When a patient has an uncomfortable experience following treatment this is commonly referred to as a healing reaction or in some rare cases, a healing crisis.
The may not necessarily be an aggravation!
Whilst aggravations do happen from time to time, it is usually clear from either the patient or practitioners perspective that something is not right.
The healing reaction, on the other hand, is the normal physiological response to the healing process.
According to the research, an upper neck manual chiropractic adjustment may create mild discomfort which usually ameliorates within 24 hours. It is rare for this to be severe. 
Healing reactions considered adverse may occur with Myotherapy and Massage therapy however, these are also very rare. 
In my experience, whilst a healing reaction maybe adverse it’s not necessarily a bad thing. For example, a detox diet may be uncomfortable in the early stages as toxins are mobilized into the bloodstream etc. however, this is a necessary part of the healing process.
And just as pain perception varies between individuals so does the healing experience.
In the case of physical therapies, if a patient/client is presenting for example, for Myotherapy or Chiropractic care after a long break or for the first time, their pain may not be a true indication of everything’s that’s going on, the ‘Tip of the iceberg’ theory. Treatment may inadvertently lift the lid and push the client into a healing reaction.
Healing reaction symptoms may include nausea, light-headedness, headache, an increase in pain, different pain, altered sensation, etc. whereas an aggravation may mean significantly worsened pain in the region of their initial complaint or a brand new focal area of pain which can be directly related to the treatment.
An experienced practitioner in my view is able to navigate the new or returning patient, seeing the warning signs early and thereby, minimizing the healing response.
I have learnt to look for signs which may indicate the client is shifting into a healing reaction. I can then adapt my techniques accordingly.
Very, very rarely the client experiences a healing crisis. This may mean an epileptic seizure with no prior history; syncope or fainting with little or no history or a significant increase in pain. As mentioned, this scenario can be avoided with careful history taking and examination.
In conclusion, even the most skilled and experienced practitioner may initiate a healing reaction however, with care the degree of response can be managed.
- Erikson K, RochesterP.,Hurwitz, E.L., Symptomatic reactions, clinical outcomes and patient satisfaction associated with upper cervical chiropractic care: A prospective, multicenter, cohort study. BMC Musculoskeletal Disorders201112:219; ©Eriksen et al; licensee BioMed Central Ltd. 2011.
- Ping Yin, Ningyang Gao, Junyi Wu, Gerhard Litscher, Shifen Xu; Adverse Events of Massage Therapy in Pain-Related Conditions: A Systematic Review; Evidence-Based Complementary and Alternative Medicine. Volume 2014, Article ID 480956.
About the Author:
Dr Andrew Arnold is a Chiropractor at Cranbourne Family Chiropractic and Wellness Ctr.