Dealing with Chronic Pain

You have chronic pain. Some of your chronic pain has been learned through neuroplasticity. Neuroplasticity is defined as the ability of the brain to form and reorganize its connections. This is similar to the concept of muscle memory.

Consider a child learning to throw a ball. The first throw is awkward.  At first the child needs reminders. The coach says “Keep your elbow up” and “aim at the target”. But soon the child is able to keep her elbow up and throw at the target without any reminders from the coach. Her muscle memory is really in the brain.

Just like the child’s brain writes new patterns to throw, chronic pain writes new patterns in the brain. This therapy program helps your brain learn new healthy patterns, and over time change your brain.

The majority of our clients are dealing with some sort of chronic pain so our team has put together a 4 part guide to dealing with, and perhaps, curing this pain.

The first and perhaps simplest adjustment you can make when dealing with chronic pain is studying your sleep hygiene.

“Good sleep has functional and structural effects in the brain”.  Sleep is important in learning, and neuroplasticity. Sleep Hygiene is defined as “habits and practices that are conducive to sleeping well on a regular basis.” Good sleep affects your ability to handle pain and stress.

12 Keys to Great Sleep
★ Have a set sleep/wake time; do not vary on the weekends.                                                                        

★ Avoid naps, especially if there is difficulty falling asleep at night. If you must, only 30 minutes                     

★ Don’t force sleep- if unable to fall asleep, leave the room and sit in the dark or read a book. NO SCREEN TIME!!                                         

★ Reserve the bed for sleep and sex                                

 ★ No caffeine after 2pm, avoid alcohol within 3 hours of sleep, avoid smoking, especially at night                

 ★ Avoid heavy meals before bed.                                          

★ Exercise is good for sleep, but not within 3-4 hours of bedtime                                  

 ★ Minimize light, noise, and excessive temperatures        

★ Hide the clock for clock-watchers, may cause anxiety

★ 15 minutes of morning sun helps regulate melatonin and circadian rhythm

★ Have a relaxing bedtime routine, avoid screen time 90 minutes before bed.

★ A hot shower one hour before bed

Please check back later this week for our second installment “Stress Management”

What is cupping and how it can help you.

Michael Phelps garnered much attention at the 2016 Summer Olympics not only for his record collection of gold medals, but also for the odd-looking symmetrical circles that covered his back. He used an ancient Chinese healing technique that he believed would advance his training and help him recover from the grueling workouts that he put his body through in order to prepare for competition.  And what is the “Ancient Chinese healing technique”?  Well, myofascial decompression of course.

Cupping therapy, doctor removes cup from the patient’s back

At Optimum Physical Therapy and Wellness, we utilize myofascial decompression (MFD) or cupping as it’s more commonly called, to assist patients with their rehabilitation from injury and/or pain. Many patients are having successful outcomes and have begun asking for it on a weekly basis. 

How is myofascial decompression/cupping used in the clinical setting.

With the patient positioned situated in a comfortable position the therapist begins by applying a small amount of lotion over the area to be treated.  They then place a plastic cup matching the size of the tissues is placed over the area; a tube is then attached with a suction pump at the end. The therapist pumps the device several times to lift the tissues into the cup, the cup will remain in place for anywhere from 2-5 minutes on average. More cups may be placed above or below the area. During treatment the therapist may ask you to perform exercises to work the muscle, or muscle group, being treated. while the suction is taking place. This often seems hard but after several repetitions, it does get easier. Finally, the therapist may release a small amount of pressure which makes it easier to drag the cup across the lifted tissues providing more of a massage effect.

MFD is a novel approach to musculoskeletal treatment, utilizing negative pressure tools and western medicine-based movement paradigms and algorithms. These applications are very effective for orthopedics, sports medicine, contractures, post-op recovery, overcoming dominance strategies, postural syndromes, hand therapy, neuro re-education, and scar mobilization.  A variety of patients have been benefitting from the addition of MFD to our clinic techniques; from Fibromyalgia, to Scoliosis, to Iliotibial Band Syndrome and scar tissue, the results have been significant.  MFD/cupping is tolerated well by the patient initially because the patient just remains in a comfortable position while the cupping is performed. 

Some of the benefits of MFD:

Increased blood flow via negative pressure

Reduced muscle stiffness and pain

Improved range of motion

Elevated space to reduce compression on tendons

Increases scar mobility

Assists with healing so athletes can train harder and longer

What Is Dry Needling



So how does dry needling compare to acupuncture? Is it the same thing?

Dry needling is done by Physical therapists with the same needles used as acupuncturists. While acupuncture is a 5000 year old art based on Chinese theory, dry needling is a therapeutic procedure using the same medium; but applied with a scientific perspective.

Dry Needling has progressed from western acupuncture. Many doctors use injections such as cortisone and to treat pathologies such as migraine headaches and neck pain. Science is finding it may not always be necessary to inject fluid (wet needling) to get the same results. Science is finding that dry needling those same muscles by Physical therapists works just as well without risk complications to medicine.




Think of your last massage. Your therapist is kneading your back then all of a sudden finds a certain spot in a back muscle and says ‘Oh, there’s the spot!”. We call that muscle spot a trigger point. For decades MRI machines, CT scans and ultrasound could not take a

picture of that painful spot! To a large portion of the medical community if there was nothing on MRI, then there is nothing to treat. This mentality is also in part driven by insurance compensation; if there’s no lesion they don’t have to pay.

Fortunately in 2015 researchers used a special MRI technique to identify tissue changes at the exact site of the Trigger point. They found out that the muscle has a painful trigger point with a host of problems. The trigger point has altered chemical levels including pH of 5 where it should be a 7 (neutral). Other researchers at the NIH found that once a therapist performs trigger point dry needling of the site the pH is instantly restored! The muscle is restored to health and years of nagging constant pain is eliminated. This in the hands of an experienced therapist helps resolve pain fast.

Our Journey Begins

We are so excited to announce the opening of Optimum Physical Therapy & Wellness in Frederick, MD on June 3, 2019. We’re thrilled to become a part of the Frederick community. We have been friends and colleagues for years and have aspired to open our own physical therapy clinic together. With the support of family, friends and colleagues, we are so excited to begin this journey.

We are passionate about working with folks who suffer from pain and have problems with mobility. It’s most rewarding for us when we see little improvements that make a big difference in your everyday life. We can’t wait to meet you and help you move forward. Please contact us with questions or to set-up an appointment.