Tag Archive for: back pain

Think Arthritis Means Slowing Down? Meet the Rise of the “Ultimate Boomer”

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For decades, arthritis has been treated like a life sentence.

Once joint pain appears or an X-ray shows “degeneration” — many adults are told to lower their expectations. Walk less. Avoid impact. Be cautious. Accept that pain and limitation are simply part of aging. In more severe cases, joint replacement is presented as the inevitable next step.

But here in Portsmouth and across the Seacoast, a different story is emerging — and it’s one I see every day in my physical therapy clinic.

Adults in their 50s, 60s, and 70s are refusing to accept the idea that osteoarthritis means slowing down. Instead, they’re hiking local trails, golfing, strength training, traveling, playing with their grandkids, and staying active in the lives they love. Many tell me they feel better now than they did years ago.

This growing group represents what I like to call the rise of the “Ultimate Boomer.”
Someone who understands that while aging is inevitable, decline doesn’t have to be.

Arthritis Is Common — But Feeling “Old” Is Optional

One of the most misunderstood facts about arthritis is this:
Most adults over 50 — and many in their 40s — show arthritic changes on imaging whether they have pain or not.

Just like wrinkles on your skin, joints change with time. But those changes alone do not determine how your body feels or functions.

Problems begin when a diagnosis of arthritis starts to define what people believe their body can tolerate.

When patients hear phrases like “bone-on-bone” or “degenerative joint disease,” fear naturally follows. Activity decreases — especially walking, lifting, and load-bearing movement. Over time, muscles weaken, circulation declines, and joints receive less nourishment — exactly the opposite of what arthritic joints need to stay healthy.

Even more damaging, people lose confidence in their bodies. That loss of trust accelerates stiffness, pain, and overall physical decline.

Arthritis doesn’t make you old. Inactivity does.

The Ultimate Boomer mindset recognizes this — and it’s the difference between aging with confidence and feeling fragile as the years go on.

Why Movement Is One of the Most Powerful Arthritis Treatments

At CJ Physical Therapy & Pilates in Portsmouth, NH, we focus on helping people move better — not less.

When done correctly, movement is protective for arthritic joints:

  • Walking improves joint lubrication and circulation
  • Strength training reduces stress on painful joints by building muscular support
  • Core stability and Pilates-based training improve posture, balance, and alignment so joints are loaded more evenly

These habits don’t “wear joints out.”
They help preserve joint health and reduce pain associated with osteoarthritis.

The Ultimate Boomer doesn’t stop moving because something hurts.
They learn how to move better.

Why Recovery Matters More as We Age

One key difference between a 30-year-old and a 65-year-old with joint pain is recovery speed.

As we age, circulation slows, tissue healing takes longer, and inflammation becomes more persistent. Improvement is still absolutely possible — but recovery needs to be supported intentionally.

This is where modern, non-invasive arthritis treatments are changing what’s possible.

At our Portsmouth physical therapy clinic, we use advanced technologies such as Shockwave Therapy and EMTT to help support healing in chronically irritated joints.

  • Shockwave therapy increases blood flow and stimulates cellular repair in stubborn, painful tissue
  • EMTT (Extracorporeal Magnetotransduction Therapy) works at a deeper cellular level, helping reduce chronic inflammation and improve tissue metabolism

When used together, these therapies can improve the internal environment of the joint — reducing inflammation, improving circulation, and making movement and strengthening possible again.

These treatments aren’t about masking pain.
They’re about restoring the conditions your body needs to respond to exercise, physical therapy, and daily activity.

For many adults with arthritis, this becomes the missing link between “I know I should move” and “my body finally lets me.”

Confidence Is the Real Anti-Aging Tool

When people tell me they want to feel younger, they’re rarely talking about appearance.

They want to:

  • Trust their knees on uneven ground
  • Lift without fear of weeks of pain
  • Stay active without worrying that soreness will spiral
  • Maintain independence

That confidence comes from a body that is strong, resilient, and supported by the right care.

The Ultimate Boomer understands that arthritis isn’t a reason to stop living fully — it’s a reason to get smarter about how you move and how you recover.

Arthritis Is Not the End of Your Story

Arthritis does not mean the end of your favorite activities.
It does not mean you are broken.
And it certainly doesn’t mean your best years are behind you.

Aging well isn’t about denying arthritis exists.
It’s about refusing to let it define you.

Because the real goal isn’t just to live longer —
It’s to live better, stronger, and more confidently at every stage of life.

