goes to sleep. It is also present in conditions such as sciatica or diabetic neuropathy.
  • Central sensitization — Pain in the brain. No, it's not all in your head, but your brain plays a big role in pain. Sometimes the brain or spinal cord amplifies the signals coming from your body and causes that area to be more sensitive. When this happens, something that is not dangerous or damaging is interpreted wrongly as pain.
  • Peripheral sensitization — This is basically the same as central sensitization, but it happens elsewhere in the body, not in the brain. The effect is almost the same. This happens naturally during the inflammation process, which is why when you sprain your ankle, the entire foot gets sore, not just the injured ligament. It becomes pathological if the peripheral sensitization continues after the healing has finished.
  • Autonomic — Autonomic pain is accompanied by changes in the sympathetic nervous system – the system controlling the fight or flight mechanisms of the body. Pain with an autonomic component will usually include skin temperature changes, increased or decreased hair growth and skin changes. Complex regional pain syndrome (CRPS I and CRPSII), formerly known as Reflex Sympathetic Dystrophy (RSD), are examples of autonomic pain disorders.
  • Affective — Pain caused or increased by unpleasant emotions.


Most physicians and PTs only think about the first two, and if treating those two doesn’t work, they decide the patient must be faking or crazy.


They are wrong.


Traditional PT is effective for the first two types of pain, but those traditional treatments can be painful or counterproductive for patients experiencing any of the other four types.


Most patients come to us with a combination of two to five of these contributors to pain, and each case must be treated differently. This approach is not taught in most schools and is not well understood by most healthcare providers.



learn more about pain

Next: Read case studies from our patients.