Why Does Chronic Pain Keep Coming Back? Understanding the Causes and Treatment Options


Chronic pain is a debilitating condition that affects millions of people worldwide. Whether it’s back pain, neck pain, headaches, or any other type of chronic pain, it can be frustrating when the pain keeps coming back despite our best efforts to manage it. In this blog post, we will explore why chronic pain persists and what can be done to manage it effectively, with a focus on physical therapy as a viable treatment option.

What is the number one cause of chronic pain? 

Since chronic pain can be brought on by a number of different circumstances, there is no one main element that causes it. An accident, an underlying medical disease like fibromyalgia or arthritis, nerve damage, or other physiological, psychological, or social factors can all contribute to chronic pain. Many times, chronic pain is a multifaceted, complex problem that necessitates an all-encompassing approach to diagnosis and treatment. To identify the underlying cause of chronic pain and create a personalized treatment plan, it's crucial to engage with a healthcare professional like a physical therapist or pain management specialist.

Why Does Pain Come Back? 

There are several reasons why chronic pain persists or keeps coming back, even after treatment. Pain is a complex phenomenon that involves both physical and psychological factors, and often it's a combination of these factors that contributes to the persistence of pain.

Factors Contributing to Chronic Pain

A. Physical Factors

Physical factors that can contribute to chronic pain include underlying medical conditions such as arthritis, fibromyalgia, and nerve damage. Injuries, accidents, and surgeries can also cause physical damage that may result in chronic pain. Poor posture, muscle imbalances, and weak core muscles can also contribute to chronic pain by putting unnecessary stress on the body.

 poor posture

B. Psychological Factors

Psychological factors such as anxiety, depression, and stress can also contribute to the persistence of chronic pain. Chronic pain can lead to feelings of hopelessness, helplessness, and isolation, which can worsen psychological distress. Research suggests that emotional stress can amplify the intensity of pain, making it harder to manage.

C. Social Factors

Social factors such as lack of social support, poverty, and social isolation can also contribute to the persistence of chronic pain. Chronic pain can disrupt our ability to work, socialize, and engage in hobbies, leading to a sense of isolation and loneliness. This, in turn, can exacerbate feelings of stress and anxiety, further worsening the pain.

How Physical Therapy Can Help Manage Chronic Pain

Physical therapy is a non-invasive treatment option that can be effective in managing chronic pain. Physical therapists are experts in diagnosing and treating musculoskeletal conditions that contribute to chronic pain. It can also address psychological and social factors that contribute to pain.

Physical therapy treatment for chronic pain may include manual therapy, therapeutic exercise, and modalities such as cupping and dry needling. Manual therapy techniques such as myofascial release, joint mobilization, and soft tissue mobilization can improve joint range of motion, reduce muscle tension, and improve circulation. Therapeutic exercise can strengthen weak muscles, improve posture, and reduce the risk of further injury. Modalities such as cupping and dry needling can help reduce pain and inflammation.

Physical therapy also addresses psychological and social factors that contribute to pain. Physical therapists can teach relaxation techniques, stress management skills, and coping strategies to help patients manage the emotional distress associated with chronic pain. They can also provide support and guidance to help patients engage in social activities and regain a sense of purpose and meaning in life.

Effective Chronic Pain Treatment: Tips and Strategies

Why does chronic pain come back shortly after discharge from physical therapy?

For several causes, chronic pain might return soon after being released from physical therapy.

First off, it's crucial to realize that physical therapy does not treat chronic pain. Instead, by treating the underlying physical, psychological, and social aspects that contribute to pain, physical therapy is a therapeutic option that can aid in managing chronic pain. It is essential for a patient to carry on using the exercises and skills they learned in physical therapy after being discharged from the facility. The physical variables that contribute to pain can get worse if a patient quits doing these activities or doesn't keep up an active lifestyle, which can cause pain to return.

Second, social and psychological factors may also play a role in the recurrence of pain. Physical therapy-discharged patients who have anxiety or depression may experience increased discomfort that is more difficult to manage. Similar to how social isolation or a lack of social support for the patient once physical therapy is over can intensify stress and anxiety symptoms, making the pain worse.

Last but not least, it's critical to remember that chronic pain can be a complicated and multidimensional condition, and there may be underlying illnesses or injuries that demand continuing care. To effectively manage their chronic pain, a patient may need to keep working with their healthcare professional, which may include a physical therapist.

Effective Chronic Pain Treatment: Tips and Strategies

In summary, a number of factors, such as the failure to maintain an active lifestyle, psychological and social issues, and underlying medical disorders, can cause chronic pain to return soon after physical therapy is finished. In order to effectively manage their chronic pain, patients must continue to use the exercises and strategies they learned during physical therapy and closely collaborate with their healthcare professional.


Chronic pain is a complex phenomenon that involves physical, psychological, and social factors. Effective management of chronic pain requires a comprehensive approach that addresses all of these factors. Physical therapy is a non-invasive, safe, and effective treatment option that can help manage chronic pain. If you are struggling with chronic pain, contact a physical therapist to learn more about how physical therapy can help.

External Resources and Links for Managing Chronic Pain:

  1. American Physical Therapy Association (APTA) - Chronic Pain Management
  2. National Institute of Neurological Disorders and Stroke
  3. "Physical Therapy for Pain Management: What You Need to Know" by the Cleveland Clinic: https://health.clevelandclinic.org/physical-therapy-for-pain-management-what-you-need-to-know/
  4. "Physical Therapy for Chronic Pain Management: The Benefits, Techniques, and More" by Verywell Health: https://www.verywellhealth.com/physical-therapy-for-chronic-pain-management-4157647
Co-Owner / Physical Therapist at CORE Therapy and Pilates
Stephen Dunn, a pioneer in physical therapy, merges Pilates and Gyrotonic approaches with hands-on therapy for comprehensive injury prevention and rehabilitation. His innovative methods prioritize holistic well-being.
Stephen Dunn
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