So many times patients will come to us with an ache or pain and after two or three visits, their pain is resolved and they stop their therapy. More often than not, these same patients return to us because the pain returns.

The reason for return of pain is due to the nature of inflammation and healing. Generally inflammation has three stages: acute, sub-acute and chronic. The longer a stage is experienced, the longer it takes to recover.

As one can imagine, with any stage of inflammation there are associated problems with surrounding body parts whether it be muscle weakness, muscle guarding or loss of endurance.

Consider the following example:

A patient sees a physical therapist for back pain that they have experienced for two weeks. After their third therapy visit, they are free of pain and discontinue treatment. One month later, the patient again returns to therapy with the same complaints of back pain. Why?

During the patient's initial episode of pain, the injured area developed de-conditioning, weakness and dysfunction. Even though the pain resolved, the tissue's tolerance to exertion remained poor. Thus, when the patient returned to their normal daily activities the dysfunction in this area, although not painful, still existed.

The vital elements to prevent this from happening are:

1. Patient follows through with Home Exercise Program (HEP)

2. Patient modification of offending activity

3. Completion of physician's orders regarding medication/supplementation

4. Continuing therapy if unable, unsure or unwilling to strictly adhere to HEP.

This example illustrates the importance of understanding that an absence or decrease of pain is only the first step in complete recovery. To stop your therapies or HEP based solely on your level of pain will leave you susceptible to re-injury and re-occurrence of your condition.

Jeff Kitchen is a physical therapist at Rehab Plus in Ahwatukee Foothills. Visit for more information.


(0) comments

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.