Back MRI

Do You Really Need an MRI for That?

/in /by

Possibly the number one question I get from clients on a daily basis is…

“Should I get an MRI for that?”

Hey… I get it… you’ve got pain that won’t go away and you want to see what’s going on inside… why not?

Not so fast!

What if I told you that getting an MRI too soon (or when you don’t even need one) can actually lead you to getting unnecessary procedures, or even surgery! 

Don’t get me wrong… 

MRI’s are an amazing advancement in medical technology that have saved many lives. And if you’ve had trauma – like a major fall or accident – or you’re exhibiting symptoms that we call “red flags” (progressive/serious neurological deficits, bowel and bladder issues, unrelenting/unexplainable pain) –  then you want to get an MRI. But when it comes to musculoskeletal pain (back, neck, knee, hip, shoulder, etc) – again – unless you’ve had a major fall or trauma – you typically DO NOT need an MRI.

Let me explain…

When it comes to musculoskeletal pain – 80% of the time it’s what we call “mechanical” in nature. That means it’s due to the way you are (or aren’t) moving. For example, let’s say you’re suffering from low back pain and terrible sciatica. Most people in this situation want to get an MRI. And it will reveal anything from a bulging disc, to stenosis, to arthritis, to degenerative discs. Whichever one of these “ailments” shows up on your MRI will typically get blamed as the source of your problem. From there – you’ll typically be prescribed some type of procedure (or surgery) to “fix” said ailment.

Sound familiar?

Well… here’s the thing… research has shown over and over that these so-called ailments appear in the MRI’s of just about everyone over the age of 50. In a 2015 study by Brinkjiki et al – they did MRI’s on over 3000 people who had NO back pain. And you know what they found? For people in their 60’s – they found that 70% of them had disc bulges – 88% had disc degeneration – and 50% had facet degeneration (something you often see with arthritis). And as the age groups increased – so did these ailments!  

The meaning of this and other studies like it is profound…

It means that you absolutely can NOT rely on your MRI to diagnose your problem.

It also means that many people are getting procedures on these normally occurring structural ailments when it’s not even the root cause of the problem.

So what IS the root cause of the problem?

 Typically – it’s “mechanical” – meaning your problem has to do with the way you move, bad postural habits learned over the years, muscular and joint imbalances, or “wear and tear” issues. It’s also why we tend to see more mechanical problems show up in people once they hit age 40 and beyond – because these problems take awhile to manifest.

Although the pain you experience may be coming from one of those ailments we spoke about earlier (for example – a bulging disc irritating your nerve route – a meniscus tear irritating your knee when it moves) – the root cause is how your movement habits are irritating the structure. When you fix the movement problem – the structural issue becomes irrelevant – at least 80% of the time.

If you’re confused – I don’t blame you.

Most medical doctors are not trained in what mechanical pain truly is or what it means. They are trained to diagnose problems using images such as Xrays and MRIs. Nothing wrong with that of course – but it can become a problem when you do an MRI too soon – without first ruling out if your pain is due to a mechanical cause.

If you’re currently suffering from back, neck, hip, knee, shoulder, ankle pain, etc… and you’ve been told you need an MRI to “figure out what’s going on” – hold that thought!

Why don’t you first consult with a mechanical pain specialist. There’s an 80% chance your problem will fall into this category. And you can save yourself from unnecessary treatments that might not work.

You can talk to one of our mechanical pain specialists for free by clicking HERE. It’s a completely free, no-obligation appointment that will give you all the information you need to make the best decision for YOUR health – whether that’s working with us or not!

Dr. Carrie Jose is a Physical Therapy Specialist and Mechanical Pain Expert, and owner of CJ Physical Therapy & Pilates in Portsmouth, NH. To get in touch – or inquire about getting help – CLICK HERE or call 603-380-7902

Active and Mobile

Six Ways to Keep Your Thanksgiving Festive and Fit

/in /by

Six Ways to Keep Your Thanksgiving Festive and Fit (Portsmouth NH Healthy Holiday Tips)

Thanksgiving is one of my absolute favorite holidays here on the Seacoast. I love the food, the sweets, family time, the Macy’s Day Parade, afternoon naps, and football. Traditionally, Thanksgiving means slowing down and indulging—but more and more people in Portsmouth, NH and across the Seacoast are looking for ways to stay active and feel good throughout the holiday.

And the benefits are real: improved digestion, better energy, happier joints (hips, knees, back, neck, shoulders), and a healthier balance to the extra calories you may enjoy.

If you want a festive and more active Thanksgiving this year, here are six simple, healthy Thanksgiving tips to help you stay moving and feeling great.

1. Practice Mindful Eating

You can enjoy every part of your Thanksgiving meal—while still supporting your digestion and energy—with mindful eating.

