Upon your initial evaluation in physical therapy (or after your first couple of appointments), patients often report experiencing similar phenomena. The good news is that the negative side effects of physical therapy are typically mild and tend to resolve within the initial few treatment sessions. Nevertheless, we advise our patients to anticipate the possibility of experiencing them during their early appointments.
The more common side effects of physical therapy include:
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- Mild initial soreness or discomfort
- Tiredness or fatigue
- Swelling or bruising
The less common side effects of physical therapy include:
- Headaches
- Dizziness or lightheadedness
- Increased pain
While we hope that you don’t experience any unpleasantness between physical therapy sessions or as result of your treatment, we acknowledge that pain is a very individual experience and that each patient responds to treatment a little differently. In this article, we’ll detail each of these side effects and discuss what to do about each one:
Common side effects of physical therapy
Soreness or discomfort
Why It Happens: During physical therapy, you use muscles and joints that may not have been active for a while. Additionally, you may be accessing a range of motion that is outside of your norm in daily life. This increased activity can lead to muscle soreness, similar to what you might experience after a workout.
What to Do: The first thing to note is that a little bit of mild soreness can be a sign that physical therapy is working. If you’re concerned about your level of soreness, communicate with your therapist about your pain levels. If they become too great, the therapist can adjust your exercises to ensure you’re not overdoing it. Applying ice or heat and using over-the-counter pain relievers can also help.
Fatigue
Why It Happens: Depending on the diagnosis, physical therapy can be physically demanding. The exercises and activities are designed to challenge the musculature and connective tissue we are targeting, which can lead to tiredness or fatigue after physical therapy.
What to Do: Ensure you get plenty of rest between physical therapy sessions. A balanced diet and proper hydration also play crucial roles in maintaining energy levels.
Swelling or bruising
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Why It Happens: Increased activity can sometimes lead to swelling, and certain modalities can leave a little bit of bruising, particularly in areas affected by injury or surgery. This effect is highly variable from patient to patient, and can often be mitigated by changing modalities.
What to Do: Elevate the swollen area, use ice packs, and follow any specific recommendations your therapist provides to manage swelling. Additionally, if you’re concerned about this effect, mention it to your therapist so they can avoid the modalities which cause irritation in the future.
Less common side effects
Headaches
Why It Happens: Certain therapies, especially those involving the neck and shoulders, can sometimes trigger headaches. This effect can be more pronounced if we’re doing any type of vestibular therapy or physical therapy for migraines.
What to Do: Discuss any headaches with your therapist. They might adjust your treatment or suggest ways to alleviate the discomfort, such as hydration or relaxation techniques.
Dizziness or lightheadedness
Why It Happens: Rapid changes in position, certain balance exercises, or therapies for medical conditions targeting the cervical spine can occasionally lead to dizziness.
What to Do: Report these symptoms immediately. Your therapist can modify your treatment to avoid triggering these reactions.
Increased pain
Why It Happens: While some discomfort is normal, a significant increase in pain might indicate that an exercise or technique is too intense or not suitable for your condition.
What to Do: Stop the activity causing pain and inform your therapist. They will reassess your treatment plan to ensure it is safe and effective.
How long do these side effects last?
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While it’s impossible to give a true one size fits all answer regarding these side effects, we can provide some general guidelines.
In general, any negative side effects that you experience will only be present for the first few appointments, and in some cases the first couple weeks. They certainly shouldn’t continue over the long term.
We often note to our patients that physical therapy can sometimes make things feel worse before they get better. However, this isn’t necessarily a sign that physical therapy isn’t working.
If you experience these effects, take note of the suggestions below:
Managing physical therapy side effects
The first and most important suggestion we have for managing any undesirable side effects of your therapy is to maintain open communication with your therapist. Always keep your therapist informed about any side effects or discomfort you experience. This way, they can tailor your treatment plan to your needs.
Next, we advise that you follow the instructions your therapist gives you regarding use of medications, getting rest from physical therapy, and taking care of yourself at home. Pay attention to how your body responds to therapy. Rest when needed and avoid pushing through severe pain.
Lastly, make sure you’re asking questions if there’s something about your treatment plan that you don’t understand. It is sometimes the case that a therapeutic modality may be causing some normal discomfort, and understanding the purpose of this modality can help you (and your therapist) make better decisions regarding adjustments going forward.
Conclusion
While physical therapy is very effective for many musculoskeletal issues, being aware of potential side effects can help you navigate your treatment more smoothly. By maintaining open communication with your therapist and taking proactive steps to manage any issues, you can maximize the benefits of physical therapy and work towards a successful recovery.
For personalized advice and detailed information, always consult with your physical therapist or healthcare provider.
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