Shockwave Therapy

Four Non-Invasive Ways to Get Rid of Arthritic Knee Pain

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Knee arthritis is one of the most common and debilitating forms of joint pain affecting adults over 50. It’s a condition that slowly wears down the protective cartilage in your knee joint – leading to stiffness, swelling, and pain that can make even simple activities like walking the dog or climbing stairs feel like a chore. 

While conventional treatments like traditional physical therapy, cortisone injections, and pain medication have been used for years to offer temporary relief – they don’t always work for everyone – and they fail to address the root cause . The good news is that there are several non-invasive, natural, and cutting-edge alternatives that go beyond masking symptoms and instead aim to support your body’s ability to heal and repair itself – especially when traditional treatments have come up short.

Corrective, Therapeutic Movement Strategies:

Perhaps the most accessible (and free) non-invasive solution is movement. Now, it might sound counterintuitive – and even laughable – to consider this as a viable strategy for arthritic knee pain, especially when your knee hurts. But not all arthritic knee pain is due to the arthritis itself.

Let me explain.

Much of the pain you experience when you’ve got arthritis is due to joint immobility and the compensatory patterns that develop over time. When you can identify these faulty movement patterns—and correct them with specifically prescribed therapeutic movement strategies designed to fix the mechanics in your knee joint – you can get significant pain reduction in your arthritic knee. You’ll need to work with a specialist to figure out which specific movements (or set of movements) your knee needs, but once you know what they are, you can use them forever to manage your knee pain – and it won’t cost you a dime.

Weight Management

Extra weight – even just a few pounds – can significantly increase the load placed on your knees when you’re walking, climbing stairs, and moving through your day. In fact, research from Dr. Stephen Messier and colleagues at Wake Forest University found that for every pound of weight lost, there is a four-pound reduction in knee joint stress during daily activities. In other words, losing just 10 pounds can reduce pressure on your knees by a remarkable 40 pounds with every step you take. Healthy, manageable weight loss – through a combination of smart nutrition and regular activity – can make a meaningful difference in pain levels and joint function. And the benefits aren’t limited to your knees. Losing weight reduces mechanical strain throughout your body, supporting the health and longevity of other joints as well.

Adopt an Anti-inflammatory lifestyle

While most people associate knee arthritis with “wear and tear,” it’s also a condition fueled by chronic inflammation. When you reduce inflammatory triggers – especially through your diet – it can lead to noticeable improvements in how your knees (and other joints) feel. Eating more whole, unprocessed foods that are rich in omega-3 fatty acids, antioxidants, and healthy fats is a powerful way to calm inflammation naturally. Aim to incorporate fatty fish like salmon, sardines, and mackerel at least twice per week, along with daily servings of dark leafy greens (like spinach and kale), berries, walnuts, chia seeds, and extra virgin olive oil. Spices like turmeric and ginger have natural anti-inflammatory properties and can easily be added to meals or smoothies.

On the flip side – it’s important to avoid refined sugars, processed grains (such as white bread and pastries), and fried foods – which are all known to promote inflammation. Beyond food, other daily habits that support lower inflammation include getting 7–8 hours of quality sleep, managing stress with activities like deep breathing or walking in nature, and drinking enough water – typically half your body weight in ounces per day. These foundational habits not only help reduce knee pain – but they’ll support your overall health and energy levels as well.

Explore non-invasive Regenerative Therapy

One of the most exciting technologies to hit the market in recent years – and that’s quickly gaining popularity – is the use of non-invasive regenerative therapies like Shockwave Therapy and EMTT. What I love about these treatment options is that they work with (not against) your body’s natural healing ability to regenerate degenerated or inflamed tissue – a major contributor to the pain and stiffness associated with knee arthritis. Shockwave Therapy uses mechanical sound waves to increase blood flow, break down scarred or damaged tissue, and reawaken dormant healing cells in the affected area. EMTT (Extracorporeal Magnetotransduction Therapy), on the other hand, uses high-frequency electromagnetic energy to reduce inflammation at the cellular level – boosting mitochondrial activity, improving cellular metabolism, and accelerating tissue repair. It’s particularly effective at targeting bone marrow lesions and chronic joint inflammation – both of which are commonly seen in knee arthritis.

While each of these therapies can be effective on its own, recent studies have shown that using EMTT and Shockwave together significantly enhances treatment outcomes. A 2021 clinical study published in Orthopedic Reviews found that the combination of EMTT and Shockwave Therapy led to greater improvements in pain relief and functional mobility compared to either treatment alone – while also providing longer-lasting results. For individuals who have already tried traditional physical therapy or cortisone injections without success – this combination of cutting-edge technology offers a powerful, drug-free solution that doesn’t just mask symptoms – it promotes actual healing.

Take Control of your Knee Pain – Naturally

If you’re struggling with knee arthritis and feel like you’ve tried everything – don’t give up hope. Medications and injections aren’t your only options. And surgery does not have to be your next step. By combining strategic movement, healthy weight management, anti-inflammatory lifestyle choices, and cutting-edge non-invasive regenerative therapies – it’s absolutely possible to reduce knee pain and reclaim your mobility naturally – without having to rely on pills, injections, or surgery. The key is finding the right combination that works for you – and being proactive about exploring alternatives that go beyond standard prescriptions and treatment strategies.

Are you local to Portsmouth, NH?

