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osteopath and massage technique used to treat muscles around the shoulder blade

Why It Is Possible To Feel Worse Following a Treatment Session

By Sumaiya Farheen and Andrew Siyabalawatte, March 2023.

There could be a number of reasons why it is possible to feel worse immediately or shortly after a osteopath, chiropractic or massage treatment session. To try and help you understand that this may not be a negative thing, we explore the reasons below.

The Body’s Defence Mechanism

Healing process of an individual after seeing an osteopath

We are subject to many kinds of stresses, both physical and emotional, every minute of the day, but our body is designed to cope with these through tissue repair, a healthy immune system, sufficient sleep, and optimal nutrition.  It is only when the stress is excessive or when the body’s normal defence or repair mechanisms are impaired that we start to experience symptoms such as pain, stiffness, and reduced mobility. This is when treatment is necessary.

Why It Is Possible To Feel Worse Following An Osteopathy Session

Understanding the process behind the cause of pain with a chiropractor


The healing process is a natural process that your body undergoes to repair and regenerate damaged tissues or cells. When you receive an osteopathy treatment, your osteopath may manipulate and mobilise the muscles, bones, and joints in your body to promote healing and alleviate pain. During this process, your body may experience some discomfort or soreness, which is a normal part of the healing process.


If any trauma/injury is left untreated for a period of time, say 48 hours, the body’s compensatory/adaptive mechanism will try its best to fix the problem. If the body is unable to fix itself, the adaptation to the injury may make treating it more likely to trigger further discomfort, as treatment is carried out to reset the body’s natural defence mechanism in order to restore proper functionality and to return the body to its previous normal state.

Injury and trauma being assessed by an osteopath

Osteopathy focuses on manipulating this mechanism, to restore harmony and balance to the body. Commonly, arthritis (both osteoarthritis and rheumatoid) and slipped discs are among the various conditions where the body is affected enough shortly after to create long term postural imbalances/joint stability issues.

Spinal Joint Misalignment

HVLAT (high velocity low amplitude thrust) to adjust the lower back

Spinal joint misalignments are commonly treated by an Osteopath or a Chiropractor. Misalignment in the spine or peripheral joints, can cause pain and discomfort.

Osteopathic or chiropractic techniques such as functional release technique and HVLAT (high velocity low amplitude thrust) are known to improve overall body function. Regular osteopathic treatments along with regular exercise, can correct spinal joint misalignments for the short and long term, by helping you improve your posture and implement change to your daily habits. If the misalignment has been present for several days, there maybe more discomfort or soreness following adjustment. This byproduct of treatment is usually temporary and depending on the severity of the issue, it may subside within a few days.

Spinal joint misalignment and its affect on posture. Massage can help to fix the problem.

Why It Is Possible To Feel Worse Following A Massage Session

Massage is like exercise, following application there is an induced demand of blood to your muscles, which in turn, carry nutrients to the tissues in demand and removes toxins from the blood. This process can temporarily increase inflammation (the healing response) to areas that the body feels need attention. This inflammation can bring discomfort.

Another reason, is delayed onset muscle soreness (DOMS) through the stimulation of muscles, that are not used to being activated. This effect is seen mostly in those with postural/spinal imbalances and particularly those muscles that are being overused.

If you are concerned about any discomfort or soreness after a treatment session, it is important to speak with your osteopath or massage therapist. They can assess your symptoms and provide advice on how to manage them.

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