For any health issue, there is usually more than one management option.
One option that is often overlooked by both patients and clinicians is not doing anything.
That does not mean ignoring serious symptoms. The important caveat is that you should be reasonably confident the issue is not sinister, which is something your clinician can help with.
But when a problem is not medically serious and is likely to improve by itself, not doing anything can be a perfectly reasonable option – especially when other treatments are not clearly better or necessary.
So, before you get a test, treatment or procedure, it can be worth asking:
‘What happens if I don’t do anything?’
Let’s use delayed onset muscle soreness (DOMS) as an example.
Most people have experienced DOMS before. It is the muscle soreness that often appears after unaccustomed or strenuous physical activity, especially exercise involving eccentric contractions, where muscles lengthen while contracting.
Muscle pain is the most obvious symptom, but DOMS can also involve tenderness, stiffness and weakness.
So, what happens if you don’t do anything?
The usual pattern is no pain immediately after exercise, followed by soreness starting about 12–24 hours later. It often peaks 1–2 days after exercise and typically resolves within 7 days.¹˒²
Although DOMS can be uncomfortable and functionally limiting, it is not medically serious and usually settles with time.
There are treatments that may slightly reduce DOMS-related pain, such as massage, cryotherapy and other recovery strategies, but the current evidence is generally low quality and the effects are usually modest.³˒⁴
That means DOMS is often a good example of a situation where reassurance, patience and sensible activity modification may be enough.
If something is not sinister and has a positive prognosis, ignoring it can sometimes be better than ruminating about it.
That said, we do not need to fear DOMS, but we also do not need to chase it.
Current research suggests muscle soreness is not a good proxy for how effective your workout was. You can stimulate muscle growth without meaningful soreness, and being extremely sore does not necessarily mean your workout was more effective.⁵˒⁶
DOMS often just reflects novelty or eccentric loading.
So, if you feel a bit sore after training, it is usually nothing to panic about. But if you never feel sore, that does not mean your training is not working.
--
References:
- Newham (1988) PMID: 3371343
- Howell et al. (1993) PMID: 8229798
- Davis et al. (2020) PMID: 32426160
- Nahon et al. (2021) PMID: 34365084
- Flann et al. (2011) PMID: 21270317
- Damas et al. (2018) PMID: 21270317
