In the evolving world of pain management, one debate continues to spark attention: the role of passive therapies in the treatment of persistent or chronic pain. For decades, treatments such as massage, acupuncture, TENS (transcutaneous electrical nerve stimulation), ultrasound, and hot/cold therapy have been staples in pain clinics and rehabilitation programs. But are they effective long-term solutions?
Jordan Sudberg, a renowned pain management specialist and advocate for patient-centered care, believes that while passive therapies have their place, their role must be thoughtfully integrated into a larger, more active treatment strategy. With a deep background in physical medicine and rehabilitation, Dr. Sudberg has helped thousands of patients navigate chronic pain and regain quality of life — not by relying solely on quick fixes, but through comprehensive, evidence-based approaches.
In this article, we’ll explore what passive therapies are, how they fit into persistent pain treatment, and why Jordan Sudberg believes they must be used with caution, purpose, and balance.
Understanding Passive Therapies
Passive therapies are treatments applied to a patient without requiring active participation. This includes:
- Massage therapy
- Heat or ice application
- Acupuncture
- Electrotherapy (TENS, EMS)
- Ultrasound therapy
- Spinal manipulation
- Dry needling
These methods are often appreciated by patients because they provide temporary relief and are non-invasive. However, as Dr. Sudberg emphasizes, relief does not necessarily mean resolution.
“Passive therapies can reduce symptoms, but they don’t typically address the underlying causes of persistent pain,” says Jordan Sudberg. “They’re tools — not cures.”
Why Passive Therapies Appeal to Chronic Pain Patients
People living with persistent pain often seek relief wherever they can find it. The immediate sensation of comfort after a massage or the soothing effects of heat therapy can be profound, especially when pain has been unrelenting for months or years.
According to Dr. Sudberg, it’s natural for patients to gravitate toward therapies that don’t require exertion — particularly when movement is painful. However, he cautions that over-reliance on passive modalities can lead to a cycle of dependency without true improvement.
“It’s easy to confuse short-term relief with long-term recovery,” Sudberg notes. “But pain management isn’t just about feeling better — it’s about getting better.”
What the Research Says
Research over the past decade has begun to challenge the effectiveness of passive therapies as stand-alone treatments for chronic pain. Studies have found:
- Massage therapy may offer short-term pain reduction but shows limited long-term benefit unless combined with exercise.
- TENS and ultrasound lack consistent evidence in managing chronic low back pain.
- Acupuncture, while effective for some conditions, varies widely in outcomes depending on patient expectations and practitioner skill.
- Heat and ice are effective for acute injuries but may not offer meaningful benefit in long-standing pain conditions.
Jordan Sudberg acknowledges that while science hasn’t written off passive therapies, context is everything.
“The best results occur when passive modalities are paired with active rehabilitation and education,” he explains. “Pain is complex — we need multi-dimensional solutions.”
The Real Risk: Patient Passivity
Perhaps the greatest drawback of overusing passive therapies is the message it sends: someone or something else will fix your pain.
Dr. Sudberg warns that this can lead to passive coping behaviors, where the patient becomes disengaged from their own recovery process.
“We see patients who bounce from one modality to another — acupuncture on Monday, massage on Wednesday, chiropractor on Friday — without making real progress,” he says. “They’re exhausted, frustrated, and still in pain.”
In Sudberg’s practice, a key goal is to shift patients from passive recipients to active participants in their own care. That often begins with education — helping patients understand the nature of chronic pain, the role of the nervous system, and the power of movement and mindset.
When Passive Therapies Are Helpful
Despite their limitations, Jordan Sudberg isn’t anti-passive therapy. Rather, he believes they serve a strategic purpose when used wisely:
1. As an Entry Point
For patients in severe pain who are fearful of movement, passive therapies can offer a gentle starting point.
“If a massage helps someone trust their body again, that’s a win,” Sudberg says. “But we use it as a bridge to more active treatment.”
2. For Acute Flare-Ups
During pain flare-ups, modalities like heat, ice, or electrotherapy can reduce symptoms enough to keep the patient engaged in exercise or therapy.
3. To Complement Active Rehab
When paired with functional training, passive therapies can support tissue recovery, improve circulation, and reduce muscle guarding.
“It’s not either/or,” Sudberg reminds. “It’s about sequencing and balance.”
Active Therapies: The Foundation of Recovery
In contrast to passive therapies, active therapies require the patient to participate — physically, mentally, or both. These include:
- Targeted exercise therapy
- Stretching and mobility routines
- Postural correction and ergonomic training
- Cognitive-behavioral therapy (CBT) for pain
- Education on pacing, sleep, and nutrition
According to Dr. Sudberg, these active interventions are the cornerstone of long-term success in persistent pain treatment.
“Movement is medicine. We now know that even in conditions like fibromyalgia or chronic low back pain, graded movement can retrain the nervous system, rebuild confidence, and reduce pain intensity.”
His clinics focus heavily on active rehab programs designed to recondition the body and recalibrate the brain’s perception of pain.
Creating an Integrated Treatment Plan
For chronic pain sufferers, the most effective path forward is personalized and integrative. Jordan Sudberg advocates for a treatment model that blends the best of both worlds — leveraging passive therapies to support active rehabilitation, never to replace it.
Key elements of an integrated plan include:
- A thorough assessment of physical, emotional, and behavioral contributors to pain
- A structured exercise and mobility plan
- Judicious use of manual therapy or modalities for symptom relief
- Patient education to foster self-efficacy
- Ongoing progress monitoring and goal setting
“When patients understand that they have a role in their recovery — and are supported by a team who respects that — outcomes improve dramatically,” says Sudberg.
Final Thoughts: Relief vs. Recovery
Passive therapies can play a meaningful role in pain relief — but relief and recovery are not the same. As Jordan Sudberg has shown throughout his career, sustainable pain management requires empowering patients, embracing movement, and thinking long-term.
“There’s nothing wrong with feeling better today,” Sudberg concludes. “But our real job is to help patients build a life where they’re not chasing relief — they’re living in recovery.”