That’s what it truly means to be an Ultimate Boomer.

About the Author

Dr. Carrie Jose, DPT, is a Physical Therapy Specialist and Regenerative Therapy Expert and the owner of CJ Physical Therapy & Pilates in Portsmouth, NH. She specializes in helping adults with arthritis, joint pain, and chronic injuries avoid unnecessary medications, injections, and surgery through expert physical therapy and non-invasive healing technologies.

Dr. Jose also writes for Seacoast Media Group.

To learn more about your options or request a free Discovery Visit CLICK HERE or call 603-380-7902.

Healthy couple exercising outdoors, promoting back-friendly fitness and injury prevention in Portsmouth, NH.

Why New Year’s Fitness Goals Backfire — And How to Protect Your Back

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Why New Year’s Fitness Goals Backfire — And How to Protect Your Back

Every January, it happens like clockwork.

Gyms fill up. Fitness challenges kick off. People recommit to moving more, getting stronger, and finally prioritizing their health. And honestly — that motivation is a great thing.

But then February and March arrive… and we start seeing a different pattern here at our physical therapy clinic in Portsmouth, NH.

Back pain flares up. Old injuries resurface. New aches suddenly derail workout routines. And many people quietly decide they’re “too old,” or that certain exercises “just aren’t for them.”

In reality, the issue usually isn’t motivation or effort. More often, unresolved or low-grade back pain quietly follows people into their New Year’s fitness routines — and when increased intensity, load, or frequency is layered on top of poor movement patterns, even the best intentions can backfire.

If your goal this year is to stay active and pain-free, the solution may not be doing more — but doing things smarter.

Why January Is a High-Risk Month for Back Injuries

January is one of the highest-risk months of the year for back injuries — and that’s no coincidence.

Back pain rarely appears out of nowhere, even when it feels sudden. In most cases, it develops gradually over months or even years due to prolonged sitting, repetitive bending or twisting, and subtle compensations the body makes without you realizing it.

The holiday season often magnifies these stressors:

  • Long car rides and travel
  • More time sitting on soft couches
  • Disrupted routines and less daily movement

By the time January arrives, many people are already showing early warning signs of a brewing back pain episode — stiffness, mild aches, or irritation.

Then comes the abrupt shift:
New workouts. Heavier lifting. High-intensity classes. Aggressive stretching. Movements the body hasn’t been prepared to tolerate.

This combination is why so many people start the year strong — only to find themselves sidelined weeks later with back pain or sciatica.

Exercise Is Medicine — But Only When the Dose Is Right

Exercise is one of the most powerful tools we have for preventing and resolving back pain — when the dose is appropriate.

When your back is healthy, general exercise and strength training can be excellent preventive tools. But when back pain is already present, a more specific and individualized approach is often needed.

Roughly 80% of back pain is mechanical in nature, meaning it comes from how your body moves, sits, bends, lifts, and responds to load — not simply from structural issues like arthritis or disc degeneration. In fact, research consistently shows that many people with disc bulges or degeneration have no pain at all.

When faulty movement patterns and underlying spine mechanics aren’t addressed first, working harder in the gym can unintentionally amplify the habits that caused the problem in the first place. This is a major reason New Year’s fitness routines fail — despite great intentions.

How to Pursue Fitness Goals in a Back-Friendly Way

The good news? You don’t have to choose between staying active and protecting your back.

A few simple strategies can dramatically reduce injury risk while supporting long-term fitness.

1. Reduce Prolonged Sitting

Sitting increases compressive forces on the spine by up to 40%. Spending most of the day seated and then jumping into intense workouts puts your back at a disadvantage before exercise even begins.

Breaking up sitting time every 30 minutes with brief movement or posture changes gives your spine a break and creates a healthier foundation for exercise.

2. Don’t Underestimate Walking

Walking restores natural spinal movement, improves circulation, and reduces hip stiffness — a common contributor to back pain.

Aiming for 6,000–7,000 steps per day (about 45–60 minutes spread throughout the day) supports spinal health, joint mobility, and cardiovascular fitness without overwhelming your system. If walking consistently worsens your back pain, that’s a sign to seek expert guidance — not to stop moving altogether.

3. Focus on Postural Variety, Not “Perfect Posture”

No posture is healthy if it’s held too long. The spine thrives on movement and variability.

Rather than chasing perfect posture, focus on changing positions often while maintaining general postural awareness.

