Why isn't my physical therapy working?

If you're asking yourself this question, you're not alone. Many people do physical therapy for weeks without seeing any real progress—and end up believing that "nothing can help them."

The truth? Often, the problem isn't you. It's the quality of care. The research is clear: quality physical therapy can speed up your recovery, while inadequate care can leave you with persistent pain.

Here are 8 signs that will help you recognize whether you are receiving quality care—or whether it's time to look elsewhere.

The 8 signs of quality physical therapy

1. You have the physiotherapist's undivided attention.

The physical therapist should spend the entire appointment time with you. You should not be treated at the same time as other patients. You deserve the professional's full attention during your appointment.

2. You have personalized exercises to do at home.

Therapeutic exercises are among the best tools for healing. No matter what your injury, you should have exercises to do at home. Your physical therapist should have taken the time to show you these exercises, do them with you to correct your form if necessary, and explain why and how they will help you.

3. You understand your diagnosis and the cause of your problem.

Your physical therapist should have given you a clear and understandable diagnosis. This diagnosis should make sense to you. If you don't understand what is happening in your body, it is difficult to actively participate in your recovery.

4. You know what to do when you are in pain

The physical therapist should have given you tips and advice on how to regain control of the pain. Ideally, the strategies should go beyond simply taking medication, applying heat, or using ice.

5. No electrotherapy as the primary treatment

During your appointments, you should not be connected to electrotherapy devices (ultrasound, TENS). These machines are not recommended for the vast majority of injuries, as there is no evidence to support their effectiveness. If the essence of your treatment is to receive this type of intervention, you are probably not in the right place.

6. You have a personalized treatment plan

Your physical therapist should have explained the game plan that will be used to heal your injury. You should feel that this plan has been tailored to your condition, taking into account your expectations, your reality, and your preferences.

7. Psychosocial factors were discussed.

We know that it can sometimes be difficult to discuss stress, anxiety, and fears with your physical therapist. However, if your physical therapist brings up these topics with you, it means that they truly care about your progress. Fear of movement, anxiety related to your injury, workplace injustices, and stress are examples of factors that can severely limit your recovery and need to be addressed.

8. Your treatment is not exclusively passive

Your care should not be limited to receiving manual interventions (manipulations) from the physical therapist. You should have received education about your condition, advice, and exercises. You are the main actor in your recovery—the physical therapist is there to guide you.

Give yourself a second chance

If you've had a bad experience with physical therapy in the past—perhaps it didn't work, you didn't feel listened to, or you didn't see any progress—don't let that experience close the door forever.

Give yourself a second chance with someone who has optimal practice. The difference between quality physical therapy and inadequate care can be immense. Many patients who thought that "nothing could help them" finally found solutions with the right professional.

Sources

• Lin I, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines. British Journal of Sports Medicine. 2020
• Foster NE, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018