07/10/2026
“Why did the treatment help… but the pain keep coming back?”
This is something I often think about when I look back at my own recovery.
I spent thousands of pounds on physiotherapy and osteopathy over many years.
And I genuinely believed that if I could just find the right person, treatment, exercise or technique, someone would eventually “fix” my back.
Sometimes the hands-on treatment helped.
I would leave feeling looser. The sensations would settle. I had some relief.
But then… the pain would return.
And over time, it was actually getting worse.
My osteopaths were incredibly kind and knowledgeable. They were trying to help me with the information available to them, and I don’t blame them at all.
But eventually, they were confused by the level of pain I was experiencing compared with what they could find physically, and by why it seemed to be getting worse despite all the treatment I was having.
And this is where my understanding of pain completely changed.
Manual therapy can help — but it may not be the whole answer.
Hands-on treatment can influence pain and movement in the short term. It can help someone feel safer moving, reduce muscle tension and provide a welcome window of relief.
But for some people with persistent pain, particularly when there isn’t an ongoing tissue injury that adequately explains the pain, there can be other factors keeping the pain system switched on.
Our brains and nervous systems constantly assess:
“Is this safe?”
And when the nervous system has learned that certain sensations or movements might mean danger, it can continue producing pain as a protective response — even when the tissues themselves aren’t being damaged.
So you can massage, mobilise, stretch and release the body…
…but if your brain is still interpreting normal sensations as threatening, the pain can return.
This isn’t saying “the pain is in your head.”
Quite the opposite.
The pain is real.
It’s being produced by the brain, which is doing its job of protecting you — sometimes a little too enthusiastically.
This is one of the reasons my own recovery involved learning something very different from simply trying to fix my back.
I had to learn to understand my pain.
To reduce the fear around sensations.
To change some of the beliefs I had about my spine.
To stop constantly checking, protecting and trying to correct my body.
And gradually, to teach my nervous system that movement and sensation didn’t automatically mean danger.
That’s a big part of the work I now do as a Pain Recovery Coach, SIRPA Practitioner and PRT Coach.
I’m not anti-physio.
I’m not anti-osteopathy.
And I’m certainly not suggesting manual therapy is useless.
It helped me at times too.
But for me, it wasn’t enough to create lasting change.
The really important question became:
“What else might my brain and nervous system have learned about pain, safety and movement?”
And that question changed everything for me.
Research into Pain Reprocessing Therapy has also shown promising results for people with primary chronic back pain, with benefits maintained at one-year and, in a later follow-up, five years in the study group. (JAMA Network)
Of course, PRT isn’t right for everyone, and persistent pain can have many different causes.
But if you’ve spent years having treatment done to your body and you’re still struggling, it may be worth exploring what happens when you start working with your brain, nervous system, thoughts, emotions and relationship with your sensations too.
Sometimes recovery isn’t about finding the person who can finally fix you.
Sometimes it’s about discovering that your body was never as broken as you thought it was. ❤️