Mindful eating involves slowing down, savoring each bite, and paying attention to hunger and fullness cues. Studies show this can reduce calorie intake by up to 25%, simply by giving your brain time to register fullness.

It also helps digestion by encouraging thorough chewing and reducing the bloating or discomfort that often comes with holiday meals. Instead of loading your plate immediately, take your time, taste every dish, and enjoy the experience.

2. Interrupt Your Sitting

Even if you don’t feel overly full after practicing mindful eating, long periods of sitting can make your hips, back, and knees stiff—especially on soft couches.

Aim to stand up at least once every 30 minutes. This can be a fun job for a younger family member—let them be responsible for making everyone stand!

Regular movement breaks are one of the easiest ways to keep your spine and joints happy throughout Thanksgiving Day.

3. Sign Up for a Turkey Trot (or Create Your Own)

Turkey Trots are popular across New Hampshire and the Seacoast, and they’re a fun activity for the whole family. Most are 5Ks (3.1 miles), but even creating your own neighborhood walk or jog counts.

A morning walk or run boosts circulation, lubricates your joints, and elevates your metabolism for hours afterward. It’s one of the best ways to balance your Thanksgiving Day indulgence while giving your body a healthy start.

4. Be Active During Commercials

Whether you’re watching the Macy’s Day Parade or football, hours on the couch can wreak havoc on your back and neck.

A simple solution? Do something active during commercial breaks. It doesn’t have to be complicated:

  • Squats

  • Heel raises

  • Planks

  • Back or hip stretches

Turn it into a family challenge if you’ve got competitive relatives—you know who they are.

5. Walk Your Dessert Off

Skipping dessert is optional—but walking afterward is highly recommended. Even a short 10–20 minute walk supports digestion, stabilizes blood sugar, and offsets stiffness from sitting.

Walking is one of the most natural, joint-friendly exercises you can do, and it’s especially beneficial after a big Thanksgiving meal.

6. Stay Hydrated

Hydration matters every day—but especially on Thanksgiving. Drinking water helps with digestion, nutrient absorption, and energy levels.

We often confuse thirst with hunger, so staying hydrated before and during your meal can help you feel more in control of your portions. Hydration also keeps your mind clear and your body energized, making healthier choices easier throughout the day.

Final Thoughts

There you have it—six easy ways to keep your Thanksgiving festive, active, and healthy. If back, hip, knee, neck, or shoulder issues are getting in the way of enjoying the holiday—or even these simple tips—it may be time to talk with a mechanical pain expert.

They can help you find the root cause of what’s bothering you and keep it gone—so by next Thanksgiving, you can enjoy the day fully.

And—it’s the perfect time to take advantage of our Black Friday Sale!
We’re offering our lowest prices of the year on sessions with our Physical Therapy Specialists and our Regenerative Shockwave Therapy.

👉 CLICK HERE to get full access to the Black Friday deals — packages are limited and only available while deals last!

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch—or to request a copy of her free guide “5 Simple and Easy Ways to Get Rid of Back Pain”—CLICK HERE or call 603-380-7902.

What Your Doctor May be Missing About Your Pain’s True Source

/in /by

Pain can be frustrating and overwhelming, especially when it doesn’t go away.

It’s only natural to seek answers – and for many – that means a trip to the doctor. But here’s the thing. Even the best doctors can miss the true source of your pain.

Why?

Because too often they rely on imaging (like MRIs or X-rays) focused on the location of your pain – rather than considering the true source of your pain – and that it could be coming from somewhere else in your body. 

I often see this with pain in areas like the hips, knees, elbows, arms, and legs. Take persistent knee pain, for example. Most doctors will start by ordering an MRI of your knee – which might show things like arthritis or a torn meniscus. But what you may not realize is that these findings are common as we age and often appear in people who don’t have knee pain at all.

The problem is

– once something shows up on your MRI – it grabs your doctor’s attention – and becomes the full focus for treatment (even if it’s not the real problem). 

This misdiagnosing of pain like this is a huge reason why so many people suffer longer than necessary. It also leads to unnecessary surgeries, procedures, and treatments that never address the root cause of the problem. Back to our knee pain example, your doctor might not even consider that your knee pain could be coming from somewhere else (such as your lower back). And if that’s the case – no amount of knee-focused treatment will solve your knee pain – all because we allowed the MRI to make assumptions about the root cause of pain and dictate the treatment plan. 

What most medical doctors miss is this: The way your body moves and reacts to pain is often a much more reliable way to determine its true source than what shows up on an image. I’m not blaming your doctor – it’s just not how they are trained to examine and look at pain. But it is important for you to be aware of this – especially when your pain isn’t going away. You have to at least consider that the root cause was missed and could be coming from elsewhere.

Let me explain a little more.

