Chronic pain – how long is the road?

Physiotherapy Phnom Penh blog article about chronic pain

Many patients ask me on their first visit: “How long will it take to treat my condition?”

The duration of treatment depends on several key factors, which we will explore in this article.

The length of your condition defines your prognosis

I’m often surprised when patients come in with a long history of chronic pain—back pain, neck stiffness, joint locking, the aftermath of an untreated fracture, or an immobile joint for years—and expect to be cured in just one or two sessions.

If you come to me with three years of functional limitations, it will take time. Your body will need joint mobilization, stretching, muscle strengthening, and sometimes a full re-learning of basic movements like walking. Don’t expect to be healed in one visit.

You can always turn to pseudoscientific therapies if you’re looking for instant promises—they’re great at selling their miracle techniques, despite having no scientific foundation or proven results.

But the first step is to stay realistic.

Acute pain vs. chronic pain

Acute pain is defined as pain lasting less than 12 weeks. Chronic pain is pain lasting more than 12 weeks. This classification is first and foremost a medical label.

Chronic doesn’t mean lifelong. But it does mean your pain is now processed in the brain differently—and research shows this clearly.

When acute pain goes untreated, the brain can overreact, creating a persistent pain experience, even if the original tissue is fully healed. This is how pain becomes chronic—not because the body is still injured, but because the nervous system continues to generate pain signals.

What slows down recovery from joint pain?

If you don’t have full joint range of motion,

If you’ve lost flexibility and your joint is stiff,

If your muscles are too weak to support the affected area,

And if no treatment has been done for months—or even years—

Then it’s no surprise your mechanical recovery is stuck.

You need time, commitment, and a structured approach.

What can be done? How should we proceed?

There are two key aspects to address:

1. Mechanical recovery:

Your joint must regain normal, healthy movement. That’s our first goal in physiotherapy.

2. Central sensitization:

Pain that persists often comes from the brain, not the joint.

The way you perceive your condition, what you believe about your pain, and how you react to it, can all fuel your symptoms.

Let’s take a common example: someone had a disc herniation years ago.

They’re still in chronic low back pain and believe the herniated disc is still the cause. But that’s simply wrong.

The disc healed long ago.

The inflammation resolved after a few weeks.

All that remains is a healed disc with a small scar—nothing more.

Its function is barely altered.

Often, people confuse correlation with causation.

You can have an X-ray that shows disc degeneration and still have pain coming from another source. The degeneration is visible, but the pain may come from something entirely different.

This is where physiotherapy steps in—not just to restore mechanics, but to rebuild understanding, reduce fear, and guide you with evidence-based education on pain.

Conclusion:

Joint pain is managed by physiotherapists—university-trained professionals, specialists in musculoskeletal disorders, and practitioners of evidence-based medicine.

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