Conditions We Treat

If you've had pain for months or years, you've probably heard a lot of explanations. Some may have fit. Some may have left you more confused. Some may have felt dismissive.

Here's where I start: pain is always real. I don't need a scan or a test result to believe you. If you feel it, it's real — and it matters. But maybe you have had a scan, or a physical test where someone has told you identified the source of the pain. In many situations, those explanations are incorrect at best, and harmful at worst. 

What often gets missed in chronic pain is the nervous system's role. The body has an alarm system that's designed to protect you. In the short term, it does exactly that. But in some cases, that alarm becomes sensitized over time — it starts firing in response to things that aren't actually dangerous, or stays on long after the original issue has healed. That's not a sign of weakness. It's just how nervous systems work under prolonged stress or repeated threat.

Understanding that pattern is often the first thing that starts to shift things. When pain stops feeling like a signal of damage and starts feeling like a message from a nervous system that needs some reassurance, the relationship with it tends to change. That doesn't mean the pain isn't real, that's how all pain is created. But it is good news, because it means there's a pathway through it.

The work here usually involves a combination of education, somatic tracking, PRT, and gradual movement. We take it at a pace that fits where you are. I won't put a firm timeline on it, because it varies a lot from person to person. But for most people who engage with the work consistently, symptoms can be literally changed.

Long COVID is one of those conditions that can be incredibly hard to explain — to others, and sometimes even to yourself. The symptoms are real and often severe. But tests come back normal, timelines don't make sense, and the usual approaches either don't help or sometimes make things worse. Sometimes you'll hear about research saying there's something wrong with your cells - Mast Cells, Mitochondria, Small Blood Vessels, etc - but all of the treatments people go through don't really move the needle. That experience of not being believed, or not being able to make sense of what's happening, adds its own layer to an already difficult situation.

What I see in a lot of Long COVID cases is a nervous system that got hit hard during acute illness and hasn't fully found its way back. The fatigue, the brain fog, the way even small amounts of activity can trigger a crash — these patterns often point to a system that's stuck in a protective state. That's not the whole story in every case, but it's a thread worth following.

One of the most important things I bring to this work is a careful, paced approach. Pushing through doesn't work here — and for many people, it actively makes things worse. What tends to help is working with the nervous system gently, building a sense of safety, and being very deliberate about what we ask the body to do and when.

This is an area I approach with a lot of humility. The research is still developing, and I won't pretend to have all the answers. What I can offer is a thoughtful, individualized approach that takes your symptoms seriously — and that adapts as we learn what helps you specifically.

Myalgic Encephalomyelitis / Chronic Fatigue Syndrome is one of the most complex and historically misunderstood conditions I work with. People with ME/CFS have often had long, frustrating journeys through the healthcare system — being dismissed, misdiagnosed, or given advice that made things worse. I want to be upfront about that, because it matters.

ME/CFS involves a nervous system that is severely dysregulated causing very real neuroimmunological changes, often producing profound fatigue, post-exertional crashes, unrefreshing sleep, cognitive difficulties, and a wide range of other symptoms. The hallmark — post-exertional malaise, where even small amounts of activity trigger a significant worsening — is something I take very seriously in how I structure the work.

This is not a condition where pushing harder helps. Pacing is foundational, and any approach that doesn't respect that will likely backfire. My work here is careful, slow, and built around what the nervous system can handle at any given point — not what it should theoretically be able to do.

The nervous system thread — the dysregulated alarm system, the stuck protective state — is central to how I think about ME/CFS. That's where the work is focused. It's not about fixing fatigue directly. It's about helping the system feel safe enough to gradually come out of the state that's producing it.

I'll be honest: this work takes time, and progress is often non-linear. There will be ups and downs. I approach this condition with a lot of patience and a genuine respect for how hard it is to live with.

This one is for the people who don't quite have a label — or who have several labels that don't fully explain what they're experiencing.

