A Bethesda man suffering from chronic pain in his lower back.At Bethesda Physiocare, our physical therapists are well-trained in the management of complex chronic pain conditions.  Treating chronic pain requires a thorough understanding of the biological, psychological, and sociological factors that can influence one’s symptoms.  Ultimately these biopsychosocial factors can manifest as three types of pain, known as nociceptive pain, neuropathic pain, and nociplastic pain.  

Many of the patients we treat at Bethesda Physiocare demonstrate components of all three types of pain.  This is especially true of patients with Ehlers-Danlos Syndrome, pelvic pain, orofacial pain, and chronic back/neck pain.  Let’s look at how these types of pain manifest and how physical therapy can help.

Suffering from chronic pain? Our team of Bethesda physical therapists can help. Call (301) 205-5477 today to schedule an appointment.

Nociceptive Pain  

The International Association for the Study of Pain (IASP) defines nociceptive pain as “pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors.”  Nociceptors are receptors in the body responsible for sending signals to the brain of potential damage or injury.  

Clinically this presents as pain arising from receptors in muscles, fascia, joints, viscera, and other connective tissues.  The good news is there are a variety of physical therapy techniques that can decrease nociceptive pain, including dry needling, fascial manipulation, joint mobilization, and therapeutic exercise. 

Neuropathic Pain  

This type of pain is caused by a lesion or disease of the somatosensory nervous system.  Many patients are misdiagnosed with a variety of orthopedic conditions when the true culprit is actually an irritated peripheral nerve.  At Bethesda Physiocare, our therapists are expertly trained to diagnose neuropathic pain through a variety of assessments and measures, including neurodynamic testing.  We have successfully treated many failed cases of tennis elbow, plantar fasciitis, frozen shoulder, and carpel tunnel syndrome, to name a few, by utilizing neurodynamic testing and treatment techniques. 

Nociplastic Pain

Nociplastic pain arises from altered nociception despite no clear evidence of tissue damage causing the activation of peripheral nociceptors or disease or lesion of the somatosensory system.  While there may be components of neuropathic or nociceptive pain present, often, these patients have an exaggerated level of pain due to changes in their nervous system.  This can then lead to increased fear of movement and exercise.  

Our experienced clinicians have had many successful cases of decreasing nociplastic pain by teaching patients to access their endogenous pain-relieving chemicals using externally focused exercise and exergaming

Contact Bethesda Physiocare to Learn More

If you are struggling with chronic pain, we encourage you to reach out to our skilled team of Bethesda physical therapists. We can identify the many factors that are causing your symptoms and utilize a range of effective techniques to successfully alleviate your pain. Call Bethesda Physiocare today at (301) 205-5477 to get started.