If so, consider speaking to one of my specialists for free by CLICKING HERE.

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.

7 Fun and Healthy Ways to Celebrate Mother’s Day on the Seacoast

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Mother’s Day is a time to honor the incredible women in our lives. While flowers and brunch are timeless, sometimes the most meaningful gift is simply quality time spent together. This year, why not swap the restaurant waitlists and crowded gift shops for something a little more memorable?

Here on the Seacoast of New Hampshire, we’re lucky to have access to some of the most beautiful coastline, trails, and natural parks in New England. Whether your mom loves to move, relax outdoors, or try something new – there’s no shortage of ways to celebrate with her in a fun, active, and healthy way.

Here are 7 fun and healthy ways to celebrate Mother’s Day on the Seacoast:

 

Take a Scenic Coastal Bike Ride

Treat Mom to a leisurely bike ride along the Seacoast’s stunning shoreline. Begin in downtown Portsmouth and pedal out toward Rye via Route 1A. This route winds through the historic charm of New Castle, offers sweeping ocean views, quaint seaside cottages, and scenic beaches along the way. It’s the perfect mix of fresh air, gentle movement, and quality time – made even sweeter with a stop for coffee or ice cream along the way.

Explore the Rockingham Rail Trail

If Mom prefers a quiet ride or walk away from busy roads, the Rockingham Rail Trail is a fantastic option. This converted rail corridor stretches for miles through peaceful woodlands, wetlands, and charming rural areas. The wide, flat trail is perfect for casual biking or a long walk, and it’s ideal for chatting as you move at your own pace. Access points in Newfields allow for convenient parking to explore as much or as little of this trail as you desire.

Kayak or Paddle at Odiorne or Rye Harbor

If your mom loves being on the water, an afternoon of paddleboarding or kayaking could be the perfect outing. Paddleboarding challenges your balance and engages the core, while kayaking offers a more relaxed rhythm with a great upper-body workout. No gear? No problem. Local favorites like Portsmouth Paddle Co. and Portsmouth Kayak Adventures offer rentals, lessons, and even guided tours – making it easy for beginners to join in the fun.

Hike Mount Agamenticus or the Urban Forestry Center

If your mom enjoys hiking, there are plenty of local trails that offer both beauty and tranquility. Mount Agamenticus in York, Maine provides several loop trails and beautiful summit views. For something a little less strenuous, check out the Urban Forestry Center in Portsmouth. It offers peaceful, wooded trails that are perfect for an afternoon stroll. The forest and mountains are great places to unplug, breathe deeply, and enjoy each other’s company away from the hustle of everyday life.

Visit Nubble Lighthouse and Stroll the Marginal Way

Make a scenic drive to York, Maine and surprise Mom with a visit to the iconic Nubble Lighthouse. It’s one of the most photographed lighthouses in the country—and for good reason. After taking in the views, consider walking a portion of the Marginal Way in nearby Ogunquit, a picturesque oceanside path with sweeping vistas and benches for a rest or a nice chat.

Celebrate Mom’s Green Thumb

If your mom has a love for gardening, flowers, or nature’s beauty, spend part of the day visiting your favorite local nursery or garden center – and then help her get her hands dirty by planting something together. Whether it’s herbs, flowers, or even a raised veggie bed – she’ll appreciate the help and time spent together.

Stroll Through Prescott Park and the Portsmouth Waterfront

Put your best walking shoes on and take a walk through Prescott Park and along the Portsmouth waterfront. By mid-May, the gardens are beginning to bloom, and the salty air and river breeze make for a perfect spring stroll. Grab a treat from a local café, browse the shops, or simply sit and take in the view together.

Is Pain or Injury Keeping you from Enjoying these Activities?

Mother’s Day lands at a great time of year to get outside and do something active with your loved ones. But if nagging pain or injury is holding you back – or has you hesitant to try something new this season – it may be time to seek help from a mechanical pain specialist. They will help you figure out the source of your problem and provide you with natural treatment methods designed to get you out of pain and back to doing everything you love quickly.

Local to the Seacoast? CLICK HERE to speak with a specialist now.

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.

tight hips

Why Stretching Isn’t Solving Your Tight Hips

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If your hips always feel tight – whether during workouts, long walks, or just sitting at your desk – it can be incredibly frustrating. Not only is it uncomfortable, but tight hips often contribute to nagging lower back pain. And what’s even more confusing? No matter how much stretching you do, the tightness keeps coming back.

For me – that’s typically a clue that the problem isn’t what you think it is.

Muscles can feel tight for many different reasons – and not all of them have to do with flexibility. While some muscles truly are short and need to be lengthened – others feel tight because they’re overworked, weak, or compensating for something else. In those cases – stretching alone won’t solve the issue – and might even make things worse.

Let’s break this down…

Take your psoas muscle, for example. It’s one of your deep hip flexors and also plays a key role in spinal and pelvic stability. If your core and glutes (also spinal and pelvic stabilizers) aren’t doing their jobs – your psoas will kick in to help. That overcompensation can lead to it feeling chronically tight – even though it’s not technically “shortened”. So while the inclination will be to stretch your psoas – you’re actually putting an unintended strain on an already tired and stressed muscle. 

While stretching might give you a temporary break in this instance – it won’t address the real problem. You need to strengthen your deep abdominals, your core stability, and your glutes. When all of these systems kick in collectively, your psoas can finally relax – and your chronic tightness will resolve on its own.