Maybe you've had extensive testing and nothing comes back clearly. Maybe you've been told everything looks normal, but you know it doesn't feel that way. Maybe you've got a diagnosis, but it still doesn't explain why you feel the way you do or why the usual treatments haven't worked.

Nervous system dysregulation is often the common thread. You can think of it as a state where the nervous system has gotten stuck — usually in some version of high alert or protection — and is having trouble finding its way back to a more settled baseline. That can produce an enormous range of symptoms: fatigue, pain, sleep problems, digestive issues, emotional reactivity, difficulty concentrating, sensitivity to sensory input. The list is long because the nervous system touches everything.

This isn't a diagnosis I give. It's more of a framework for understanding what's happening — and it's a useful one, because it points toward what might actually help. The work here starts with a thorough look at what's going on in your system. From there, we build from the ground up — helping your nervous system relearn what safety feels like, and gradually expanding what you can do from there. You don't need a perfect answer to get started. You just need a place to begin.

Anxiety and trauma often get treated as separate things. In my experience, they're frequently two sides of the same coin.

Trauma, whether from a single event or from a long pattern of difficult experiences, can leave the nervous system in a state of heightened alertness. That's not a flaw. It's the system doing exactly what it learned to do to keep you safe. The problem is when that protective state becomes the baseline -- when the alarm stays on even when the danger has passed.

Anxiety, in a lot of cases, is what that looks and feels like from the inside. The racing thoughts, the physical tension, the sense of dread that doesn't always have a clear cause -- these are often the nervous system's way of staying ready for a threat that isn't currently present.

That's why trying to reason your way out of anxiety often doesn't get very far. It's not primarily a thought problem. It's a physiological one. And that's also why the approaches I use — things like BWRT, somatic tracking, HRV biofeedback, and paced breathing — tend to be more useful than talk alone. They work with what the nervous system is actually doing.

A note on scope: for deeper trauma work — particularly complex or developmental trauma — I often recommend working alongside a therapist who specializes in that area. My work is most useful as part of that picture, or as a bridge toward it. I'm happy to collaborate with other providers, and I can refer when that's the right call.

Stress-related symptoms are very common and underestimated.

Most people think of stress as a mental or emotional experience. And it is partly. But it's also deeply physical. Chronic stress keeps the nervous system elevated over time, and that has real effects on the body: on sleep, on digestion, on muscle tension, on immune function, on how much energy you have and how well you recover.

Over time, those effects can build into symptoms that start to feel like their own separate problems.
What I find useful is helping people understand their own stress response — not just what stresses them, but how it shows up in their body and what it takes to actually bring the system back down. That's different for everyone. Some people carry it in their breathing.

Some in their sleep. Some in the way their pain or other symptoms flare during high-demand periods.

The tools I use here include biofeedback to get an objective picture of what's happening, breathwork to directly influence the nervous system's state, and a close look at lifestyle factors that might be quietly adding to the load. The goal isn't to eliminate stress — that's not realistic. It's to build enough capacity and skill that stress doesn't knock you as far off balance, and recovery happens faster.

Most injuries follow a predictable path — something happens, tissue heals, function returns. That's the expected arc. But a lot of people who come to see me are somewhere off that path. The injury was real. The healing happened. But the pain, the guarding, the fear of movement — they're still there.

This is one of the clearest examples of the nervous system doing its job a little too well. When an injury occurs, the body ramps up its protective response — which makes sense. But sometimes that response doesn't scale back the way it should once the tissue has healed. The alarm stays on. Movement still feels threatening, even when it no longer poses a real risk.

What I look at in these situations is what's keeping the system in that protective state. Sometimes it's fear — often below conscious awareness. Sometimes it's been reinforced by well-meaning advice to rest, avoid, or protect. Sometimes there are other stressors that have kept the overall threat level elevated.

The work here usually involves a combination of education — helping you understand what's actually going on — and gradually rebuilding confidence and safety in movement. I also bring in manual physiotherapy when it genuinely adds value. The goal is to help the nervous system update its understanding of what's safe, so that function can return in a sustainable way.