4. Strengthen Your Core — Intelligently

Core strength is important, but it’s not always the fix for back pain people expect. Because back pain is often sensitive to position and load, generalized core exercises can sometimes make symptoms worse.

Targeted, well-coached strength training and functional movements — guided by a back-aware professional — help build stability at the right time and in the right way.

5. Don’t Wait for Back Pain to “Go Away”

Mechanical back pain rarely resolves with time alone. It adapts, compensates, and quietly becomes limiting.

The absence of pain doesn’t always mean the absence of a problem. Understanding why your back hurts — and which movements help or worsen symptoms — is far more effective than relying on short-term fixes.

Work Smarter, Not Harder This Year

A successful New Year’s fitness plan isn’t defined by how hard you push in January.

It’s defined by how consistently you can move throughout the year — and whether you can keep doing the activities you love without setbacks.

With the right approach, movement becomes the solution — not the reason you’re sidelined.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for the Seacoast Media Group.

To get in touch — or request a free discovery visit with one of our specialists — visit our website or call 603-380-7902.

person holding lower back due to pain during holiday season in Portsmouth NH

What If Your Back Pain Didn’t Have to Follow You Into 2026?

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What If Your Back Pain Didn’t Have to Follow You Into 2026?

As the year winds down here in the Seacoast, many people in Portsmouth and the surrounding New Hampshire area take time to reflect on the last twelve months. You might think about your accomplishments, challenges, and the changes you hope to make in 2026. It’s a natural rhythm as the calendar turns over — and with it often comes the desire for a fresh start.

But one thing people rarely reflect on is their musculoskeletal health. We often focus on appearance, weight loss, and goals we can measure on a scale or in the mirror. What gets overlooked are the subtle physical signals that something is “off.”

Nagging back pain is a perfect example.

It’s easy to brush off, label as normal, or assume it’ll disappear on its own. Back pain slowly becomes something you adapt to without realizing it — you change how you bend, avoid activities, modify how you sit or sleep. Without careful attention, back pain blends into the backdrop of everyday life.

So if there’s one thing worth leaving behind in 2025, it’s the back pain that’s been following you around for months — or even years. And despite what you may have been told, you do not have to carry this year’s pain into the next one. When you finally understand how back pain works, addressing it becomes one of the most important steps you can take for your long-term health.

Back Pain Rarely Arrives “Out of Nowhere”

Back pain might feel sudden, but there’s almost always a buildup behind it. Most back problems develop gradually — from months or years of poor bending habits, long hours of sitting, repetitive strain, or small compensations your body makes without your awareness.

Then one day you sneeze, lean forward, or twist just a little too far… and suddenly, you’ve “hurt your back.”

People blame the moment — but the real cause is what’s been simmering underneath.

The holidays (and other busy seasons) make this worse:

  • more sitting while traveling
  • more lifting, decorating, and preparing
  • more time on soft couches or guest beds during family visits

The body is already managing everyday stress — and the added strain of the season pushes it beyond what it comfortably tolerates.

The good news? Once you understand that back pain is rarely random — but rather the result of microhabits over time — you can start correcting it. Small adjustments in how you bend, sit, lift, and move can make a remarkable difference.

Before long, not only will you have less back pain… you’ll have far more control over it.

And that kind of control changes everything.

Back Pain Doesn’t Just “Go Away”

Many people hope their back pain will fade once the holidays end and life settles down. But pain that lingers into the new year rarely behaves that way.

When your back is aggravated from mechanical or movement problems, time alone won’t fix it. Rest may help temporarily, but unless you address how you move, sit, bend, or load your spine — the pain returns (often worse).

This is why so many people start January strong, only to be sidelined by February. They unknowingly bring unresolved back pain into their new routines.

Although exercise is one of the best long-term solutions for back pain, it isn’t simple:

  • No pain? Exercise is excellent prevention.
  • Already in pain? You need very specific corrective movements first.

When your foundation isn’t solid, even the best fitness plan can derail. Back pain affects everything — how you walk, lift, twist, breathe, sleep, and even how much motivation you feel.

Don’t wait for back pain to “go away” on its own. And be cautious of quick-fix New Year’s programs that layer new problems on top of old ones. Ignoring your back now may leave you worse off in 2026 than you planned.

Most Back Pain Has a Mechanical Cause — and a Natural Fix

Here’s the encouraging part: about 80% of back pain can be resolved naturally once you understand its mechanical origin.