But there’s one more thing most people don’t even think of –  and it’s that the tightness in your hip flexors could also be a symptom of a mechanical problem – not a muscular one.

Mechanical pain refers to pain (or tension) that’s caused by poor movement patterns or joint dysfunction, not necessarily tissue damage, compensation, or tightness. If the way your hips, pelvis, or lower back are moving is off – even slightly – your body will compensate. Over time, this leads to overuse of certain muscles – like your psoas, for example – which then feel constantly tight or strained. Unless the underlying movement problem is corrected, you’ll keep chasing symptoms instead of fixing the root cause by constantly stretching.

This concept of tightness due to overworking and compensation can happen to any muscle in your body. With hips in particular, your psoas isn’t the only culprit. Your piriformis and TFL (tensor fascia latae) can become victims of these patterns as well. In addition to your psoas muscle – your piriformis and/or TFL loves to pitch in and compensate for weak gluteal and core muscles as well. An overworked piriformis leads to difficulty sitting cross-legged – and a tight TFL can be painful and lead to IT band problems. You can stretch all you want – but if you don’t address the underlying cause and give these muscles a chance to relax – your hips will constantly feel tight. Plus, stretching in and of itself is a form of load on your muscle. You don’t want to add more load to an already tired and angry muscle.

The moral of the story? 

If your hips feel chronically tight – and stretching all the time isn’t making a lasting difference – it’s time to consider a different approach. Most people don’t think to strengthen a muscle that feels tight – but it might be exactly what your body needs. When it comes to your hips, the areas to assess are your deep abdominals and your glutes. Often, there’s an underlying weakness or movement dysfunction you just can’t see on your own. And if your muscle tightness stems from a mechanical issue – like poor joint alignment or faulty movement patterns – no amount of stretching or strengthening will fully work until that’s addressed.

A trained mechanical pain expert can help you identify whether it’s a strength problem, a movement problem, or a combination of both – so you can finally get lasting relief.

Feel free to reach out to our mechanical pain specialists if you’re local and looking for help by clicking here.

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.

Why Your Ab Exercises Aren’t Fixing Your Back Pain

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Why Your Ab Exercises Aren’t Fixing Your Back Pain

If you’ve been dealing with back pain for a while, chances are good that someone – whether a well-meaning friend, fitness influencer, or even your doctor – has told you to strengthen your core. It’s one of the most common recommendations I hear from people who come into my clinic. And while core strengthening can be helpful, it’s not the magic fix everyone hopes it will be.

Believe me, I wish it were that simple. But the truth is this: core strengthening alone rarely solves back pain – and in some cases, it can even make it worse.

Let’s unpack why.

Most persistent back pain is what we call “mechanical” in nature. That means the root of the problem is related to the way your spine moves (or doesn’t move) – not how strong it is. Mechanical back pain is typically the result of years of repetitive stress or poor movement habits. These issues can’t be fixed with planks, crunches, or “functional mobility strengthening.” Strengthening your core might make you feel a little better temporarily – but it won’t solve the deeper dysfunction.

Mechanical back pain tends to sneak up over time. It’s not the result of one big injury, but rather the accumulation of little things. Sitting all day at your desk. Constantly lifting and carrying your toddler. Spending weekends bent over in your garden or rotating through your golf swing. Eventually, these patterns start to cause subtle movement problems in your spine – and when left unresolved – those problems lead to pain.

Now here’s where things get even trickier.

When you go to your doctor – or get an MRI – you’re often told your back pain is from something structural: a disc issue, arthritis, or stenosis. But these findings are incredibly common, especially after age 50, and don’t always correlate with your actual pain. Plenty of people have these “abnormalities” and feel just fine. What’s more likely is that your mechanical problem is irritating these structures – not the other way around.

So if you’ve been religiously doing your core workouts but not seeing progress – this might be why. You’re treating the symptoms, not the cause. You have to relieve the mechanical irritation happening around these structures in order to get full pain relief. And core strengthening – not even surgery – will cut it.

To truly get rid of mechanical back pain, you need to address the underlying movement dysfunction. This requires a very specific and individualized approach – something you won’t find on YouTube, in a gym, and definitely not in a doctor’s office. Once that’s resolved, core strengthening does become incredibly valuable. In fact, it’s a key part of staying pain-free and preventing future flare-ups after your back pain is gone.

But timing matters – and I get it – most back pain sufferers have little patience when they’ve been in chronic pain. By the way – I don’t blame you. But if you jump into a core strengthening program too soon – or focus on the wrong exercises – you’re more likely to aggravate your symptoms rather than help them – and prolong your chronic pain.

Here’s the bottom line:

If you’ve been working on your core and not seeing results, don’t assume you’re doing it wrong or that you’re destined for a surgery or procedure. You might simply be skipping a crucial step – mobility before stability. Get your mechanical back pain properly diagnosed and addressed first. Once your mobility is restored and the foundation is solid – then your core strengthening efforts will stick. And your back will thank you.

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.

Back Pain

Think You’ve Got Piriformis Syndrome? It Might Actually Be Sciatica

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Think You’ve Got Piriformis Syndrome? It Might Actually Be Sciatica

A reader of this column recently wrote to me with the following question:

“I’m getting Physical Therapy for lower back pain and sciatica that is said to be from ‘piriformis syndrome’. My PT treatment has consisted of various exercises and some massage. Eight sessions in and no change at all. I’m still having pain when sitting or walking a distance. What now? Do I need an ultrasound or MRI to see if there is any damage or tear to my piriformis? Should I get an injection?”

