How often should you see your Physiotherapist?

Some traditional beliefs about physiotherapy are no longer valid in 2025. Patient education is now central to treatment. It helps reshape beliefs, adjust attitudes, and prevent the drift from acute pain into chronicity. Physiotherapy today is not about endless appointments; it is about targeted, evidence-based care tailored to the stage of your condition.

Acute pathology and the risk of chronic pain

When treating an acute condition, the primary goal is to reduce pain on a 0–10 scale. This reduction desensitizes both the peripheral nervous system (the nerves around the injured structure) and the central nervous system (the brain’s interpretation of pain).

Often, an acute problem can be resolved in just one or two sessions, allowing the patient to be pain-free and avoiding chronicity. The difficulty arises when pain persists for weeks. After about 12 weeks, pain can enter a nociplastic phase, where the brain itself amplifies pain signals. At this point, the original tissue is usually healed, yet the nervous system continues to send pain messages unnecessarily.

Fractures and immobilization

For fractures or severe sprains, immobilization is often required. A strict cast may be necessary for a fracture, but for sprains, immobilization today is shorter or relative (allowing some controlled movement). This change reflects modern evidence showing that movement helps recovery.

The acute immobilization phase often lasts up to six weeks. Afterward, the secondary effects of immobilization become visible very quickly: joint stiffness, loss of flexibility, and muscle wasting. Research shows muscle mass under a cast can decrease by about 1% per day. In these cases, more than ten physiotherapy sessions may be required to restore mobility, flexibility, and muscle strength.

Loss of Muscle Mass

When immobilization has caused muscle wasting, rehabilitation focuses on restoring joint function. This includes regaining strength, mobility, and range of motion through progressive and targeted exercises. Recovery is not limited to the acute stage but continues until full function is restored.

Atypical, chronic, and degenerative pathologies

Some conditions require regular or lifelong physiotherapy. Rheumatologic diseases, such as rheumatoid arthritis, are good examples. Patients may not need three sessions a week forever, but consistent manual therapy and exercise are essential to maintaining quality of life.

Unfortunately, physiotherapy is still underestimated by parts of the medical system. Too often, physiotherapy is reduced to “just massages,” while in reality conservative approaches—mobilization, strengthening, exercise therapy—are supported by strong scientific evidence and can be as effective as, or superior to, surgery.

For example, arthroscopic meniscus surgery without detachment has been shown to provide no more benefit than placebo. Yet surgery is often promoted, while conservative physiotherapy options are overlooked.

Is pain mechanical?

For decades, the mechanical model of pain dominated medicine. It assumed that degeneration seen on imaging—such as wear of a joint—directly caused pain. Today, science shows this view is incomplete. Pain messengers from the joint are only one piece of the puzzle. The interpretation of these signals is greatly amplified or modulated in the brain.

This can be frustrating for patients. When I explain that pain is primarily processed in the brain, some struggle to accept it. But brain connections, beliefs, and perceptions play a huge role. For example, if you believe that an MRI showing “degeneration” of your spine means your pain will inevitably worsen with age, that belief alone can heighten sensitivity and prolong pain.

Scientific evidence now proves the opposite in many cases. I once treated a patient who had avoided running for years after a disc herniation. Through education, he learned that running actually reinforces the disc structure and that there was no risk years after his initial injury. His fear had held him back—not the injury itself.

These misperceptions highlight the importance of diagnosis and prognosis. Most patients who come to me have never received either. Yet both are essential for recovery. Understanding the condition, its likely course, and the real evidence behind it helps patients break free from fear and regain movement.

Conclusion

The number of physiotherapy sessions you need depends entirely on your condition and your individual response. What matters most is working with your physiotherapist to set clear goals, regularly assessing pain on a 0–10 scale, and moving toward zero pain both at the joint and at the brain level.

I am Yannick Sarton, Physiotherapist (MSc.), specialized in evidence-based rehabilitation. If you have questions about your condition, do not hesitate to reach out. Together, we can plan the right path for your recovery.

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