3 Stages of Healing a Back Injury

Healing after neck and back injury progresses through stages, and each stage has its own characteristics. Different things are happening at the injury site in each unique phase; this means that your recommended exercises and activity level will vary depending on how long it's been since you've injured yourself.

Woman holding the back of her neck in pain
Cecilie_Arcurs / Getty Images

The good news is there are only 3 stages you really need to know about when you are healing from a neck or back injury.

The Acute Stage

Also called the inflammatory stage, the acute stage occurs at the time of the injury, and can continue for up to 72 hours. During the acute stage, symptoms of inflammation—which include redness, swelling, pain at rest, and diminished function—will likely occur.

The inflammation and pain during this first phase are caused by the body's repair chemicals that are released into the area in response to tissue damage. This biological reaction is meant to decrease mobility so the area that's injured can rest and heal. But the chemicals that promote healing also cause pain and promote swelling.

Scar tissue also begins to form during the inflammatory stage. During the acute stage, rest and gentle movement, along with physical therapy and anti-inflammatory drugs are generally recommended.

The Sub-Acute Stage

The sub-acute phase is marked by the new growth of connective tissue and capillaries (to help repair damaged structures) and decreased inflammation.Scar tissue continues to grow during this time, as well.

In this stage, your tissues are still very fragile, so placing stress on the injured area should be limited to times when your therapist or doctor is examining or working with you.

Most physical therapists recommend that you begin with gentle movement during the sub-acute phase — with the intent of gradually building up the intensity of exercise. Mild isometric exercise might be appropriate. Because activity is restricted at this point, your muscles may seem weak. You will start off with focused, low-intensity exercises.

Depending on the type of tissue that was injured (i.e., tendons vs muscles, where tendons have less blood supply and, therefore, will likely heal more slowly), it usually lasts between 72 hours to six weeks.

The Chronic Stage

During the chronic stage of healing from a neck or back injury, the inflammation goes away entirely. The new collagen fibers strengthen, and the wound becomes smaller.During this stage, pain that's associated with the injury tends to be limited to the end reaches of the joint's range of motion.

The first 10 weeks of the chronic phase are prime for doing exercises that help remodel the fibers so they will eventually function as close as possible to the way they did before you were injured.(This prime time may also include a bit of the later part of the sub-acute phase.)

Why should you care about doing exercises during this special 10 week period? Because otherwise, you may permanently lose some of your ability to move and function in your daily life. 

After about 10 weeks, the scar tissue can permanently change so that re-acquiring strength and flexibility may necessitate surgery or manual release treatment from a physical therapist.

But doing exercises as prescribed by your therapist during this vital 10 week period enhances your healing —making it happen sooner and more thoroughly.

During this time, the scar tissue can be remodeled with exercise. This means that the activities and motions that the injured area is taken through will affect the formation of new tissue fibers. That is why getting exercise instruction from a physical therapist is crucial for healing. 

An adjunct treatment that may also help during these phases is massage therapy.

But the chronic stage of healing, which begins after 21 days, doesn't end after that 10-week prime time. Actually, it may continue for quite some time. And even after these important 10 weeks have passed, maintaining your exercises will continue to make you stronger and more flexible, as well more functional and pain-free.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.