What is it about?

This study analyzed how the degree of pain amplification (nociplastic pain) can impact the response to physical therapy for patients with muscle (myofascial) pain. This prospective, observational cohort study compared pain phenotyping and functional measures in 30 participants with non-acute neck/shoulder girdle primary myofascial pain following 3-months of physical therapy. The Fibromyalgia Survey Questionnaire (FSQ) Score served as a surrogate of pain amplification. The degree of nociplastic pain in patients with myofascial pain appears to be inversely related to improvements from a peripherally based treatment. This is not to say that individuals with moderate to higher levels of nociplastic pain do not benefit from physical therapy, but they proportionally benefit less.

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Why is it important?

This study indicates that the baseline degree of nociplastic pain has an impact on both symptomatic and functional outcomes following a referral to physical therapy regardless of the type of treatment or the number of therapy visits.


This study provides helpful information for clinicians when considering referring a patient to physical therapy with muscle pain. Physical therapy may offer some but not full relief for patients with moderate or higher degrees of nociplastic pain. Identifying where a patient resides on the continuum of nociplastic pain, using the relatively simple Fibromyalgia Survey Questionnaire (FSQ) Score, can help guide clinical decision making and managing expectations.

David Kohns
University of Michigan

Read the Original

This page is a summary of: The impact of nociplastic pain features on the response to physical therapy in patients with primary myofascial pain, Journal of Back and Musculoskeletal Rehabilitation, September 2022, IOS Press,
DOI: 10.3233/bmr-210244.
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