When I hear something like this, my first thoughts are that either the diagnosis has been missed – or the treatment plan is all wrong – because you absolutely should be seeing some progress and results after 8 sessions of quality physical therapy.

Is it really piriformis syndrome – or is it sciatica?

These two conditions are frequently confused and all too often interchanged. The reality is, piriformis syndrome is far less common than you might think. In fact, research suggests piriformis syndrome is often misdiagnosed and may account for only 6–8% of all cases of sciatica-like symptoms (Boyajian-O’Neill et al., Am Fam Physician, 2008).

What’s the more likely reason for your radiating leg pain? That it’s coming from your lower back, not your piriformis.

Sciatica is a symptom – not a diagnosis

Sciatica refers to pain that radiates down the leg along the sciatic nerve. It can stem from a number of causes, but the most common – by far – is a mechanical problem in the lumbar spine. Things like a bulging disc, joint dysfunction, or even a poorly moving vertebra can irritate or compress a nerve root and cause sciatic pain.

Piriformis syndrome, on the other hand, involves the piriformis muscle compressing the sciatic nerve as it passes through the buttock. This can happen, but true cases are very rare – and diagnosing it correctly requires a process of elimination that most general practitioners and physical therapists don’t have the training to perform correctly.

Why mechanical diagnosis matters

Mechanical diagnosis matters because 80% of all musculoskeletal problems – including sciatica – are due to mechanical causes. And if you don’t take someone through a proper and thorough mechanical exam you will not be able to accurately diagnose the source of your sciatica. This is very likely what happened in this reader’s case.

A mechanical specialist will take you through repeated movements designed to map your symptoms and confirm specific responses to movement. This involves testing how your symptoms respond to specific repeated movements – like bending forward, arching backward, or twisting – and tracking which movements improve or worsen your pain. This is the only way to truly diagnose a mechanical pain issue. MRI’s and X-rays can’t detect mechanical pain problems – which is why they often lead to misleading diagnoses when used too soon.

Without a proper mechanical exam, treatment becomes a guessing game. Massage therapy, stretching, dry needling, and general exercises aimed at loosening your piriformis might feel good temporarily, but they won’t solve the problem if the issue is coming from your spine. Research shows that when mechanical diagnosis and therapy is applied correctly, it’s highly effective at resolving back and leg pain – even in cases that have failed previous treatment (May et al., J Man Manip Ther, 2006).

What to do if PT isn’t working

Let’s say your therapist did perform what they believe to be a thorough mechanical evaluation and still thinks it’s piriformis syndrome. And yet, you’ve gone through 8 sessions and feel no better.

This is a red flag for me.

In my clinic, we expect to see at least some change by session 4 or 5 – even if it’s small. If you’re not seeing meaningful progress by then, it’s time to reassess. That doesn’t necessarily mean it’s time for imaging or surgery. It may simply mean you need a different approach – or a more specialized provider.

A mechanical back pain specialist can help

When it comes to distinguishing between true piriformis syndrome and sciatica caused by a spinal issue, no one is better equipped than a mechanical back pain specialist.

These clinicians are experts at figuring out where your pain is coming from and what movement strategies will actually help you.

They don’t rely on vague diagnoses or cookie-cutter treatments. They use a methodical approach based on how your body responds to specific, repeated movements – and this approach has been shown to be highly effective for resolving back pain and sciatica.

The bottom line?

Piriformis syndrome is real – but very rare. If you’re dealing with leg pain, numbness, or tingling and have been told it’s from your piriformis, there’s a good chance it’s actually sciatica from a mechanical problem in your back. And that’s good news – because it means there’s often a clear and natural solution.

Find someone who specializes in mechanical diagnosis, and you’ll be one step closer to getting answers – and finally getting some relief.

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.

When your Back Hurts – is Rest Helping or Hurting?

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Whenever someone finds out I’m a physical therapist, the next question is almost always something like… “What can I do for [insert the blank] injury?” And when it comes to back pain specifically, people often ask me: “Should I be resting it?”

It’s no surprise that the vast majority of folks I speak with about back pain have been told by well-meaning friends, family, or even doctors that rest is the best thing for back pain — especially when you first hurt it. But what if I told you that rest might actually be the worst thing you can do? That resting and doing nothing — even when you’ve acutely hurt your back — can actually delay recovery and even make your back pain worse in the long-term.

Conventional advice tells us that back pain should be treated with ice, inactivity, and as little movement as possible — and when it feels better — to start slowly moving it. That advice makes sense on the surface — after all, if something hurts, shouldn’t you avoid using it? But research (and decades of clinical experience) shows us that this approach can actually prolong healing, increase pain sensitivity, and make it more likely that your back pain will return again and worse, become a long-term issue.

Why Rest Doesn’t Work

Modern health research is very clear on this: too much rest after a musculoskeletal injury like back pain leads to muscle deconditioning, joint stiffness, poor circulation, and even heightened pain sensitivity. A well-known review published in The Lancet concluded that staying active is one of the best things you can do for non-specific (mechanical) low back pain. In fact, people who remain as active as possible — within reason — recover faster and are less likely to develop chronic symptoms.

