Management of a Patient With High-Impact Chronic Pain Presenting With Mixed Pain Types: A Case Study

BACKGROUND: High-impact chronic pain (HICP) is defined as chronic pain that significantly hinders patients’ function and often results in elevated psychological distress. A multimodal approach inclusive of pain mechanism-based treatments and standard outcome tracking assists clinicians in treatment tailoring and supports effective patient management. CASE PRESENTATION: A 52-year-old male presented to physical therapy with over a 20-year history of chronic neck pain and radiating symptoms into bilateral upper extremities. The patient’s clinical picture showed signs of a mixed pain mechanism presentation, with nociplastic signs being predominant. OUTCOME AND FOLLOW-UP: After 27 visits across five months, a 12% improvement in the Neck Disability Index score was observed. Cervical and shoulder range of motion improved beyond measurements error. The patient returned to work and was able to participate in family and social events. DISCUSSION: This case demonstrates how standard outcome assessment and intervention tailoring was used to inform a pain mechanism-based treatment approach to manage a patient with HICP.