Is Physiotherapy Painful? Your Top Worries Answered Honestly

Let’s address the question that’s probably keeping you awake at night: will physiotherapy hurt? The honest answer is that physiotherapy should not be excruciatingly painful, but it’s not always comfortable either. If you’re worried about pain during your treatment, you’re not alone: this concern tops the list for nearly every patient walking through our doors.

Understanding what to expect can help ease those pre-appointment nerves and ensure you get the most from your recovery journey.

The Difference Between Pain and Discomfort

The first thing to understand is that there’s a significant difference between pain and discomfort during physiotherapy. Your body has been compensating for an injury or condition, often for weeks or months. When you start moving properly again, some discomfort is natural and expected.

Think of it like this: if you haven’t exercised in months and suddenly go for a long walk, your muscles will feel it the next day. That’s not harmful pain: it’s your body adapting to renewed activity. The same principle applies to physiotherapy.

What physiotherapists call “good pain” feels similar to the muscle soreness you might experience after gardening or trying a new workout. This type of discomfort actually signals that healing is happening and progress is being made. Good pain typically:

• Occurs during or immediately after exercise

• Feels like muscle fatigue or mild aching

• Gradually decreases over 24-48 hours

• Doesn’t interfere significantly with daily activities

“Bad pain,” on the other hand, is sharp, severe, or gets worse rather than better. This type of pain suggests something isn’t right and should always be communicated to your physiotherapist immediately.

What Pain Levels Are Normal During Treatment

Healthcare professionals use a 0-10 pain scale to help patients communicate their discomfort levels. During physiotherapy sessions, pain ranging from 1 to 5 on this scale is considered typical, especially when working on a range of motion exercises.

Here’s what these numbers typically mean:

• 0-2: No pain to mild discomfort. You’re aware of the area being treated but can easily carry on conversations and focus on other things.
• 3-5: Moderate discomfort that’s noticeable but manageable. You can still function normally, though you’re definitely aware of the sensation.
• 6-10: This range indicates severe pain that dominates your attention, significantly limits your activities, or interferes with sleep. This level should never be the goal of physiotherapy treatment.

For example, if your knee/hip/back pain normally sits at 1-2 out of 10 but reaches 4-5 during a gentle stretching exercise, this is acceptable as long as the pain decreases back to your baseline level within one to two hours after treatment.

Different Conditions, Different Experiences

Your pain experience during physiotherapy will vary significantly depending on your specific condition and personal pain tolerance. Some treatments naturally involve more discomfort than others.

Conditions that typically involve more therapeutic discomfort include:

Post-surgical rehabilitation: After operations like joint replacements, ligament repairs, or other soft tissue surgeries, your tissues are healing, and regaining movement requires working through some discomfort.

Frozen shoulder: The nature of this condition means that stretching exercises to restore range of motion can be uncomfortable, but this discomfort is essential (when done at the correct stage) for recovery.

Chronic pain conditions: If you’ve been experiencing pain for months, your nervous system may be more sensitive, making normal sensations feel more intense.

Conditions that typically involve less discomfort include:

Minor sprains or strains: These often respond well to gentle movement and manual therapy with minimal discomfort.

Postural problems: Exercises to improve posture and muscle balance are usually comfortable and pain-free.

Early-stage injuries: When treated promptly, many conditions can be managed with minimal therapeutic discomfort.

How Your Physiotherapist Manages Pain

At Recover Physio, our physiotherapists use several strategies to ensure your comfort while maximising your recovery. Communication is the cornerstone of pain management during physiotherapy. Your physiotherapist will explain what they’re doing and why, and they should check in with you regularly about your comfort levels.

Before starting any exercise or manual therapy, your physiotherapist will explain what you might feel and establish clear communication signals. Many patients find it helpful to use the 0-10 pain scale throughout their session.

Your treatment can and will be modified if it becomes too uncomfortable. There are often multiple ways to work on the same problem, and your physiotherapist can adjust techniques, intensity, or positions to find what works best for you, so let them know!

Manual therapy techniques like joint mobilisation or soft tissue work are carefully graded. Your physiotherapist will start gently and only progress to firmer pressure if your tissues respond well and you’re comfortable.

What You Can Do to Stay Comfortable

While your physiotherapist leads your treatment, there are several things you can do to minimise discomfort and maximise your progress.

Before your appointment: Take any prescribed pain medication as directed, but avoid taking it so close to your appointment that it masks important feedback about your condition. Arrive a few minutes early so you’re not rushed or stressed, as tension can increase pain sensitivity.

During your session: Breathe normally during exercises: holding your breath increases muscle tension and discomfort. Communicate openly about what you’re feeling, and don’t try to be a hero by pushing through severe pain.

After your appointment: Apply ice, heat or a combination as recommended by your physiotherapist. Gentle movement often helps more than complete rest, so follow any home exercise recommendations. Stay hydrated and get adequate sleep, as both support your body’s healing processes.

Managing Expectations About Recovery

It’s important to understand that some soreness after physiotherapy is normal and often indicates that your treatment is working. This post-treatment soreness typically:

• Peaks within 24 hours of your session

• Gradually decreases over the following day or two

• Feels similar to muscle soreness after exercise

• Doesn’t prevent you from performing daily activities

However, you should contact your physiotherapist at Recover Physio if you experience:

• Pain that continues to worsen 24-48 hours after treatment

• New areas of pain that weren’t present before your session

• Severe pain that interferes with sleep or daily activities

• Any concerning symptoms like numbness, tingling, or weakness

The Bigger Picture: Short-Term Discomfort, Long-Term Benefits

While the prospect of discomfort during physiotherapy might seem daunting, it’s essential to consider the alternative. Living with permanent loss of motion, function, or strength significantly impacts your quality of life far more than temporary therapeutic discomfort.

The discomfort you might experience during physiotherapy is purposeful and time-limited. Each session is designed to progressively improve your condition, meaning that what feels uncomfortable today should become easier as you heal and strengthen.

Many patients find that their anxiety about pain is often worse than the actual experience. Once they understand what to expect and develop trust in their physiotherapist, they’re able to relax and focus on their recovery goals.

Your physiotherapy team at Recover Physio is committed to ensuring your treatment is as comfortable as possible while still being effective. Every technique, exercise, and progression is carefully chosen to maximise your recovery while respecting your comfort levels.

Remember, you’re in control of your treatment experience. Good physiotherapy is a collaborative process where your feedback shapes your treatment plan. By communicating openly, setting realistic expectations, and trusting the process, you can navigate any discomfort and emerge stronger, more functional, and pain-free.

The temporary challenge of physiotherapy pales in comparison to the lasting freedom of movement and function you’ll gain from sticking with your treatment plan.