Amplified Pain Syndrome

Amplified Pain Syndrome (APS) is a term that is used to describe an increase in sensitivity due to abnormal nerve function. Instead of stimulus only causing the pain-sensing nerves to fire, it also causes the nerves that control the vascular system to fire. This causes the blood vessels to constrict, which decreased blood flow to the muscles and causes more pain than normal. There are typically three factors that can cause APS: injury, illness, or stress. People with APS have increased pain with stimulations that might not be painful for people who do not have APS, such as light touch or temperature changes. Pain associated with APS is real and does not resolve with medication, but physical therapy can help.

Exercise programs for patients with APS typically will include about 45 minutes of aerobic exercise per day. The patients should work through the pain or discomfort in the affected area without changing the exercises to make them less painful. The exercise program should be performed daily, even when the patient is experiencing increased pain or muscle soreness. For patients with APS, the focus should not be on pain levels but instead on improved function such as speed, endurance, balance, etc. Many times, pain will worsen during rehabilitation before it gets better, and functionality will often return before the pain is resolved. If an activity is not painful or uncomfortable or challenging for the patient, it is time to progress that exercise to a more difficult one or increase the repetitions. This is one situation where the saying “no pain, no gain” holds true!

Along with the aerobic exercise, patients with APS should perform 5-10 minutes of desensitization techniques to the affected area 5 times a day. Desensitization techniques can be simple, such as rubbing on lotion, washing the area with a wash cloth, or using warm and cold water for temperature changes. It is good to incorporate desensitization techniques into the daily routine, such as drying off with a towel after a shower and then applying lotion to the area.

In order for the pain cycle to be broken, it is important for all aspects of APS to be addressed. Along with the increase in exercise and desensitization techniques, stress management is also imperative for APS patients’ rehabilitation. Techniques such as deep breathing, imagery, and other relaxation techniques should be used to work through pain daily. If a patient is not seeming to progress and has continued pain, it is likely that the stress component of APS is not being addressed properly.

For patients with APS, consulting with a physical therapist to initiate a proper home exercise program is important. Everyone’s level of function and fitness is different, and a physical therapist will be able to prescribe the correct exercises to challenge the patient within his or her abilities. Attending physical therapy sessions also gives the therapist a chance to monitor and evaluate the patient’s progress and change exercises as appropriate. If you or someone you know has been diagnosed with APS, please give one of our clinics a call. Visit to find one of our locations near you. Physical therapy can help!

Content provided by Myranda Griebel, PTA

Children’s Mercy Kansas City – Amplified Pain Syndrome. (n.d.). Retrieved December 7, 2018, from