Comprehensive Guide to Managing Neuropathic Pain
A clinical reasoning–driven framework for physical therapists treating complex nerve presentations
Managing patients with complex nerve pain requires more than symptom-based treatment or generic protocols. This course synthesizes the foundational, diagnostic, and therapeutic principles taught by Dr. Sean to help physical therapists move away from non-specific, “shotgun” care and toward a highly individualized, data-driven framework.
The goal is not to memorize techniques, but to understand what you are treating, why it hurts, and how to dose interventions appropriately—so cases improve instead of becoming chronic.
How to use this course
Before we begin...
Course Notes
Lesson 1.1: Introduction to the Course
Lesson 1.2: Getting On My Nerves...
Lesson 1.3: Nothing Gold Can Stay
Lesson 1.4: Important Definitions to Master
Lesson 1.5: Symptomatology and Pathologic Indicators
Lesson 1.6: Neuropathic Definitions
Lesson 1.7: Diagnostic Classifications
Lesson 1.8: Identifying the Location of the Neuropathy
Lesson 1: Knowledge Checkpoint
Lesson 2.1: Nerve Structure Organization
Lesson 2.2: Nerve Cellular Anatomy & Function
Lesson 2.3: Application of Why These Concepts Matter
Lesson 2.4: The Deep Tendon Reflex
Lesson 2.5: Functional Nerve Classification
Lesson 2.6: Application of Why These Also Matter
Lesson 2.7: Conductional Nerve Components
Lesson 2.8: Autonomic Nervous System
Lesson 2.9: Bringing It All Together
Lesson 2: Knowledge Checkpoint
Lesson 3.1: Goals of the Subjective Interview
Lesson 3.2: What We Need to Find Out
Lesson 3.3: Sean's Subjective Order
Lesson 3.4: Tips for Getting More Information
Lesson 3.5: Review of Framework
Lesson 3.6: Case Study Exercise
Lesson 3.7: Case Discussion
Lesson 3: Knowledge Checkpoint
Lesson 4.1: Goals of the Objective Exam
Lesson 4.2: What to Check in the Physical Exam
Lesson 4.3: Range of Motion
Lesson 4.4: The Neurologic Assessment
Lesson 4.5: The Neurodynamic Assessment
Lesson 4.6: Special Tests
Resources: Cervical ROM
Resources: Lumbar ROM
Resources: Myotomes
Resources: Straight Leg Raise
Resources: Slump
Resources: Upper & Lower Extremity Deep Tendon Reflexes
Resources: Upper Limb Tension Testing
Lesson 4: Knowledge Checkpoint
Lesson 5.1: Review of Framework
Lesson 5.2: Case 1
Lesson 5.3: Case 2
Lesson 5.4: The Process
Lesson 5.5: Example Case 1
Lesson 5.6: Example Case 2
Knowledge Checkpoint: Lesson 5
This course organizes complex nerve pain into a structured framework that improves decision-making:
Pathology vs Symptoms
You’ll learn why vague labels like “sciatica” undermine reasoning and how to anchor decisions in objective neurologic findings.
Conduction vs Sensitivity
You’ll identify when a nerve is failing to transmit signal versus when it is hypersensitive to movement—two problems that require very different approaches.
Three Clinical Buckets
Patients are categorized into:
Neural tension
Mechanical compression
Chemical irritation
This categorization guides testing, treatment selection, and dosing.
Physical therapists treating patients with radicular symptoms or nerve-related pain
Clinicians frustrated by inconsistent outcomes with nerve presentations
Providers who want a clear diagnostic and dosing framework, not protocols
Therapists acting as gatekeepers within the healthcare system
Clear differentiation of nerve-related pain presentations
Confidence in examination and treatment decisions
More consistent patient progress
Reduced burnout from second-guessing and stalled cases
For physical therapists who want to excel at being evidence-based practicioners.
Move beyond guesswork. Learn how to spot the subtle, often-missed signs of neuropathic pain and distinguish it from other sources of dysfunction using clear, evidence-informed frameworks.
No more “try and see” or chasing symptoms. You'll walk away with an adaptable system to guide your decisions — rooted in neuroscience, function, and patient context.
Gain the clarity and confidence you need to handle complex pain presentations without freezing up, burning out, or relying on protocols that don’t fit real-life patients.