Your spine is remarkably resilient. It’s designed to move, adapt, and support you for decades — even with arthritis or bulging discs.

When pain appears, it’s usually signaling that something in your movement pattern needs attention.

Your body gives clear clues:

  • certain movements feel better
  • others make symptoms worse
  • pain may change throughout the day

These patterns tell a far more accurate story than any X-ray or MRI.

Once your movement “story” is understood, meaningful change and lasting relief become possible.

A new year is the perfect time to leave unhelpful habits behind. You don’t have to wake up stiff, brace every time you bend, or avoid activities you love because you’re afraid of making things worse.

Small, strategic changes — paired with guidance from the right expert — can transform everything.

If your goal is to leave back pain behind in 2025 and start 2026 feeling stronger, more mobile, and more confident, consider consulting with a mechanical back pain specialist. We help people across Portsmouth, Dover, Rye, Kittery, and the greater Seacoast get natural, lasting relief every day.

Or reach out to me personally — I’m always happy to help.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for the Seacoast Media Group.

To get in touch — or request a free discovery visit with one of our specialists — visit our website or call 603-380-7902.

Holiday Stress

Don’t Let Holiday Stress Turn Into Pain: 3 Simple Strategies

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Don’t Let Holiday Stress Turn Into Pain: 3 Simple Strategies to Stay Healthy in Portsmouth, NH

The holidays are meant to feel warm, festive, and joyful. But for many people here in Portsmouth and the Seacoast area, they also bring a level of stress your body can’t help but absorb. Between shopping, hosting, traveling, and trying to squeeze everything in, your nervous system can go into overdrive. And when that happens, stress often shows up physically — tight shoulders, a stiff neck, a cranky low back, or even tension headaches.

The good news? You can interrupt this cycle with a few simple habits. These strategies can help you keep holiday stress from turning into neck, shoulder, or back pain — and they’re easy to start right away.

1. Try Belly Breathing to Reset Your Body’s Alarm System

When stress rises, your breathing becomes shallow. You might not notice it, but your brain definitely does. Shallow breathing tells your nervous system that you’re under pressure, and your muscles respond by tightening. I personally feel this tension through my rib cage and into my neck when it gets bad enough.

Just one or two minutes of deep, intentional breathing can reverse this entire pattern.

Wherever you are — in the car, standing in line on Congress Street, or even at a holiday party — try this:

✔ Take a slow inhale.
Fill your belly, sides, and lower back with air.

✔ Exhale naturally.
Let the air fall out without force.

Each deep breath acts like a reset button for your nervous system. It helps stop tension from turning into knots, spasms, or lingering pain in your neck or lower back.

2. Practice Gratitude (It Physically Changes Your Stress Levels)

Gratitude isn’t just a feel-good idea. It’s a simple mindset shift that has measurable effects on your body.

When you pause to focus on something positive, your brain reduces its release of cortisol — your main stress hormone. Lower cortisol leads to:

  • Lower muscle tension
  • Happier blood pressure
  • Better sleep
  • Less strain on your neck, back, and hips

A gratitude practice doesn’t need to be fancy. It can be as simple as:

  • Thinking of one thing you appreciate while drinking your morning coffee
  • Writing a single sentence in a journal before bed
  • Setting a daily alarm to remind yourself of something good

These tiny moments tell your body: “You’re safe. You can relax.” Your muscles respond in kind.

3. Move Daily to Break the Stress Cycle

Chronic stress triggers your fight-or-flight system. It’s helpful if you’re running from danger — but in modern life, most of our stress comes from calendars, inboxes, and long to-do lists. If that stress energy has nowhere to go, it lingers in your body as muscle tension.

Movement is how you release it.

Personally, I love walking around Portsmouth and the Seacoast. I aim for 10,000 steps a day. When the weather is too cold or I’m stuck on Zoom, I use a walking pad. I always feel better afterward.

But walking isn’t the only option. You can also:

  • Go to the gym
  • Stretch for a few minutes
  • Run up and down your stairs
  • Do 30–60 seconds of jumping jacks

Just 5–10 minutes at a time is enough to tell your brain the stress has passed. Once that happens, your cortisol levels naturally come back down — and tension is less likely to settle in your joints, neck, or back.

Your Body Will Thank You

You may not be able to eliminate holiday stress (and if you figure out how, please let me know!) — but you can prevent it from turning into pain. Small habits, repeated throughout the season, make a huge difference. And you can keep using these same habits long after the holidays.