Here’s why: your joints and tissues thrive on movement. Motion promotes circulation, reduces inflammation, and helps your muscles and nerves return to normal function. When you stop moving, the opposite happens. Your muscles tighten, your joints stiffen, and your brain becomes more sensitized to pain signals. That’s how a small tweak in your back can turn into months (or years) of recurring pain if you’re not careful.

Movement is Medicine

Now, this doesn’t mean you should ignore your pain and go back to the gym, golf, or even all your daily house chores the next day. There’s a difference between smart movement and overdoing it. But most people fall on the other side of the spectrum — they stop moving entirely, waiting for the pain to just “go away.”

What I recommend instead is gentle, intentional movement that keeps your body active without making things worse. Walking, for example, is one of the best low-impact ways to get your spine moving and your blood flowing. If walking feels okay, it’s a great first step toward healing.

Specific exercises tailored to your pain are also incredibly powerful. These movements help “reset” your nervous system, calm down overactive muscles, and restore balance to the structures around your spine. In my clinic, I call these “first-aid movements.” They’re often simple, but highly specific — and they can help you move from debilitating pain to something much more manageable.

But What If Movement Feels Impossible?

I get it — sometimes your back pain is so bad that even getting out of bed or walking across the room feels unbearable. If you’re stuck in this kind of pain cycle, you may not be able to figure out on your own what’s safe to do. And in those cases, the worst thing you can do is wait it out or rely on generic advice from Google or YouTube.

This is where working with a mechanical back pain specialist can be a game changer. A trained expert can evaluate your pain based on movement patterns — not just an image or MRI — and guide you toward the exact movement your body needs to start calming the pain down. In fact, I often see patients go from 10/10 pain to 3/10 in their very first session, simply by finding and repeating the movement that’s right for their spine.

That kind of progress might seem like magic — but it’s just smart biomechanics. The body wants to heal, but it needs the right inputs. A movement-based mechanical specialist knows how to give your body those inputs safely and effectively.

Finding the Middle Ground

The key takeaway is this: while you may need to modify your activity levels when your back flares up, the goal should never be total rest. There is always some kind of movement you can do — and the sooner you find it, the sooner your healing process will begin.

If you’ve been dealing with back pain for more than a few days, and especially if it’s stopping you from doing the things you love, don’t wait around hoping rest will fix it.

The better alternative?

Talk to a professional who understands movement, mechanics, and pain. A customized plan — not a generic rest-and-wait approach — is what truly sets people on the path to lasting relief. Movement is powerful medicine — especially when it’s prescribed correctly.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists for free by clicking HERE.

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.

Back Pain, Herniated Discs, and Cortisone Shots: What You Need to Know

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A recent conversation about cortisone shots and back pain due to herniated discs inspired me to write this article.

The person I was speaking with was quite misinformed about when cortisone shots are useful – and when they aren’t. By the way, it’s a very common misunderstanding. But since I hate seeing people undergo unnecessary injections or procedures – I’m here to educate. 

So let’s break it down: when is a cortisone shot a good idea, and when should you think twice?

When Cortisone Shots Work

Cortisone shots can be highly effective if your pain is primarily caused by inflammation, which is what I call “chemical pain.” Chemical pain results from your body’s inflammatory response to an injury. This response produces chemicals and nutrients that help heal the area, but sometimes the process gets “stuck”. The lingering chemicals cause persistent pain that doesn’t respond to movement or rest.

If your back pain is constant, feels hot and inflamed, and doesn’t improve with positional changes, you might have chemical pain. In these cases, a cortisone shot can eliminate the chemicals causing the pain and provide relief. 

In other words – exercise – which is the best treatment for herniated discs and back pain – won’t work well when you have chemical pain. Historically that’s when cortisone shots are necessary. But in 2021 – an amazing technology called Electrocorporeal Magnetotransduction Therapy (EMTT) came to the United States and works just as well (if not better) than cortisone, except it’s natural and non-invasive. EMTT uses a high-frequency magnetic field that can penetrate up to 6 inches into the body – so it can heal inflammation in places like your lower back down to the cellular level. I’ve seen great results from it – so I’m starting to recommend this over a cortisone shot for anyone that needs it. 

When Cortisone Shots Don’t Work

Most back pain (even those related to herniated discs) – aren’t chemical in nature. It’s mechanical, meaning it stems from issues with mobility and movement patterns. Mechanical pain – responsible for 70-80% of all musculoskeletal issues (including back pain) – will improve and resolve with precisely prescribed corrective-movement exercises. How do you know if you’re in this category? If your back generally feels better after walking, stretching, or changing positions – it’s almost certainly mechanical – because it’s responding to movement. If this sounds like you – a cortisone shot won’t address the root cause.

The key to resolving mechanical pain is identifying and correcting mobility restrictions and faulty movement patterns. Once you do this, the structural issue (like the herniated disc) becomes less relevant. Many people live symptom-free with herniated discs once they’ve addressed their underlying movement pattern problems and mobility.

The Gray Area

Here’s where it gets tricky: a herniated disc can irritate surrounding structures like muscles and nerves, causing localized inflammation. This type of pain can feel intense, but it’s not quite the same as chemical pain. But it will be tempting to get a cortisone shot for quick relief. The thing is – it will only be a temporary fix. The shot won’t address the underlying mechanical issues that caused the disc to “act up” in the first place. Worse, masking the pain can lead you to unknowingly worsen your problem, potentially leading to more procedures or surgery. In most cases, this type of inflammation can resolve naturally without drugs. Something like EMTT that I already mentioned, and other regenerative therapies like Shockwave Therapy work great for this type of inflammation.

