The Rate of Recovery depends on several factors. Acute problems resolve with minimal therapy. Sprains, contusions and strains respond rapidly to acupuncture, which not only provides quick pain-relief but decreases warmth and swelling, increases mobility, and shortens the period of recovery. Chronic problems take longer to resolve and those associated with degenerative changes may not resolve completely. Some alleviation of pain and improvement in function is however usually achieved despite the underlying degeneration. The severity of symptoms directly relates to resistance to therapy; the more intense symptoms are the most resistant to therapy.

Exercise, a key component of the management of musculo-skeletal problems, facilitates recovery but has to be graded to suit the needs of each person. Both exercise and physical activity are best self-regulated. Under-activity is associated with decalcification of bone, muscle-wasting, weakening of tendons and ligaments, destabilisation of joints and with a range of atrophic (wasting) changes which retard recovery. Conversely, over-activity places patients in the trauma zone where damage, as evidenced by pain to the affected part, will also delay recovery. There is a range of activity between the two extremes. This therapeutic range may be narrow e.g. activity may be restricted to 3-4 minutes at minimal load. Pain with activity or exercise denotes trauma and defines the boundary between the therapeutic range and the trauma zone.

Pain may be apparent during exercise. This is due to overload and calls for a reduction in load, effort or range of movement. Pain may also occur after a particular activity. This is likely to be an endurance problem and may be rectified by a decrease in the duration of that activity. Limitation in exercise capacity can be overcome by exercising gently in short stretches and repeating these sessions frequently. A person with back pain may have difficulty walking more than three minutes at a time. He can be encouraged to walk three minutes every half hour, always ensuring that pain is not accentuated by his exercise. If performed daily, a total of 45 minutes exercise can be achieved at the end of the day. This equates to approximately five hours a week, a level of exercise which will ensure progressive recovery.

When symptoms are severe, a self-exercise program based on frequent, brief, graded exercise at home is often more effective than prolonged, focussed, structured exercise sessions two or three times weekly. When symptoms are severe and the therapeutic zone for exercise is narrow, an exercise routine lasting an hour will place the person in the trauma zone and aggravate the problem. These people will complain of pain and worsening of symptoms during or after the exercise session. Continuation of such a routine will often lead to progressive deterioration of symptoms. Avoidance of trauma and pain is crucial to recovery. Only the patient can determine the level of activity or exercise s/he can tolerate, and inducing pain with exercise will retard recovery.