Manage acute pain correctly to avoid chronic pain!

Management acute injury - Physio Phnom Penh

The problem start

Many people come to me months after their injury, still in pain. When I ask about the first few days, the story is always the same: they didn’t know what to do. Some went back to sport too quickly. Others used massage or ice the wrong way. These choices matter. The first hours and days after an injury are not just about pain—they are about healing. And when the early phase is mismanaged, recovery becomes longer, more difficult, and often incomplete.

Inflammation is your friend

After a trauma—like a fall, a twist, or a sudden shock—your body reacts instantly. You might see swelling, redness, or bruising. That’s not a sign of failure. That’s your body doing its job. The inflammation process brings blood and healing molecules to the injured area. These molecules come from your liver and help the body start repairing itself. The pain you feel is often linked to this process, not to a mechanical problem. Inflammation is not your enemy—it’s part of the healing.

Massage and sport? Not yet.

One common mistake is getting a massage in the first 48 to 72 hours. That phase is delicate. Applying pressure too early can interrupt the natural healing response. It may feel good temporarily, but it slows the process and increases the risk of lingering symptoms.

Another mistake is trying to stay active or go back to sport too soon. It’s important to move eventually, but right after the injury, you need to let the body settle. Stressing the joint or muscle too early can aggravate the damage and delay healing. What your body needs in those first days is calm and support, not effort.

Should you ice it?

For years, we’ve been told to put ice on every injury. But recent research has shown that too much ice, especially in the early stage, may actually delay healing. It can slow down the delivery of essential blood cells and block the natural inflammatory signals needed to begin repair. Pain relief from ice might be real—but if it blocks the healing process, it can make things worse in the long run. Inflammation, when it happens in the right dose and at the right time, helps you recover.

The healing timeline

After the first week, your body enters what we call the sub-acute phase. This is the moment when tissues—muscles, ligaments, joints—start to rebuild. During this period, you should not return to high-impact or intense training. But you also shouldn’t do nothing. Gentle stretching, light resistance, and simple mobility exercises help maintain function and prevent stiffness. It’s a balance: protect the injury but keep the body moving.

At around six weeks, the healing reaches the remodeling phase. The inflammation is gone, and the structures are no longer fragile. This is the time to start rebuilding strength. Your tissues adapt to the mechanical stress you give them, which is why progressive strengthening is key. The risk of damaging the structure again is low if you increase intensity slowly and intelligently.

What if pain lasts?

Pain after 12 weeks is called chronic pain. But that doesn’t mean your injury is still there, or that you’ll live with pain forever. It just means the pain has lasted longer than expected. Often, the tissue is already healed, but the nervous system stays on high alert. This is called sensitization—your body overreacts to small signals.

The good news? Even if your pain has lasted months, you can still become completely pain-free. With the right rehab, movement, and guidance, your nervous system can calm down, and your body can get back to normal. Chronic doesn’t mean permanent—it just means it’s time to manage things differently.

Don’t manage it alone

Too many people try to treat their injuries with old advice or guesswork. But musculoskeletal pain is complex, and the way your body heals depends on timing, movement, and understanding. As a physiotherapist, I help you navigate each phase of recovery, from day one to full return. If you’re dealing with an injury—or stuck in pain that never fully went away—it’s not too late. Get help early, or even late. What you do next still matters.