Passive Treatments vs. Personal Agency: What Really Drives Long-Term Pain Relief
Agency, in the context of pain and rehab, is your belief that your actions matter—that what you do can meaningfully shape your health, mobility, and life.
Put simply: agency is the ability to control the controllables.
We all live with uncertainty. Even when it comes to our health, there are factors that sit outside of our control—things like age, genetics, prior injuries, stress, and sometimes just plain bad luck.
And yet, how we respond matters deeply. Two people with the same injury can have drastically different outcomes depending on how they view their role in the process. One believes their actions influence recovery. The other doesn’t. Guess who tends to do better?
Why Pain Recovery Isn’t Linear—and Why That Matters in Rehab
Pain recovery is rarely a straight line.
You can be consistent with your rehab and still have a setback. You can do all the “right” things and still have a flare-up. That’s the nature of complex systems like the human body—progress is real, but it’s not always immediately felt.
If your behavior is tightly linked to how much pain you're in today, you’ll be tempted to constantly change course. You'll chase symptom relief. You’ll over-rely on quick fixes. You’ll question whether it’s even working.
That’s where people lose their agency—when they confuse daily pain levels with long-term success.
Thinking in Bets: A Smarter Approach to Pain and Injury Rehab
In her book Thinking in Bets, poker player and decision strategist Annie Duke explains that in games of skill and luck (like poker… and life), you can make the right decision and still lose. Or make the wrong one and still win.
So how do you know if you're on the right track?
You evaluate your process, not just your outcome.
This mindset shift is key for injury rehab. You won’t always feel better right away. But if you’re investing in behaviors that consistently improve strength, mobility, and resilience—you’re stacking the odds in your favor.
How to Build Agency in Rehab: Focus on Controlling the Controllables
Agency doesn’t mean controlling everything. It means owning what’s yours to control:
How consistently you train
How you move throughout the day
How you respond to setbacks
What narratives you believe about your body
Whether you seek passive relief or active progress
Even with variables like genetics and age in the mix, research and experience both show that people who adopt this mindset—who focus on what they can do—are more likely to return to the life they want.
Passive vs. Active Treatments: Which One Leads to Long-Term Relief?
This isn’t an attack on passive modalities like massage, dry needling, or injections. They have their place. But they often come with an unintended side effect: they reinforce dependence. The more you rely on others to fix you, the harder it is to believe you can create change.
Passive care may bring short-term relief, but long-term progress is usually the result of active participation—of showing up, putting in the work, and committing to a process even when the pain hasn't fully subsided.
Pain-Free Doesn’t Equal Progress: Why Process-Based Rehab Works
You don't need to ignore pain, but you do need to detach from it as your primary feedback loop.
If today’s discomfort is the only metric you track, you’ll miss the bigger picture. You’ll miss the quiet, powerful transformation that happens when you lift a little heavier, move with more confidence, or feel just a bit more capable navigating your day.
Pain may ebb and flow. But strength? Endurance? Resilience?
Those are the results of a process you can control.
What Actually Works for Long-Term Pain Recovery?
The most powerful strategies aren’t flashy. They’re consistent.
Long-term relief comes from:
Building physical capacity
Practicing movement with intention
Investing in strength, mobility, and endurance
Developing a mindset grounded in agency and self-efficacy
Final Thought: You Can’t Control Everything—But You Can Shift the Odds
The goal isn’t to eliminate all uncertainty. That’s impossible.
The goal is to embrace agency, to double down on the behaviors that are most likely to move you forward—even when today doesn’t feel like progress.
Because in rehab, as in life, you don’t need guarantees.
You just need to keep stacking the odds.
