Magnolia Physical Therapy’s Beth Winkler Seeks to Eliminate Chronic Pain

Beth Winkler has long been fascinated by the workings of the human body. Her passion for the topic, combined with a desire to help others, led her into physical therapy work — and it inspires her to continue exploring new ways to help people heal.

On a constant lookout for tools to add to her toolbox, Beth Winkler, co-owner and CEO of New Orleans-based Magnolia Physical Therapy, began trying pain neuroscience education to tackle chronic pain.

Winkler treats musculoskeletal disorders, specializing in spinal and pelvic disorders. She sees a lot of clients with chronic lower back and neck pain. Pain neuroscience education has provided tools needed to help eradicate chronic pain instead of just manage the pain, Winkler said.

“This is the missing link,” she said, offering promise for clients who have battled pain for decades. “There is hope to get out of it. That’s so exciting to me.”

Winkler has been providing physical therapy for about 30 years. She earned her Bachelor of Science degree in physical therapy from Northeastern University in Boston in 1995. She then returned to her native New Orleans to work at Touro Infirmary and quickly gravitated to outpatient practices.

Winkler enjoyed the challenges particular to outpatient work, but grew frustrated with a lack of patient improvement and felt her ideas were being dismissed in the “very male-dominated” field.

She founded Magnolia Physical Therapy in July 2005 with Lisa Taglauer, intent on creating more opportunities to help patients, partly through embracing a shift toward hands-on therapy. Patients wanted more manual therapy, as opposed to the more exercise-based therapy, as they started seeing significant improvement through hands-on methods, Winkler said.

She also began incorporating dry needling, which involves inserting thin needles into a muscle “trigger point” to decrease pain and increase function.

Winkler began learning about pain neuroscience education a few years ago, while searching for better methods to treat chronic pain. She has since seen major progress for people battling chronic pain — including herself.

Winkler experienced a concussion 15 years ago, setting off a 14-year struggle with chronic pain.

“I had a physical injury, so I thought this was how it would be for the rest of my life,” she said.

However, she noticed that stress triggered her symptoms, indicating at least some of the pain stemmed from her nervous system. She dove into pain neuroscience education, trying the techniques on herself and a few others, and saw her pain go from “all the time” to “95% gone.”

Pain neuroscience education involves educating patients on how pain works and how the nervous system can contribute to pain.

“How is pain produced? Most people think it’s that you hit your elbow and a nerve at your elbow sends a message to the brain that it hurts,” she said. However, “the receptors in the elbow aren’t sending pain signals — they just send input of what happened, and then the brain decides how much danger is involved.”

The nervous system sends “pain” alerts as a protective measure, but the system can become faulty, continuing to send pain alerts even after tissues heal, Winkler said. The faulty signals can stem from sources like fear of movement or trauma.

Winkler said she treads lightly when broaching the topic of pain neuroscience education, to ensure patients don’t feel as though their pain is being minimized or dismissed.

“The pain is not all in their head, but it is in their brain,” she said. “It’s a learned neural network.”

Winkler uses a variety of pain neuroscience education techniques to treat pain based in the nervous system. Examples include breathwork, sensory exercises and working with patients on movement, but with a focus on function, rather than what does or does not cause pain.

One of her patients with debilitating neck pain saw major improvements through visualization, in which patients think of their movements as safe and pain-free.

The patient’s goals included being able to sit for extended periods at the Superdome to watch New Orleans Saints games.

Winkler had the patient visualize walking up to the Superdome for a game and associate positive emotions with the experience.

“The Saints are winning,” Winkler would tell her.

After about two months of pain neuroscience education combined with traditional physical therapy, the patient was able to cheer on the Saints in person as her pain had largely disappeared.

Winkler has found relief from her own pain through pain reprocessing therapy, a meditative approach that involves mentally scanning the body for “sensations” and regarding them with curiosity instead of judgment.

“It’s helped me so much,” she said.