How to Re-Treat Patients with Recurrent Rehabilitative Issues

16th Mar 2017

Posted by Sara Zuboff on

How to Re-Treat Patients with Recurrent Rehabilitative Issues

If someone has an injury, the rehabilitation process is designed to treat the existing injury with the necessary education to avoid or prevent a recurrence. A lot of times this can be successful, but with some cases like those with carpal tunnel, a patient may need to have more than one round of physical therapy to reduce symptoms and return to pain-free function.

Physical Therapy for Patients With Recurrent Pain and Rehabilitative Issues

So, what of these second and sometimes third round patients? Sometimes, it means that surgery is recommended, like for those cases from our carpal tunnel example, but sometimes it means that changes to their physical therapy regimen with subsequent recurrences can all work towards the end goal of being able to participate in daily activities pain-free.

For example, someone who has chronic low-back pain may require more than one round of physical therapy treatment. As a matter of fact, 25% of patients of suffer from low back pain once will have it again(Source). Surgery is often recommended for these patients, however, low back surgeries like spinal fusion surgeries are only successful in reducing low back pain in 60% of patients. This leaves a significant amount of patients that undergoes back surgery and still experiences a recurrence of pain.

How to Treat Recurrent Pain & Injuries

  • Stay positive: Recurrent pain and injuries can feel like a failure to both patients and practitioners, but the truth is recurrence is a possibility with most injuries. And according to research, a physical therapist’s attitude or positivity directly effects whether a rehabilitative program will be successful(source). 
  • Try New Things: When a patient comes back with recurrent pain, it is an opportunity to think outside the box with rehabilitative care. Modalities are a great way to try new things when it comes to reducing pain and swelling. For example, LED light therapy is a great therapy to use when treating recurrent pain and can be used for myriad issues like: low back pain, carpal tunnel and cervical radiculopathy.
  • Consider Home Therapies: Recurrent pain and or/swelling can limit a patient’s willingness to participate in their home exercise regimens and advised lifestyle changes. Home therapy units like Transcutaneous electrical nerve stimulation (TENS) devices or cold compression therapy machines give patients access to pain and swelling reducing modalities in the comfort of their own home.
  • Try Combinations: Patient issues require combinations of techniques and modalities to treat them effectively. For example, a rheumatoid arthritis patient who has undergone an elbow replacement needs to work on strengthening after their procedure, but may have residual surgical or a flare-up of arthritis pain. Modalities like low-level laser therapy are beneficial to use to reduce any elbow pain before incorporating movement therapy using a Continuous Passive Motion device(source). 

Recurrences of injuries aren’t the desired results after someone has graduated from their rehabilitation program, however healing from injuries can be complex. When a patient returns to rehab it’s important to approach each case with fresh eyes and ideas. The end goal of returning patients to pain-free function in their daily activities is the same, it may just take some patience and innovation to make that happen. 

For more information about popular physical therapy techniquees and modalities, visit our blog at