How long does it take to get rid of chronic pain?

Posted on August 1, 2013

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In the context of this post, chronic pain is musculoskeletal pain. Typical muscle or joint pain like your shoulder, lower back, knee, neck, etc.

Simple way to think about this

When you first start exercising you don’t expect your biceps to get bigger after one workout, or even a week of workouts. You understand it’s going to take some time to grow muscle, lose weight, whatever. The body doesn’t change overnight.

Many are aware it takes about a month for a muscle to really start showing signs of hypertrophy. Because when getting someone out of pain we’re often trying to correct muscular imbalances (making some wake up and some calm down), it takes about a month to really notice a difference in your pain.

That doesn’t mean nothing happens for four weeks. You should be able to do certain things immediately to alleviate pain. Somehow, you should learn bending your knee one way = pain and another way does not = pain. So, you make an effort to go with the latter option. Week by week you become better at the new habit, so week by week you feel better. After a month or so you’re able to say to yourself, “Wow, I feel considerably better than when I started.”

Even if you change your habits immediately, you still have to be patient.

I know the Type As are thinking, “I’ve changed EVERYTHING. All I’m doing is X new habit now. But I’m still in pain.”

Not so fast.

Even if you’re actively doing everything better (unlikely), passively you aren’t. What does that mean? We’ll say actively means you consciously manipulating your body, and passively is unconscious. Not only do muscles work actively, they also work passively. They’re always pulling on things.

The size of a muscle is a great indicator for how much it’s pulling on something i.e. how much tension it’s generating.

Let’s say your lower back muscles are working overtime, but your abdominal muscles undertime. We could likely say the lower back muscles are excessively hypertrophied and the abdominals not hypertrophied enough. So, even if you’re avoiding an anterior pelvic tilt (or whatever) ALL the time, those lower back muscles are still pulling on your lower back more than you want. It’s simply going to take time for 1) The abdominal muscles to hypertrophy and catch up and 2) The lower back muscles to atrophy and calm down.

It’s not just how quickly you can correct a habit, it’s also how long it takes a muscle to adapt, and the body to heal the injured tissue. Bringing us back to that 4 week mark.

Of course, that’s if everything else goes smoothly.

Other factors

Technique

If whatever exercises you’re performing are done with the wrong technique you’re elongating the healing process. It’s important to understand expecting perfect technique immediately is unreasonable. It takes time for someone to get things ingrained.

Your starting point

If you’re an 18 year old you’re going to respond quicker than a 50 year old. If you’ve had a knee issue for 10 years it’s probably going to take longer to resolve than someone with whose knee has only been acting up for 3 months.

There isn’t as much of a difference between the people above as one might think, but there are differences nonetheless.

Adherence

If you’re prescribed certain exercises 3 days a week and you’re only doing them once a week, you’re going to progress slower, if at all.

Or maybe you’re good about one part of the plan but dismiss the other. Maybe you’re great about doing your exercises but not changing your daily living habits. Maybe you’ve been great about adding the proper exercises into your routine, but you’ve refused to take other ones out.

Willingness to stop doing painful things / contraindicated activities

You can’t add a few stretches and expect your running pain, the one which you get every time you run, to immediately go away. A huge part of getting healthy is not only what you add, but also eliminate. Doesn’t mean you have to eliminate certain things forever. But, if bench pressing has been bothering you for 2 years, cutting it out for a bit is probably going to speed the healing process.

Ability to change habits

Even if you completely buy in to whatever program you’re doing and have full adherence, your willingness to comply and actual compliance will likely vary. It’s going to take time for you to remember to stop twisting your lower back all day. First, it’ll take you time to remember to think about it. Then, you’ll catch yourself after you do it. Finally, you’ll catch yourself before you do it. Just like you can’t change other habits immediately, you can’t change how you move overnight.

Not to mention the simple fact life gets in the way. Kids, bills, spouses, hurricanes, can all affect whether you’re sticking with your exercise / physical therapy / rehab / corrective strategy.

Right plan

Finally, even if all the above is hit, you still need to assess the overall plan. Is it the proper one for the desired goals? While I’ve criticized many other methods, there are of course times I look back and go, “Ah, I could have made that better.”

If after 6 weeks or so you don’t have a noticeable difference in how you feel, something probably isn’t right.

Being honest

Physiologically, 4 weeks is a good benchmark for when someone should feel noticeably improved, if not completely. Realistically, 6 weeks is a better average, with a strong likelihood of things taking longer due to many of the factors above.

Is it an infomercial promising to throw some new shoes on and have your entire body feel better immediately? No. But feeling a bit better each week for one, two, or three months, so you can feel better the rest of your life? Still sounds pretty good to me.

Need some help navigating all the above? Maybe you should hire someone

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Posted in: Miscellaneous, Pain