1. Introduction / Plain Theory

Acute pain is the body’s natural warning system — a protective response to tissue irritation, injury, or inflammation.
It typically develops suddenly and serves an important purpose: to alert us to potential harm and encourage rest or protection of the affected area.

Acute pain is usually linked to a clear cause, such as:

• Muscle strain or joint sprain

• Postural overload or sudden movement

• Minor trauma or inflammation

• Post-surgical or postpartum recovery

• Referred pain from visceral or nerve irritation

In most cases, acute pain resolves as the body heals, typically within days to weeks.
However, if protective tension or movement avoidance persists, pain may become prolonged — evolving toward chronic pain even after tissues have healed.

2. Typical Symptoms and Functional Impact

• Sudden localised pain or tenderness.

• Muscle spasm or protective stiffness.

• Swelling, redness, or heat in the affected region (inflammatory response).

• Limited range of motion or guarded posture.

• Sensitivity to touch or movement.

Functional impact:
Acute pain can interfere with daily activity, sleep, and concentration.
In some cases, excessive guarding may slow recovery by limiting movement and circulation.
Gentle, early movement and appropriate manual care can help restore confidence and mobility.

Red flags:
Severe trauma, neurological symptoms (weakness, numbness), fever, or unrelenting night pain should be assessed by a medical professional before manual therapy.

3. Contributing Factors / Underlying Causes

Acute pain results from tissue injury and the subsequent inflammatory response — a necessary step in the healing process.
However, several factors can influence its intensity and duration:

• Mechanical overload: sudden strain, repetitive stress, or poor posture.

• Inflammation: natural but sometimes excessive local immune response.

• Protective muscle spasm: body’s attempt to stabilise the injured region.

• Stress and autonomic activation: can heighten pain perception.

• Pre-existing restrictions: may alter load distribution and delay recovery.

Osteopaths understand acute pain as both a biological and behavioural response — integrating structural, circulatory, and neurological perspectives to support safe healing.

4. Osteopathic Approach

Osteopathic care for acute pain focuses on supporting the body’s healing mechanisms, relieving local tension, and preventing secondary compensations.
Treatment is always adapted to the stage of inflammation and the individual’s overall condition.

An osteopathic assessment may include:

• Identifying the source of pain and screening for red flags.

• Gentle soft tissue and myofascial release to ease local congestion.

• Indirect or functional techniques to reduce protective spasm.

• Encouragement of pain-free mobility to prevent stiffness.

• Breathing and relaxation work to modulate sympathetic overactivity.

• Guidance on pacing, posture, and gradual return to activity.

The goal is to facilitate self-healing — enhancing circulation, reducing irritation, and restoring confidence in movement while respecting tissue recovery time.

5. Scientific Evidence & References

Evidence supports manual therapy and graded movement as effective conservative treatments for acute musculoskeletal pain.
Studies show that gentle, early intervention can help reduce pain, improve function, and shorten recovery time when integrated with patient education and reassurance.

Osteopathic techniques — particularly indirect, myofascial, and functional approaches — are shown to be safe and effective for managing acute, non-specific pain.

References

1. Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317–332. Link

2. da C Menezes Costa L, et al. Prognosis for patients with acute low back pain: systematic review. BMJ. 2012;345:e8013. Link

3. Licciardone JC, Gatchel RJ. Osteopathic manual treatment for pain management: an evidence-based update. J Pain Res. 2017;10:2467–2478. Link

4. Franke H, Fryer G, Ostelo RWJG, et al. Osteopathic manipulative treatment for acute and subacute musculoskeletal pain: systematic review and meta-analysis. Pain Physician. 2020;23(3):205–216. Link

5. Cohen SP, Hooten WM. Advances in the diagnosis and management of pain. BMJ. 2017;356:j532. Link

6. Esteves JE, Zegarra-Parodi R, Cerritelli F, et al. The role of osteopathy in the management of pain: integrative review. J Bodyw Mov Ther. 2021;27:277–287. Link

7. Urits I, Orhurhu V, Callan J, et al. Comprehensive review of pain management in acute musculoskeletal conditions. Curr Pain Headache Rep. 2022;26(2):89–103. Link

8. Xie Y, Chen Z, Yang Z, et al. Comparative efficacy and safety of manual therapy for acute musculoskeletal pain: network meta-analysis. Front Pain Res. 2024;15:1507331. Link