Understanding Post-Session Flare ups
You're Not Alone
Experiencing increased pain or discomfort after a physiotherapy session is more common than you might think. This doesn't mean something has gone wrong, that you've been injured, or that treatment isn't working. In fact, temporary flare-ups are often a normal part of the recovery journey.
What's Actually Happening?
When you experience a flare-up after treatment, it's helpful to understand what's going on:
Your nervous system is adapting. We've introduced new movements or challenged your body in ways it hasn't experienced recently. Your nervous system can respond with increased sensitivity as it processes these changes—this is protective, not harmful.
Tissues are responding to load. When we work muscles, joints, and other tissues that may have been underused or moving differently, they need time to adapt. Some temporary soreness or stiffness is part of this normal adaptation process, similar to how you might feel after starting a new exercise routine.
Pain doesn't equal damage. This is one of the most important concepts in modern pain science. An increase in pain after treatment doesn't automatically mean tissue damage has occurred. Pain is more complex—it's influenced by many factors including sensitivity, stress, sleep, expectations, and how your nervous system interprets threat.
What Research Tells Us
Current pain science research shows us that:
Temporary pain increases following exercise or manual therapy are normal and don't predict poor outcomes
Continuing appropriate movement and activity during a flare-up typically leads to better long-term outcomes than rest and avoidance
Gradually loading tissues helps them become stronger and more resilient over time
Staying engaged with treatment maintains the therapeutic alliance and momentum in your recovery
What You Can Do
Keep Moving (Within Your Tolerance)
Movement is medicine. While you might need to modify intensity or duration temporarily, continuing to move helps:
Reduce nervous system sensitivity
Maintain function and independence
Prevent secondary problems from disuse
Build confidence in your body's capacity
Practical approach: Use a 0-10 pain scale. Activities that cause pain up to 4-5/10 during or shortly after are generally safe. If pain settles within 24 hours and doesn't progressively worsen, you're on the right track.
Short-Term Comfort Measures
While the flare-up settles, you might find helpful:
Heat or cold application (whichever feels better)
Gentle movement and stretching
Normal pain relief medication if needed (as per instructions)
Relaxation or breathing exercises
Maintaining your usual activities where possible
Don't Cancel Your Next Session
Please still attend your next appointment. Here's why this matters:
We can assess how you're responding and adjust treatment accordingly
We can reinforce helpful strategies and correct unhelpful ones
Your flare-up provides valuable information about your recovery
Avoiding treatment due to fear of pain can actually slow recovery
We're partners in this journey—communication keeps us on track
When to Contact Us
While flare-ups are normal, please reach out before your next appointment if:
Pain is severe and unmanageable
You have new symptoms like numbness, weakness, or other neurological changes
You're feeling anxious or uncertain about what to do
You have questions or concerns about your experience
Remember
Recovery isn't always linear. Flare-ups don't mean you're back to square one—they're often part of the process of building resilience. Your body is capable of adaptation and healing, and we'll work together to support that process.
Think of this like strength training: temporary muscle soreness doesn't mean damage—it's part of building capacity. The same principle applies to the work we're doing together.
Questions or concerns? Don't hesitate to call, text, or email before your next session. We're here to support you through all parts of your recovery.
This information is based on current pain neuroscience research and evidence-based practice. It's intended as general guidance and doesn't replace individual assessment and advice from your physiotherapist.