But if you’re already dealing with significant tightness or pain that isn’t improving, these strategies might not be enough on their own. A mechanical pain specialist can help you identify the true root cause, calm things down quickly, and give you a clear plan so you enter the New Year feeling better — not worse.

If you need help or guidance, we’re here for you.

Dr. Carrie Jose, Physical Therapy Specialist & Mechanical Pain Expert, writes for Seacoast Media Group and helps people on the Seacoast get rid of back, neck, hip, and shoulder pain naturally.

For more resources or to get in touch, visit www.cjphysicaltherapy.com or call 603-380-7902.

Stretching for lower back pain in Portsmouth NH that may not relieve stiffness

3 Reasons Your Lower Back Stretches Aren’t Working

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Why Your Lower Back Still Feels Tight — Even When You Stretch Every Day

If you’re dealing with lower back pain in Portsmouth NH and stretching every day — but still feel tight, stiff, or sore — you’re not alone.

At our physical therapy clinic in Portsmouth, New Hampshire, we see this all the time. People are consistent. They’re motivated. They stretch daily.
And yet — their back still feels tight, restricted, or painful.

The truth?
Stretching your lower back isn’t always the solution. And in many cases, stretching can actually make back pain worse instead of better.

If your lower back still feels tight despite everything you’ve tried, here are three common reasons why stretching may not be helping — and what you can do instead.

1. Your Stretching Technique Is Working Against You

Most people assume that simply doing the stretch is enough.
But how you stretch is just as important as what you stretch.

At our Portsmouth physical therapy office, we often see people stretching while:

  • Holding their breath
  • Tensing their glutes or shoulders
  • Forcing positions instead of easing into them

When your body feels strained, your nervous system responds by tightening — not relaxing. This makes tight muscles even tighter.

If this sounds familiar, try slowing your stretches down. Focus on calm breathing, gentle movement, and releasing tension instead of forcing range of motion.

Sometimes it’s not what you’re doing … it’s how you’re doing it.

2. You’re Stretching the Wrong Thing for the Problem You Actually Have

Generic stretches like child’s pose, hamstring stretches, or forward bends may help if your stiffness comes from:

  • Sitting all day
  • Muscle fatigue
  • General stress

But if your pain is mechanical — such as:

  • Disc irritation
  • Sciatic nerve involvement
  • Poor movement patterns
  • Hip or pelvic imbalance

… those same stretches may not help at all. In fact, they can aggravate lower back pain even more.

This is why one-size-fits-all routines fail.

As a mechanical pain specialist, I assess:

  • Which movements make pain better or worse
  • How your back responds to direction of motion
  • How your body compensates

This allows us to prescribe exact stretches and exercises for your condition — not generic ones. That’s what true corrective physical therapy looks like.

If your current routine hasn’t changed your symptoms, the issue may not be effort — It may be accuracy.

3. Your Lower Back May Not Need Stretching At All

This surprises many people.

A back that feels “tight” is often reacting to weakness or instability nearby —
especially in the hips, pelvis, or core.

When your body feels unsupported, it tightens muscles as a protective reflex.

If your back stiffens after:

  • Core workouts
  • Prolonged sitting
  • Busy days
  • Certain movements

…your real issue may be weakness, not flexibility.

In these cases, strengthening the right muscles — and teaching them to work together — provides far more relief than stretching ever will.

The Bottom Line: Lower Back Pain Is Fixable

If daily stretching hasn’t helped your lower back pain in Portsmouth NH, it’s time to stop guessing.

Your tightness may be happening because:

  • Your technique is off
  • Your stretches aren’t specific enough
  • Stretching isn’t what your body needs at all

Once the true mechanical reason behind your pain is identified, recovery becomes faster — and far less frustrating.

Get Expert Help for Lower Back Pain in Portsmouth NH

If your lower back stiffness or pain isn’t improving, working with a mechanical back pain specialist in Portsmouth NHmay be your next step.

Correct diagnosis leads to:
– Faster pain relief
– Fewer flare-ups
– Less trial-and-error
– Better long-term results

About the Author

Dr. Carrie Jose, DPT, is a Physical Therapy Specialist and Mechanical Back Pain Expert and the owner of CJ Physical Therapy & Pilates in Portsmouth, NH.

She regularly writes for Seacoast Media Group and helps residents throughout the Seacoast overcome back pain without medication, injections, or surgery.

