One of the most important things I have learned in treating the thousands of patients we have seen, is that if we can noticeably improve symptoms at any point, we are triggering healing.  If we are triggering healing, the symptom fluctuations along the course of treatment do NOT mean that the patient is ‘going backward’, or the the treatment has ‘stopped working’.  Instead, tensile strength in these structures will eventually increase to the point that the ‘stretch’ will stop, the nerve damage will heal, the tenderness will resolve, and all other symptoms will resolve.  But, until healing is COMPLETED, symptoms can vary widely and ‘upticks’ can be ‘as bad as the patient has ever had’.  Envision an individual connective tissue structure that is ‘non-loadbearing’ as that cable that ‘stretches’ under load.  The healing system is building wires back into the cable progressively.  But, as long as the cable is capable of stretching under load, until the job of strengthening is fully completed, the remaining ‘stretch’ is very capable of yanking on damaged nerve fibers, or damaging new ones, and causing symptoms that are just as bad as the patient has ‘ever felt’.  This is annoying to the patient, but it does not mean that the treatment ‘is not working’, and that it ‘will not fix the problem’:  it simply means that the patient triggered the ‘strain gauge’ in a few structures, loaded them until they stretched, aggravated some nerves, and paid the price…just like they were doing before treatment started.