At our clinic, we’ve helped thousands of people work through injuries, surgeries, and chronic pain, so we understand the hesitation when someone asks if physical therapy is going to be painful. It’s a fair question. Maybe you’ve heard stories from friends, or maybe your last experience left you unsure. The truth is, physical therapy shouldn’t be painful, but it might involve some temporary discomfort in the beginning.
Physical therapy is not supposed to hurt, but some discomfort is normal as your body adjusts and heals. You may feel soreness during or after sessions, especially if you’re working through injury recovery. A skilled therapist will guide you through movements that challenge you without causing sharp or worsening pain.
In this article, we’ll walk you through what to expect and how to make your experience as smooth and productive as possible.
Is physical therapy supposed to hurt?
This question comes up often, especially in the early sessions (sometimes accompanied by a little bit of fear). If this describes you, don’t worry. Here’s what we usually tell patients:
Physical therapy should challenge you, but it should not create sharp or worsening pain. We often say in physical therapy that things may get worse before they get better.
If something feels wrong, your therapist wants to know immediately. The goal is progress, not punishment.
Certain treatments (deep tissue massage, joint mobilizations, or aggressive stretching, etc) can be uncomfortable in the moment. But even these are never supposed to cause lingering or pain. Think of it more like the burn you feel during a good workout, not the sting of an injury.
Knowing the difference between pain and discomfort
Physical therapy is designed to help reduce pain, not create it. However, the process of restoring movement, strength, and function can involve some temporary discomfort—especially if you’ve been dealing with stiffness, muscle imbalances, or post-surgical limitations.
There’s a difference between pain that signals injury and discomfort that comes from working through healing tissue or reactivating weak muscles. Discomfort tends to be dull, achy, or tight and improves after moving or stretching. Pain, on the other hand, is often sharp, stabbing, burning, or persistent—and may worsen with continued activity.
If you’re unsure whether what you’re feeling is pain or discomfort, try a few simple self-checks:
- Location: Discomfort often stays in the area you’re working. Pain may radiate, shoot down a limb, or affect unrelated joints.
- Duration: Discomfort fades with rest or gentle stretching. Pain tends to linger or worsen over time.
- Response to pressure: Gentle pressure on sore muscles may feel relieving or neutral. Pressing on an injured area usually increases sharp pain.
- Reproduction: If a specific movement causes the same sharp pain every time, that’s a red flag. Discomfort is more likely to vary with position or ease with warming up.
A good physical therapist will help you recognize these patterns and adjust your plan accordingly. Don’t be afraid to speak up—identifying what you’re feeling is part of the process.
Why does physical therapy hurt sometimes?
Pain or discomfort during physical therapy typically stems from a few specific factors:
- Inflammation and healing: Injured tissues may be inflamed or hypersensitive, making movement uncomfortable even with gentle guidance.
- Scar tissue and stiffness: When joints or muscles haven’t been used, they become stiff. Stretching and breaking through that tightness can lead to short-term soreness.
- Muscle reactivation: Weak or atrophied muscles may ache after being reengaged in exercise routines.
These sensations usually decrease over time as your body adjusts. The goal is always to improve function without causing harm, and your therapist will adjust the intensity of your sessions based on your feedback.
Sessions should feel better as time goes on
Physical therapy should not hurt every session. In fact, sessions should become more comfortable over time, as your body adapts and grows.
Certain treatments—like manual therapy, stretching, or resistance exercises—may cause temporary soreness, especially if the area has been inactive. But intense or lingering pain that lasts for hours after therapy is a sign to alert your therapist.
Remember, one of the primary benefits of physical therapy is that we help set you up for a mobile and pain-free life moving forward. Letting us know how you feel during and after sessions helps us tailor your care for comfort and effectiveness.
Should physical therapy be painful afterward?
Another common concern is delayed pain. During a therapy session, it’s possible to experience pain after physical activity. Should physical therapy be painful hours or days later? A little soreness is a common side effect of physical therapy, especially after a challenging session. It’s your body adapting to new demands.
But if the pain sticks around, gets worse, or interferes with your daily life, it’s important to communicate that to your therapist. Your program can always be modified.
What to do if a physical therapy session creates pain
If you’re experiencing more than mild discomfort during or after therapy, we strongly recommend speaking up immediately. Don’t push through severe pain. Your therapist can modify exercises or switch techniques.
If you’re experiencing pain after your session (at home), then we recommend:
- Track your symptoms: Take note of when and where you feel pain, its intensity, and how long it lasts. This helps your provider make informed adjustments.
- Use recovery tools: Ice, rest, and gentle movement can help ease post-session soreness. Ask your therapist about some of the inexpensive tools that can be bought or brought home. Sometimes simple tools like the Thera Cane or a simple lacrosse ball can work wonders.
- Stay consistent: Oddly enough, sticking with your therapy schedule can reduce long-term pain as your body adapts.
Your recovery shouldn’t be about suffering. Instead, it should involve gradual challenges that your body can handle and grow from. Good pain—the kind that comes from hard work—can be normal. But lingering pain after physical therapy should never be ignored. Communicating with your therapist is key in order to achieve progress and improve pain control.
What to expect and how to stay comfortable
Throughout your physical therapy treatment, it’s important to stay engaged and informed. A licensed physical therapist will help you manage discomfort, monitor your progress, and modify your treatment plan as needed. The key is consistent communication and staying active in your recovery. Here’s what we recommend to help keep discomfort to a minimum:
- Be honest about what you’re feeling, both during and after sessions
- Follow your home exercise program carefully
- Use ice, heat, or other modalities as advised
- Stay consistent—missing sessions often leads to more discomfort later
- Ask questions of your physical therapist, technicians, or assistants
Healing shouldn’t be a mystery
So, does physical therapy hurt? Our answer, generally, is NO.
Our job as physical therapists is to guide you through the healing process safely, at a pace that challenges you without overwhelming you. Therapy pain can be part of the healing process, but it’s not the end goal. With the right treatment plan, physical therapy can help reduce pain, build strength, improve range of motion, and provide long-term pain relief.
Discomfort is part of the journey—but pain is a signal to stop and reassess. When done correctly, physical therapy should leave you stronger, more mobile, and more confident in your body.
