In short
Pain that lasts longer than three months often involves a nervous system that has become more sensitive, rather than ongoing damage. As a certified Therapeutic Pain Specialist, Dr. Patel uses pain neuroscience and graded movement to help you move with less pain and more confidence.
Reviewed by Dr. Manan Patel, PT, DPT, TPS. Updated October 17, 2026.
Common symptoms
- Pain lasting more than three months
- Pain that spreads or flares unpredictably
- Pain that continues after an injury has healed
- Sleep, mood or activity affected by pain
Not sure this matches? Use the 30-second pain finder or the full symptom self-check.
Why pain persists
When pain continues, the nervous system can become more protective and sensitive, so normal movement can trigger pain. Sleep, stress, fear of movement and past injuries all influence how much pain you feel. This does not mean the pain is imagined.
This approach often helps people with long-standing low back pain, neck pain and pain that lingers after auto accidents.
Persistent dizziness, too?
A sensitized nervous system can affect balance as well as pain. Persistent dizziness (PPPD) and vestibular migraine respond to some of the same principles: graded exposure, calming the system and rebuilding confidence.
How we evaluate it
Your first visit is a full 60-minute, 1-on-1 evaluation with a Doctor of Physical Therapy, and treatment often starts the same day. It can include:
- A detailed history of your pain and what affects it
- Movement and strength testing
- Assessment of sensitivity and protective movement patterns
- Goals for the activities that matter to you
Pain neuroscience care from a Therapeutic Pain Specialist
A Therapeutic Pain Specialist is a physical therapist with advanced post-graduate certification in pain science. Instead of chasing a single structure, the plan targets the whole pain system: how your nervous system interprets signals, how much activity it currently tolerates and what keeps it on high alert.
Pain neuroscience education has been studied for more than 15 years. Systematic reviews show it can reduce pain, disability, fear of movement and catastrophizing in people with persistent musculoskeletal pain, and it works best alongside graded activity and exercise.
What this looks like in your visits
- Plain-language education about how pain works and why it can change
- Graded activity and exposure to movements you have been avoiding
- Hands-on care to ease sensitivity and support movement
- Sleep, stress and pacing strategies, plus a plan for flare-ups
- A link to dizziness care when persistent dizziness (PPPD) is part of the picture
Your treatment plan
Understand your pain
Pain neuroscience education that explains why pain persists and how it can change.
Calm sensitivity
Hands-on care, paced activity, and sleep and stress strategies.
Build capacity
Graded movement and gradual exposure toward your goals.
Recovery and what to expect
Systematic reviews show that pain neuroscience education can reduce pain and disability, especially when combined with exercise. Progress is usually gradual, measured over weeks to months.
Tips for daily life
- Pace activity: do a little more each week rather than pushing through on good days
- Make sleep a priority
- Stay connected with activities you enjoy
- Notice that flare-ups are common and do not mean you are damaged
When to get urgent care
Questions about persistent pain
What is a Therapeutic Pain Specialist?
A Therapeutic Pain Specialist (TPS) is a physical therapist with advanced post-graduate certification in the science of pain and the treatment of persistent pain. That training shapes how we explain your pain and plan your recovery.
Is my pain all in my head?
No. Persistent pain is real. It reflects real changes in how the nervous system processes signals, and those changes can improve with the right approach.
Can persistent pain and dizziness be connected?
They can share a sensitized nervous system, and both respond to graded exposure and confidence-building. Dr. Patel can treat persistent pain and persistent dizziness in one plan.
Will I have to give up activities I enjoy?
Usually not. We find a starting level your body tolerates and build from there, using pacing so good days do not turn into flare-ups.
Related guides
- Why pain can last after an injury has healedWhy pain can outlast healing, what sensitization feels like, and what actually helps.5 min read · Patients
- Herniated disc on your MRI? What the findings really meanWhat disc bulges and degeneration mean, and how often herniations shrink on their own.4 min read · Patients
Browse all guides in our learning center
Related conditions
- Low back painAching, stiffness or sharp pain across the lower back.
- Neck pain & cervicogenic headachesStiff, aching neck and headaches from the base of the skull.
- Whiplash & auto accident injuriesNeck, back and head symptoms after a car accident.
- SciaticaShooting pain, numbness or tingling down the leg.
References
- Louw A, et al. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice. 2016.
- Moseley GL, Butler DS. Fifteen Years of Explaining Pain: The Past, Present, and Future. The Journal of Pain. 2015.
Where to get treated
Book at either clinic. Same phone number, same team, same 60-minute visits. In-network with Traditional Medicare, BCBS / Anthem and Tricare; Auto MedPay, injury liens and Workers' Comp accepted; or $129 flat-rate visits for self-pay patients and out-of-network plans, including Aetna, Cigna and UHC.
Cumming clinic
Off GA-400 Exit 13 on Peachtree Parkway
Cumming, GA 30041
Alpharetta clinic
Inside Georgia Brain & Spine Physical Therapy
Alpharetta, GA 30022