To request a copy of her free guide: “5 Simple and Easy Ways to Get Rid of Back Pain”
Visit: www.cjphysicaltherapy.com
Or call: 603-380-7902

Holding Knee with Arthritis

Want to Avoid a Total Knee Replacement? Start Here.

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Every year, around 700–800,000 Americans undergo total knee replacement surgery – and that number continues to climb.

Here in Portsmouth, NH, we see this trend too – but what if many of those surgeries weren’t actually necessary?

It’s true that knee replacements have an excellent success rate, with more than 90% lasting 20 years or more. But here’s something most people don’t realize…

Only 15% of people who show signs of osteoarthritis on X-ray actually have symptoms. That means the majority of folks walking around with “bone-on-bone” arthritis don’t have any pain at all. Meaning, “severe arthritis” showing up on an X-ray isn’t the be-all-end-all diagnosis you thought it was.

So why do so many end up under the knife?

Because structural findings on imaging – like arthritis, bone spurs, or meniscus tears – are often blamed for pain that may actually have another cause. If you want to avoid knee replacement surgery, it’s critical to understand what’s really behind your pain and whether you’ve exhausted all your options first.

Here are three key things to look at before you resign yourself to surgery.

1. Don’t Let an X-ray Decide for You

Too often, people are told they need a knee replacement because their X-ray “looks bad.” But your level of pain and function – not your imaging – should be what drives your decision.

If you can still walk, climb stairs, and do most of your favorite activities with manageable discomfort – why rush into major surgery with months of recovery and potential complications?

Knee replacement can be life-changing for those in severe, unrelenting pain – but if you’re still functioning relatively well, it’s worth holding off. You may find that a targeted approach to movement, strength, mechanics, and healing can relieve your pain and keep you active for years – without surgery.

And if you’ve already tried physical therapy and exercise but still feel limited, regenerative treatments like Shockwave Therapy and EMTT (Extracorporeal Magnetotransduction Therapy) can help bridge the gap. These non-invasive technologies work by stimulating tissue repair, reducing inflammation, and improving circulation – essentially helping your body heal itself. For many people with chronic knee pain or mild arthritis, regenerative therapy has been a game changer – providing relief and better mobility without needles, surgery, or downtime.

In short, before deciding your knees are “too far gone” just because an X-ray told you so – explore whether your body still has the capacity to heal. You might be surprised at how much function and comfort you can restore with the right approach.

2. Check Your Back (Yes, Really)

One of the most overlooked causes of persistent knee pain is your spine.

A study published in the Journal of Manual and Manipulative Therapy found that over 40% of people with isolated limb pain responded to treatment directed at their spine – even when they didn’t think their back was involved. Plus, even without this study, I’ve seen this all too often in real-life practice.

That means your “knee pain” could actually be coming from irritation in your lower back or nerves. If your knee pain comes and goes, varies with position, or you also experience back stiffness or leg tingling – don’t ignore it or assume it’s all in your knee.

Getting evaluated by a Portsmouth, NH mechanical pain specialist who can test whether your pain is spine-related or knee-related can save you from years of ineffective knee treatments…

3. Assess Your Mobility, Not Just Your Arthritis

If your knee is truly arthritic and severely damaged, it will usually feel stiff and restricted all the time. But if your stiffness fluctuates – maybe it loosens up after you stretch, or feels fine one day and tight the next – that’s a big clue your pain could be mechanical – not degenerative.

Sometimes, a small meniscus fold or mechanical joint restriction is the real culprit, and when the joint is moved the right way, the restriction disappears – along with your pain. Unfortunately, this won’t show up on an X-ray or MRI – and many clinicians miss it unless they’re trained in mechanical diagnosis.

Before agreeing to surgery, find out whether your joint motion can be restored naturally. When you regain full, pain-free movement, your knee may not need replacing after all.

The Bottom Line:

Knee replacements absolutely have their place. For some people, they’re the best path to relief and mobility. But far too many people jump to surgery because they were told their X-ray “looked bad” instead of being evaluated properly for the true source of their pain.

If you’re over 40, dealing with nagging knee pain, and want to avoid surgery as long as possible – start by getting your back checked, your movement analyzed, and your regenerative options explored by someone trained in mechanical pain and tissue healing.

You might just find there’s still plenty of life left in your knees – and the added bonus will be you avoiding a major surgery.

Are you local to Portsmouth, NH?