Take Home Points:

Before you consider cortisone shots, take a moment to evaluate your pain:

  1. Does movement or activity influence your pain? If yes, it’s likely mechanical and won’t benefit from a cortisone shot.
  2. Is your pain constant, hot, and unresponsive to movement? If yes, you might benefit from a cortisone shot to calm the inflammation and enable movement to help.
  3. There are some amazing Regenerative Therapy Treatment technologies available now that serve as natural, non-invasive alternatives to cortisone shots if you are really inflamed. Plus – they work with your body’s own anti-inflammatory systems by giving them a boost.

Ultimately, cortisone shots don’t fix structural problems – they temporarily eliminate pain due to inflammation. While this can be useful in specific situations, it’s crucial to address the root cause of your pain to prevent long-term issues and seek healthier alternatives when you can.

Local to Portsmouth, NH? Schedule a free discovery visit with us today and take the first step toward lasting relief and better movement.

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.

knee pain source

Six Natural Ways to Relieve Arthritis Pain – Without Meds or Surgery

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Arthritis is a widespread and debilitating condition that affects over 350 million people worldwide.

In the U.S. alone, nearly 58.5 million people live with some form of arthritis, making it one of the leading causes of disability. Until recently, conventional treatments like medication, injections, and surgery were the go-to options for managing arthritis-related pain and immobility. However, more people are seeking natural, non-invasive alternatives to reduce their reliance on these treatments and avoid potential side effects.

From lifestyle changes to cutting-edge therapies like Regenerative Therapy, there are many ways to manage arthritis naturally and effectively for lasting relief. Here are six that top my list:

Anti-Inflammatory Diet

One of the best ways to combat arthritis is through dietary changes aimed at minimizing inflammation, which plays a key role in joint pain and stiffness. Research suggests that bone edema (swelling within the bone marrow) is a primary source of pain in arthritis. Since inflammation fuels this process, an anti-inflammatory diet can help reduce discomfort and slow progression. Foods rich in omega-3 fatty acids like salmon, mackerel, and sardines counteract inflammation and may ease arthritis symptoms. Leafy greens, berries, and nuts provide powerful antioxidants that protect joint tissues, while turmeric and ginger contain natural compounds that act as pain relievers. Healthy fats like olive oil further support joint health by reducing inflammation. On the other hand – processed foods, excessive sugar, refined carbohydrates, and fried foods can worsen symptoms and should be limited.

Regular Exercise and Movement

Many people avoid movement when they have arthritis – but it’s actually one of the best ways to relieve joint pain and stiffness. Movement increases blood flow, which flushes out inflammatory toxins while also delivering oxygen and nutrients to nourish cartilage and surrounding tissues. Without regular activity, joints become stagnant, leading to more stiffness, inflammation, and degeneration – ultimately making arthritis feel worse. Low-impact exercises like walking, biking, and swimming improve circulation without excessive strain on joints. Yoga and Pilates enhance flexibility and stability, reducing stiffness and strain. Strength training keeps muscles strong, reducing pressure on the joints and minimizing arthritic symptoms. The more you move – the more you promote healing – making daily activities easier and reducing long-term discomfort.

Weight Management

Maintaining a healthy weight is key to managing arthritis. Excess weight puts added stress on joints – especially in weight-bearing areas like the knees, hips, and lower back. You’d be surprised to know that even a small weight loss can make a big difference. Research shows that losing just one pound reduces knee joint stress by four pounds, easing arthritis pain. One of the most effective and accessible ways to manage weight is walking. It’s simple, low-impact, and helps burn calories. Aiming for 10,000 steps per day is a great goal – but even small increases in daily movement can lead to lasting improvements in joint health and overall well-being.

Herbal Remedies and Supplements

Before medication existed, nature was our primary source of medicine. The good news is that today – there are countless herbal remedies and supplements that can naturally and effectively help manage arthritis symptoms. Glucosamine and chondroitin are among the most widely used for supporting cartilage health and reducing joint pain. Turmeric, particularly its active compound curcumin, has powerful anti-inflammatory properties. Omega-3 fatty acids, found in fish oil and supplements, help reduce both inflammation and stiffness. Other beneficial herbs include Boswellia (Indian Frankincense), which improves joint function and reduces swelling – and Vitamin D, which supports bone health and may alleviate joint pain. If you’re new to herbs and supplements, consult a medical professional trained in herbal medicine to find the best options for you.

Acupuncture and Massage Therapy

Acupuncture and massage therapy have been providing relief for arthritis symptoms for centuries. Acupuncture, an ancient Chinese practice, involves inserting thin needles into specific points on the body to promote energy flow and reduce pain. Many arthritis sufferers find that regular acupuncture sessions help manage discomfort and improve joint function. Massage therapy works by relieving muscle tension, improving circulation, and increasing joint mobility through soft tissue manipulation. Techniques like cupping and hot stones can further enhance results. Sometimes we need extra help managing arthritis symptoms – and these two treatments are not only safe and non-invasive – but also highly effective (especially when combined with the right type of exercise and movement).