Over my 22-year career, I’ve worked with people who suffered from persistent tennis elbow for years – despite trying every recommended protocol – only to discover their pain was actually coming from their neck. I’ve met patients who underwent major knee surgery that failed to bring relief – because the problem wasn’t in their knee at all.  I’ve seen patients replace their entire hip – only to find out their real problem was coming from their lower back the entire time.

And this isn’t just my experience. Research backs this up.

A study in the Journal of Manipulative Therapy found that on average, 40% of isolated extremity pain (like your hip, knee, shoulder, elbow, etc) is actually caused by your spine, even when there’s no pain in the spine itself. In these cases, imaging of your knee, shoulder, etc. would only show “normal abnormalities” associated with aging – and not ever show you the true source of your problem – which could be your spine.

So how do you figure out the real cause of your pain?  

The key is with specialized movement testing – designed to take into account your whole body, as well as everyday movement patterns and lifestyle. When you work with a mechanical pain specialist who is trained in this type of movement testing, they don’t just look at static images of your body – they look at how your body functions as a whole.

For example – by moving your spine in specific directions and seeing how that movement affects the pain in your knee, shoulder, or elbow – they can determine whether the spine is the real culprit. 

So if you’ve been struggling with persistent pain anywhere in your body and it’s not going away – you must at least consider that the location of your pain may not be its source. This is particularly common with pain in your extremities. The problem with traditional medical approaches is that they rely heavily on imaging and assume that what you see on an X-ray or MRI is the cause of the pain.

But pain doesn’t work that way. It’s more complex than a picture can reveal, and it often requires a deeper understanding of how your body moves and responds to find the source.  

Pain can be complicated, but finding the source doesn’t have to be. When you consider how your body moves – not just what shows up on an image – you’ll get closer to the answers you need.

Are you in the Portsmouth, NH area?

CLICK HERE to connect with one of our specialists to see if we would be a good fit to help you uncover what may be the real source of your pain.

Dr. Carrie Jose, Physical Therapy Specialist, and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If local to Portsmouth, NH, and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

Black Friday

6 Reasons NOT to miss our Black Friday Flash Sale

/in /by

These will be our BEST deals – on our best services – for the whole year!

We wanted to give you a heads up that our Black Friday Sale is starting ELEVEN DAYS from now on Sunday – Nov 24th. This is our biggest sale of the year on our most popular services. And it’s your chance to save insane amounts of money (one of the packages gives away over $2500 of FREE services!!)

In order to get access to this amazing sale – you must sign up HERE.

On Sun Nov 24th the sale will start – and you’ll get daily emails updating you on the packages we have available, when things sell out, etc…

Now if saving BIG wasn’t enough…

Here are SIX very important reasons why you don’t want to miss out on our Black Friday specials this year…

1. Without your Health – you have nothing

When your health, independence, and mobility begin to decline – you start missing out on activities that you love. And It’s very easy to say to yourself… “I’ll just wait until the New Year” – or – “I’ll get started when I have more time” – or – “I’ve got so many other expenses right now so my health can wait”…

Nothing should EVER come between you and your health. Because if you wait (or ignore) it, you risk either losing it forever, or spending a lot of time and money to get it back. Whether it’s healing a nagging injury that regular physical therapy or cortisone shots have failed – or getting to the root cause of a back pain or sciatica problem that keeps coming back – we’ve got some amazing specials and huge savings that will make it easy for you NOT to have to wait any longer 🙂 Now is the time to address and invest in your health.

2. Use your left-over FSA money (before you lose it!)

Do you have a Flexible Spending Account (FSA) through work that you forgot about or maybe haven’t used? Well I have some good news for you… you can use your Flexible Spending money toward ALL of the services we have on sale this year. Typically you lose whatever is left in your FSA at the end of the year (Dec 31st) – so don’t let it go to waste!

Put it towards your health – and save a ton of money while doing it – by taking advantage of our Black Friday specials!

3. Help with your New Year’s Resolutions!

January is our busiest month every year, and for good reason… People LOVE to make health-related New Year’s resolutions for themselves. But what if you’ve got a nagging pain or injury? The last thing you want is for it to return or get worse just when you’re in the groove. Our Black Friday Specials can help you with that!

Work with our Physical Therapy Specialists to get to the root cause of your problem and finally get a treatment plan that works (and lasts). Or try Regenerative Shockwave Therapy to help speed up the healing of a stubborn injury that regular physical therapy or cortisone shots have failed.  Whatever your health goals are for now or the New Year – get help from our experts at the best rates you’ll have access to ALL YEAR.

4. This only happens ONCE per year

This is our biggest sale of the year – PERIOD. And it only happens once. You’ll never see our prices this low.

If you’re new to our community – and the ONLY reason you haven’t started working with us yet is because of your budget – then you will be very pleased with the specials we have for you. Our regular clients already know the value we provide – and that is why they consistently choose us over the cheaper alternatives available. And it’s also why they are super excited about this sale – because they plan to stock up on their favorite services.

