Resetting the Pain Threshold | Modern Manual Therapy Blog

Resetting the Pain Threshold

I thought it would be helpful for you visual learners out there (like myself) to see how I explain pain and intervention strategies to my patients.

Also, like my man Zac Cupples, you can see I missed my calling as a professional graphic artist with the high end program, MS Paint!

Enjoy the vid, it's about 6 minutes long for you impatient types.

The most important part of the mode of homework is the patient figuring out how often they need to "dose" themselves with a reset. Hourly will suffice for some, for others, with very repetitive jobs, will need 2-3 reps every 5-10 minutes. These are not forever, but just as long as it takes to keep the threshold high and the window of improvement open, so that the alarm stays off. That's typically for 48-72 hours before you can potentially start loading in the direction opposite the directional preference.

Keeping it Eclectic...


  1. Great visualization. I happen to have a white board on hand in my clinic that I normally use for with students. Why not illustrate to my patients as well?

  2. Ditto with regards to illustration. Question; 1) Do you have control tests with different age groupings? 2) Have you ever considered the idea, or come across a patient with other factors (varying)who could/may, experience the exact opposite within your pain threshold theory?

  3. Jess, modern pain research is pretty conclusive on pain threshold being lowered with persistent pain states. Not sure what you mean by exact opposite? Are you asking if I've encountered patients whose thresholds get lower with education and treatment or who elevate with increased pain?