Regenerative Shockwave Therapy and EMTT

One of the most exciting advancements in arthritis treatment is Regenerative Therapy. While some regenerative treatments (like PRP and stem cell injections) are invasive – highly effective non-invasive options like Shockwave Therapy and Extracorporeal Magnetotransduction Therapy (EMTT) are gaining popularity. These therapies stimulate the body’s natural healing process without surgery or medication.

Shockwave Therapy uses acoustic waves to promote blood flow, reduce inflammation, and encourage tissue regeneration. EMTT employs high-energy electromagnetic fields to accelerate cellular repair and relieve pain. Together, these therapies provide a drug-free, surgery-free solution for arthritis sufferers. Many patients experience reduced pain, increased mobility, and faster recovery times with no downtime. Unlike cortisone shots, which provide temporary relief but can also weaken joint tissue over time – EMTT and Shockwave Therapy heal at the cellular level – leading to lasting improvements in pain and function.

Final Thoughts…

If you’re suffering from arthritis, it doesn’t mean you have to settle for a lifetime of pain or dependence on medication. By embracing natural treatment methods – such as an anti-inflammatory diet, regular exercise, weight management, herbal supplements, and cutting-edge therapies like Regenerative Shockwave Therapy and EMTT – you can take control of your joint health and improve your quality of life. If you or someone you know is struggling with arthritis – consider exploring these drug-free, non-invasive approaches to healing. The body has an incredible ability to repair itself when given the right support and environment. Taking proactive steps today can lead to a more pain-free, active future.

Local to Portsmouth, NH?

Consider speaking to a mechanical pain specialist by clicking HERE.

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.

Could Regenerative Therapy be the Future of Healing for Active Adults?

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Staying fit and injury-free is essential for maintaining an active lifestyle – especially when you’re over 40.

And the more active you are, the better your quality of life tends to be. But here’s the unavoidable reality… As your body ages, so do your natural healing processes. Translation? Recovery times take longer than when you were in your 20s – and you become more vulnerable to injuries as you age.

Fortunately, an emerging field in medicine is gaining popularity and could be the solution to longevity you’ve been searching for. It’s called regenerative therapy. This cutting-edge field focuses on harnessing the body’s natural ability to heal and regenerate itself. Regenerative therapy includes treatments like stem cell therapy, platelet-rich plasma (PRP) therapy, regenerative shockwave therapy, and electromagnetic therapies such as Pulsed Electromagnetic Field Therapy (PEMF) and Extracorporeal Magnetotransduction Therapy (EMTT). These therapies aim to repair damaged tissues, reduce inflammation, and stimulate the production of new, healthy cells.

For the purposes of this article – let’s focus on two of these regenerative therapies – Shockwave Therapy and EMTT – and how when used together – deliver incredible results for active adults over 40.

Compared to some of the other regenerative therapy options out there – this treatment combo is non-invasive, highly accessible, and affordable. Plus – it comes with minimal side effects, no contraindications for most people, and virtually no downtime required – making it a game-changer for those who want to stay active without interruptions to their daily lives.

Let me introduce you to Regenerative Shockwave Therapy and EMTT…

What is Shockwave Therapy?

Extracorporeal Shockwave Therapy (Shockwave Therapy) is a non-invasive procedure that uses acoustic shockwave energy to stimulate healing in tendons and soft tissues. Radial Shockwave Therapy (EPAT) disperses energy broadly over an area – while Focused Shockwave Therapy (ESWT) concentrates energy on a smaller, more precise area. Both types of shockwave therapy stimulate healing by enhancing blood flow, promoting cell and tissue regeneration, reducing inflammation, and breaking down scar tissue. Originally developed to break up kidney stones, shockwave therapy has been used for decades to treat musculoskeletal conditions like tendinitis and plantar fasciitis.

What is EMTT?

Extracorporeal Magnetotransduction Therapy (EMTT) is an advanced, non-invasive, cutting-edge treatment that uses high-energy electromagnetic fields to accelerate healing and alleviate pain. It’s often compared to Pulsed Electromagnetic Field Therapy (PEMF), but it’s much more powerful. While both therapies rely on electromagnetic fields to stimulate natural repair processes – EMTT operates at frequencies up to 100 times higher than PEMF – enabling it to penetrate deeper into tissues and deliver more targeted therapeutic effects. EMTT has the capability to heal at the cellular level by enhancing your cell’s metabolic activity, which helps to reduce inflammation, promote faster healing, and accelerate the regeneration of damaged tissue. EMTT’s increased energy and intensity make it so powerful it can penetrate through clothing and even a cast (when bone healing is needed). Its high frequency also makes it virtually painless. EMTT is particularly effective for chronic pain, joint injuries, and degenerative conditions like arthritis

The Power of Shockwave Therapy and EMTT combined:

While Shockwave Therapy has been around for over 40 years – EMTT is fairly new to the market of regenerative therapies. The first EMTT device, the Magnetolith, was FDA-approved in the United States in 2010. Since then – the two therapies have proven to be a perfect pair. When combined – Shockwave Therapy and EMTT offer a powerful, synergistic approach to healing. While Shockwave Therapy focuses on mechanical stimulation of your tissues and improving circulation – EMTT works at a cellular level, resetting inflammation and promoting deeper tissue repair. Together – these therapies amplify each other’s effects – resulting in faster and more comprehensive healing.