Sign up for our Black Friday Sale NOW and see for yourself what all the hype is about 🙂

5. Try Out Services You’ve Been Curious About

Have you been eyeing one of our specialty services, like Regenerative Shockwave Therapy? This sale is the perfect time to explore them – at an unbeatable rate. Maybe you want to see how these services could change your mobility, pain, or recovery time? Here’s your permission slip to take the leap and see what you’ve been missing out on!

6. Recession-proof your Health

It may seem counterintuitive to spend money on your health right now given the economic state. Your insurance should pay for it – right? Well here’s why you might want to reconsider that thought – and put the control of your health back into your own hands…

Medicare and other health insurance companies have already cut their reimbursements for this year – and will continue to do so in years to come. Why should you care about this? Because it means the quality of your health care at traditional, insurance-based clinics only has one way to go – and that’s DOWN.

Providers are going to get paid less to take care of you, which means the quality of your care WILL suffer (just to “keep the lights on”). By investing in your own health – and not relying on an insurance company to do it for you – you stay in control of your health journey and have a better chance of avoiding the rabbit hole of expensive and unnecessary surgeries.

So… sign up for our Black Friday Sale… and join the CJPT revolution of getting active, healthy, and mobile – WITHOUT things like pills, procedures, or surgery 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, call 603-380-7902, or CLICK HERE to get early access to the Black Friday Flash Sale!

Portsmouth NH physical therapist demonstrates proper raking posture to prevent back pain.

6 Tips to Protect your Back when Raking Leaves

/in /by

6 Expert Tips to Protect Your Back When Raking Leaves in New England

Here in Portsmouth, NH, and across New England, fall foliage is beautiful — until all those leaves end up in your yard. As a local physical therapist, I often see an increase in back pain and strain injuries this time of year from people raking leaves without realizing how much stress it puts on their spine.

The good news? There are many simple things you can do to protect your back when raking leaves and prevent unwanted pain this fall season.

Below are six expert tips I share with my clients at CJ Physical Therapy & Pilates in Portsmouth to help you stay active, healthy, and pain-free while raking leaves.

1. Warm Up Before You Start

Just as athletes warm up before a game, you should too before tackling your yard. Starting any physical activity cold can lead to unnecessary strains and injuries.

Take a quick walk around the block to get your blood flowing — the gentle rotation in your torso is great for your spine. You can also include torso twists, shoulder shrugs, and arm circles to loosen up your joints and lubricate your spine before raking. A 5-10 minute warmup goes a long way in preventing back pain.

2. Choose the Right Rake

When it comes to raking ergonomics, the right equipment matters. Choose a rake that’s lightweight, durable, and long enough so you can maintain an upright posture while using it.

Poor ergonomics waste energy and increase your risk of injury. A well-designed, ergonomic rake might cost a little more, but it’s a worthwhile investment in your long-term spinal health — because back injuries are far more costly.

3. Bend with Your Legs and Hips

When raking or lifting, one of the worst postures for your back is being bent forward and twisted. To protect your spine, bend and lift using your legs and hips, not your back.

Maintain an upright posture while raking, and when scooping up leaves, squat and pivot with your hips and knees instead of twisting at your waist. Making this a habit — not just during yardwork — will keep your back strong and injury-free.

4. Take Regular Breaks

Raking is repetitive and can tire your muscles quickly. When your muscles fatigue, your form suffers — and that’s when injuries happen.

Take a short break every 30 minutes. Set a reminder on your phone, put the rake down, and give yourself a gentle back stretch or stand tall and reach overhead. These quick resets help maintain good posture and protect your back during longer yardwork sessions.

5. Engage Your Core

You don’t need six-pack abs to protect your back, but simply engaging your core muscles can provide essential support.

While raking, gently draw in your lower abdominals — you should still be able to breathe and talk easily. This subtle engagement keeps your spine stable and supported, reducing strain and helping prevent injury.

6. Keep Moving Afterwards

What you do after raking is just as important as what you do during. The biggest mistake people make is collapsing onto the couch afterward.

Right after strenuous activity, your spine is more pliable and vulnerable — so avoid slumping. Instead, take a short walk, do gentle stretches, or stay upright for a while before resting. Being mindful of your posture post-raking can save you from feeling that familiar “tweak” hours later.

Protect Your Back This Fall

Hopefully these tips give you a few things to think about before tackling all those leaves — and most importantly, help you protect your back and avoid unwanted pain this fall season.

If you’re in Portsmouth, NH or the Seacoast New Hampshire area and find yourself struggling with back pain after raking or other fall activities, we can help.

At CJ Physical Therapy & Pilates, we specialize in helping active adults in the Seacoast stay strong, mobile, and pain-free — naturally.

Call us today at 603-380-7902 or visit www.cjphysicaltherapy.com to learn more and download your free guide to preventing back pain.