Why Symptom-Focused Treatment Often Falls Short

When people seek help for pain, the most immediate concern is often symptom relief. And while this is completely understandable — especially during a flare-up — treating only the painful area can sometimes overlook the broader context.

Short-term relief does not always equate to long-term resolution. To create lasting change, it's important to ask not only what hurts, but why.

Short-term relief does not always equate to long-term resolution

The Limits of Symptom Management

It’s common to be prescribed stretches, exercises, or hands-on treatment aimed directly at the site of pain:

• Knee pain? Stretch your quads.

• Shoulder discomfort? Try some banded rotator cuff exercises.

• Back pain? Manual therapy and rest.

  
  

These interventions can certainly help — temporarily. But pain often returns once activity resumes, sometimes with increased sensitivity or reduced confidence in movement. This approach is reactive, not preventative. It may improve symptoms in the short term, but does little to change the system that created the problem in the first place.

The Importance of Root-Cause Assessment

Pain is complex, and rarely isolated to a single joint or muscle. Modern clinical reasoning and osteopathic practice both emphasise the concept of regional interdependence — the idea that one area of the body can influence, or be influenced by, another. Common examples include:

• Knee pain that stems from poor hip control or ankle mobility

• Shoulder pain related to thoracic stiffness or scapular dyskinesis

• Sciatica-like symptoms originating from load intolerance in the lumbar spine, rather than local nerve entrapment

• Recurring flare-ups due to movement habits, underloading, or unresolved compensatory patterns

  
  

This systems-based perspective is central to osteopathic thinking:

Structure and function are reciprocally interrelated. The body functions as a connected whole — and effective treatment should reflect that.

Why the Flare-Up Cycle Persists

Many people find themselves returning for treatment every few months when symptoms recur. Although short-term interventions such as manual therapy or pain-relieving exercises may reduce discomfort, they rarely resolve the underlying issue if the root cause is not identified and addressed. If the same pain continues to reappear, it’s often a sign that movement capacity, strength, or load tolerance hasn't changed. In these cases, symptom management alone can create dependency — without building resilience.

If the same pain continues to reappear, it’s often a sign that movement capacity, strength, or load tolerance hasn't changed.

Symptom Relief vs. Systems Change

Pain can be influenced by multiple factors beyond tissue damage. These include:

• Load and recovery balance

• Sleep quality, stress, and systemic inflammation

• Previous injuries and learned movement patterns

• Movement variability, strength, and endurance

  
  

While symptom relief is important — and sometimes necessary to facilitate movement — long-term outcomes are improved when care shifts toward restoring function, correcting movement patterns, and increasing capacity (O’Sullivan et al., 2018).

A Systems-Based Clinical Approach

An integrated model of care typically includes:

• Comprehensive assessment – evaluating movement quality, joint control, and global patterns

• Movement retraining – improving coordination, variability, and efficiency

• Strength-based rehabilitation – building tissue capacity and resilience under load

• Education and self-management – helping individuals understand their condition and feel confident in managing it

  
  

This type of intervention focuses not just on where the pain is located, but on how the entire system is functioning.

Summary

• Pain is rarely the result of a single, isolated issue

• Local treatment may offer temporary relief but doesn’t always address root causes

• A systems-based approach considers how strength, mobility, coordination, and habits contribute to symptoms

• Long-term recovery often requires a shift from passive management to active restoration of function

• Addressing the full picture reduces recurrence and supports independence

References

O’Sullivan, P., Caneiro, J. P., O’Keeffe, M. and O’Sullivan, K. (2018) ‘Unravelling the complexity of low back pain’, British Journal of Sports Medicine, 54(12), pp. 698–699. Available at: https://doi.org/10.1136/bjsports-2019-101033