Evidence Supporting the Combo:

A 2018 study by Kluter et al. examined the effects of Shockwave Therapy alone versus Shockwave Therapy combined with EMTT on 86 patients with rotator cuff tendinopathy. The results showed that patients receiving the combined therapy experienced significantly greater pain reduction and improved function compared to those treated with Shockwave Therapy alone. Although EMTT is relatively new, preliminary studies and case reports highlight its potential. For example – regenerative therapy using Shockwave Therapy and EMTT has shown promise in improving surgical outcomes. Case studies demonstrate that pre- and post-operative use of this combo significantly enhances scar healing, bone healing, and recovery times. And patients undergoing major procedures like Achilles tendon repairs returned to activity almost two months faster when these therapies were included as part of their recovery.

So Who Can Benefit?

The short answer is literally anyone. But active adults over 40 are prime candidates for this combination of regenerative therapies. Post-surgical patients recovering from orthopedic surgeries – including joint replacements – can experience faster healing and improved outcomes. Chronic pain sufferers dealing with conditions like arthritis or tendinopathies can find relief where other treatments have failed. Athletes or active adults with sports injuries, muscle strains, or overuse injuries will also benefit. And finally – if you’re someone who’s recovery has stalled with traditional physical therapy or cortisone injections  – you might just find renewed hope with this advanced, cutting-edge treatment.

As research into regenerative medicine advances – I believe the combined use of Shockwave Therapy and EMTT is poised to become a cornerstone of modern healthcare for active adults. These therapies not only address the symptoms of injury and degeneration – but also tackle the underlying causes – promoting true healing and long-term recovery. For active adults over 40 who want to maintain their mobility, independence, and active lifestyles – regenerative therapy offers a promising future. By harnessing the body’s natural healing capabilities through advanced, non-invasive techniques – Shockwave Therapy and EMTT provide a path to faster recovery, improved surgical outcomes, and a pain-free life.

If you’re over 40 and facing chronic pain, injury, or the prospect of surgery – consider exploring regenerative therapy.

The combination of Shockwave Therapy and EMTT isn’t just about managing symptoms – it’s about restoring your body’s ability to heal itself.

With growing evidence supporting their effectiveness, these therapies are paving the way for a healthier, more active future for adults everywhere.

Are you local to Portsmouth, NH?

Book a free discovery visit with one of my specialists to see if you could be a good fit for our Regenerative Therapies by clicking HERE.

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.

Shockwave Therapy

How Regenerative Therapy Speeds Healing After Injury and Surgery

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As we age, our bodies naturally experience wear and tear.

Degenerative conditions, arthritis, and the aftermath of surgeries can all make it challenging to stay active. Many people assume this means they have to give up their favorite activities, but nothing could be further from the truth. With the right approach, including proper hydration, nutritious food, regular movement, and now advanced therapies like Regenerative Shockwave Therapy (RSWT) and Extracorporeal Magnetotransduction Therapy (EMTT), staying active and vibrant well into your later years is entirely possible.

While both therapies use cutting-edge technology, the real story is about the benefits they provide—helping clients heal faster, reduce pain, and regain mobility so they can get back to doing the things they love.

Pain Relief That Gets You Moving Again

Pain is one of the biggest barriers to recovery and activity. Both RSWT and EMTT work synergistically to target pain at its source. RSWT uses sound waves to stimulate deep tissue healing, while EMTT employs high-energy magnetic pulses to reduce inflammation and promote cellular repair. Together, they accelerate the body’s natural healing processes, reducing discomfort and giving clients the confidence to move freely again.

Enhanced Mobility and Flexibility

Stiffness and restricted movement can become significant problems, particularly after surgery. Shockwave therapy enhances collagen production, while EMTT helps improve tissue elasticity and overall function. By addressing the root causes of stiffness and encouraging healthy tissue regeneration, these therapies ensure you can move more freely and avoid the compensatory patterns that often lead to further issues.

Accelerated Healing with Better Blood Flow

Healthy circulation is critical for recovery. Shockwave therapy promotes vasodilation, increasing blood flow and delivering essential nutrients to injured areas. EMTT complements this by stimulating cellular activity, speeding up the repair of both soft tissues and bones. For individuals recovering from surgery, this combination can significantly shorten the healing timeline, allowing for a faster return to normal activities.

Tackling Scar Tissue and Restoring Function

Post-surgical scars can cause long-term discomfort and mobility issues if not properly managed. RSWT breaks down dense scar tissue, while EMTT encourages the formation of new, healthy tissue. This duo not only improves the appearance of scars but also restores functionality to the affected area, preventing complications and ensuring you’re back on your feet sooner.

A Recovery Companion for Every Stage of Healing

One of the most exciting aspects of combining RSWT and EMTT is how they support healing at every stage. Whether you’re preparing for surgery, recovering immediately afterward, or dealing with lingering issues months later, these therapies adapt to your needs. They amplify your body’s natural ability to heal, making them a perfect companion to any rehabilitation program.

Get Back to the Activities You Love Faster

If you’ve been struggling with pain, stiffness, or prolonged recovery after surgery, RSWT and EMTT might be the missing pieces in your healing journey. These innovative therapies not only accelerate recovery but also improve overall quality of life by reducing pain, improving mobility, and restoring functionality. With these tools, you can confidently reclaim the activities you love and enjoy a fuller, more active lifestyle.

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.