CLICK HERE to request a free discovery visit with one of our specialists in downtown Portsmouth.

Dr. Carrie Jose, Physical Therapist and Mechanical Knee Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or reserve a seat in her upcoming Masterclass on How to End Knee Pain Naturally – CLICK HERE.

sciatica

Struggling with Sciatica? Why What You’ve Tried Might Not Be Working

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Struggling with Sciatica? Why What You’ve Tried Might Not Be Working

If you’ve ever experienced a sharp, shooting pain that travels from your lower back down your leg, you’ve likely been told you have sciatica. And if you’re like most people, you’ve probably tried a few things – rest, stretching, physical therapy, chiropractic care, maybe even a cortisone shot – only to find the pain returns just as quickly as it went away.

So what gives?

Sciatica can be one of the most frustrating and confusing conditions out there. It’s painful. It’s limiting. It can move around. It can be there one day and not the next. And it’s quite often misunderstood – even by medical professionals.

Let’s break down what sciatica really is, why it keeps coming back, and what you can do to finally find lasting relief – naturally – and without having to rely on pain pills, injections, or surgery.

What is sciatica?

Technically, sciatica refers to pain that radiates from the lower back through the buttocks and down the back of one or both legs. This radiating pain is caused by compression or irritation of the sciatic nerve – or one of its nerve roots – in the lumbar spine.

But these days, “sciatica” has become a bit of a catch-all term for any pain that extends beyond the back. Some people don’t feel it in their back at all – they only feel it in the buttocks or hip. Others feel it strictly in their butt. And some feel it all the way down into their lower leg or ankle. The location and intensity of your symptoms will depend on how irritated the nerve is – and symptoms can even change throughout the day.

So what causes this nerve irritation? That’s the part many people miss.

It’s not always a disc herniation, even though that’s a common assumption. And it’s rarely due to your piriformis muscle – despite what Dr. Google might suggest when you search “sciatica.”

Most of the time, sciatica symptoms are mechanical in nature. In other words, they’re caused by poor movement patterns that, over time, lead to stiffness in your spine. This stiffness creates compensations that can begin to irritate nearby structures – sometimes that’s a disc that’s slightly out of place or degenerated, and sometimes it’s not a disc at all. Either way, the underlying issue is the same: stiffness and poor movement habits that cause irritation in the spine. And when one of the structures getting irritated happens to be a nerve – you get sciatica.

The MRI trap

Now that you understand the true, underlying cause of sciatica – let’s talk about MRIs for a moment. While they can be helpful in ruling out serious conditions, they’re often overused – and in many cases, misleading – when it comes to non-specific low back pain, including sciatica.

Studies show that people without any back pain at all frequently have bulging or herniated discs on MRI. So when someone with sciatica gets imaging done and sees a disc issue, it’s easy to assume that’s the problem. But correlation doesn’t always mean causation.

The result? People end up chasing structural problems that may have nothing to do with their pain. And meanwhile, the real issue – often a mechanical one – is left unaddressed.

Why traditional treatments often fail

Traditional treatments often fail for sciatica for a few reasons. If you miss the root cause – which is mechanical about 80% of the time – and instead chase the symptoms and compensations (tight muscles, weak muscles, inflammation, etc.) – you’ll find yourself running in circles with little to no relief – and certainly not the lasting kind.

Another reason treatments fail is because of the MRI trap. In other words – allowing your MRI to dictate your treatment plan instead of making sure the findings actually correlate with what’s going on with you in real life.

If you’ve sought help for sciatica and were only prescribed rest, painkillers, anti-inflammatories – or in more severe cases, a cortisone injection – then you’ve only been chasing symptoms. And pain relief is not the same as healing. If the mechanical or movement issue that’s irritating your sciatic nerve hasn’t been resolved, the pain will almost always return. Sometimes worse than before.

That’s why it’s not uncommon for someone to feel amazing after a cortisone shot – only to be back in pain three weeks later. Or to get surgery for a herniated disc – only to find out months later that the pain is still there, or now shows up at another level in the spine.

So what actually works?

The key to lasting relief from sciatica is identifying and correcting the true source of nerve irritation. And most of the time, that comes down to improving how your spine, pelvis – and sometimes even your hip – are moving. This has to happen first before you focus on things like core strength or correcting muscular imbalances.

Yes, inflammation can be a factor – and when it’s present, it can make mechanical therapy less effective. The good news is we now have natural treatment strategies, like shockwave therapy and EMTT, that can help calm inflammation – without having to rely on anti-inflammatories or cortisone shots.

