03/10/2026
Ever felt sore or “off” after a massage? This is a good explanation! Long. But worth the read.
Healing crisis, or time for a better explanation? 🤔
‘Healing crisis’ is one of those phrases that sounds wise until you stop and ask what it actually means.
Historically, pain was not always seen as something to ease. In older models of care, pain and irritation were sometimes taken as signs that illness was active and that the body was responding. Some practitioners even provoked painful reactions because they believed that a stronger reaction meant a stronger healing process. 🕰️
That old thinking still echoes in parts of complementary therapy. ‘Healing crisis’ is often used to explain why someone feels worse after treatment, especially later that day or the next morning. The idea is that the body is ‘processing’, ‘releasing’, ‘detoxing’, or somehow getting worse before it gets better. In some traditions, a temporary aggravation is even treated as proof that the treatment is working.
The problem is that the phrase carries baggage. It suggests that something was wrong, blocked, broken, dysfunctional, or in need of being fixed, and that the worsening somehow proves the therapist has found the problem. That is a big leap, and in many cases it is simply not justified.
Current evidence does not support that explanation. If a client feels worse after treatment, the answer is not to dress it up as healing. The answer is to understand it properly.
So what might actually be happening when someone feels stiff, sore, or more painful the day after a treatment that did not hurt at the time? 🧠
Usually, the simplest explanation is the best one. The treatment may have been a bit too much for that person, on that day, in that area, at that dose. Pressure, duration, stretching, repeated contact, and time spent on a sensitive spot can all lead to a short lived post treatment response. Research on manual therapy and massage shows that soreness, stiffness, tiredness, and increased pain are common mild reactions, often showing up within 24 hours and usually settling within 24 to 72 hours.
That is not a ‘healing crisis’. It is a response to treatment.
Pain science also helps here. Pain is not a simple readout from tissue. It is a personal experience shaped by the body, the brain, the situation, previous experience, stress, sleep, and expectation. So someone can feel fine during a massage, especially in a calm room where they feel safe and supported, then feel more sore later when the system reassesses the input. Add in existing sensitivity, worry, poor sleep, or the normal ups and downs of symptoms, and the next day response starts to make much more sense.
This also matters for therapists. A mild next day reaction does not automatically mean the therapist has done anything wrong. But it does mean something important has been learnt. The client is telling you the treatment was not as well tolerated as hoped, and that needs reflection, not spin. 👂
It is also not enough to protect yourself by casually saying, ‘You might feel a bit sore tomorrow’, then applying whatever pressure or technique you like and using next day pain as a convenient excuse. That is not thoughtful practice, and it is not good consent. ⛔️A warning does not make an excessive, poorly matched, or badly judged treatment appropriate.
Therapists cannot simply apply any technique with too much confidence, then hide behind the idea that soreness proves it was effective.
The real question is whether the treatment was suitable, well judged, and responsive to the person in front of you.
Was the pressure too much? Was the area already irritable? Did the client feel able to give feedback during the session? Were expectations discussed clearly and honestly? Does the next treatment need to be lighter, shorter, slower, or more tailored to that person’s current state?
That is the issue. Not blame, not mythology, but clinical reflection.
If a client reports more pain the next day, the therapist should listen, document it, explain it honestly, and adjust the plan. If the reaction is strong, unusual, or lasts beyond a couple of days, it needs proper reassessment rather than being brushed off as a positive sign. ✅
Changing the language changes the practice. ‘Healing crisis’ makes worsening sound meaningful by default. ‘Post treatment response’ asks us to pay attention, adjust the dose, and take the client’s experience seriously.
Less mythology, more honesty. Better for clients, better for therapists, better for the profession.