A physical therapist who is specially trained – and skilled at identifying mechanical problems – is the best person to evaluate your movement patterns and determine exactly what’s triggering your pain. Often, a very specific movement or series of movements can not only relieve pressure on the sciatic nerve, but also help restore normal function so the pain doesn’t come back.

A mechanical approach to treating sciatica is drastically different from traditional physical therapy methods that focus mostly on stretching, strengthening, or even hands-on work. And while stretches and manual therapy might feel amazing and seem helpful in the short term, they still fail to address the real, underlying mechanical cause of your sciatica.

You need to identify the faulty movement patterns in your spine and reduce the tension on your nerves. Once you do that – your body can take over and heal itself naturally.

The best part about this type of approach? It’s repeatable – and something you can eventually manage completely on your own. That’s how you keep your pain gone and get long-lasting relief.

Bottom line: treat the source, not just the symptoms

If you’re dealing with sciatica – or think you might be – don’t settle for short-term relief. Look beyond the symptoms. Find someone who can assess your movement, test what improves or worsens your pain, and give you a clear plan of action.

Because when you treat the root cause – not just the nerve – you don’t just get relief. You get your life back.

Are you local to Portsmouth, NH and looking for help?

Speak to one of my specialists 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.

person holding lower back due to pain during holiday season in Portsmouth NH

Why Your Back Pain Isn’t Going Away – Even After Rest, PT, and Chiro

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In my 23-year career, back pain is probably the one problem that frustrates people the most. It affects your sleep, your mood, your energy, and your ability to enjoy the things you love. Plus, it becomes even more frustrating after you’ve tried all the “right” things – like physical therapy, chiropractic treatment, and even good old-fashioned rest.

If this sounds like your story, you are not alone. I work with people every week who have done everything they were told to do – and they’re still in pain. And it’s not because they didn’t try hard enough. It’s because the true root cause of the problem was missed.

I always say… If your treatment plan isn’t working, you either have the wrong diagnosis or a poor treatment strategy.

Let’s take a closer look at why some of the most common treatments for back pain – rest, physical therapy, and chiropractic care – don’t always work.

Rest is Not a Cure

When your back hurts, resting feels like the safest and most natural thing to do. And for an acute injury, some rest is helpful. But debilitating back pain episodes aside, resting for more than a day or two can actually make things worse.

Your spine needs movement. Movement keeps your discs hydrated, your joints nourished, and your muscles coordinated and strong. Avoiding movement out of fear can lead to stiffness, weakness, and more pain – not less.

Your nervous system relies on movement – and your body’s response to it – to help it learn and recover after injury. If you shut everything down at the first sign of pain, your brain can start to associate movement with danger. That’s how chronic pain problems begin.

The reality is, if rest alone cured back pain, we wouldn’t have so many people still suffering from it.

Your Physical Therapy Isn’t Prescriptive

The research tells us that exercise is one of the most effective treatments for back pain – which is why physical therapy should be the gold standard. Physical therapists are trained to be movement experts. They should be prescribing exercises that are designed to take your back pain away – and keep it gone – while using hands-on work and modalities selectively to help you move with less pain and more efficiency.

But sadly, this doesn’t always happen. I often see clinics that rely heavily on passive modalities like ultrasound or electrical stimulation for short-term relief. Then the exercise “prescription” ends up being a generic list of stretches and core exercises you could find on YouTube.

If your physical therapy didn’t work, it’s possible the true root cause of your back pain wasn’t correctly identified. Many cases of back pain are due to “derangement syndrome” – when something in your spine (like a bulging disc) disrupts normal movement. Unless you correct the way your spine moves – and learn how to maintain that correction – the pain keeps coming back.

Physical therapy must be prescriptive in nature. If you just want general exercises, you can find them online or go to the gym. Your back might eventually feel better – but you’ll never know what fixed it, and you’ll have no way to fix it again when the pain returns.

Chiropractic Adjustments Aren’t Always Enough

Chiropractic care can sometimes be the difference between being unable to move and finally being able to straighten yourself out – especially during an acute episode of back pain. But most chiropractic care is passive. It has its place, but problems arise when people rely solely on adjustments to stay out of trouble. Chiropractic care should be paired with prescriptive, active movement that retrains your nervous system and gives you tools to manage your pain.

Another issue I see is people who have relied on adjustments for years. Eventually, they realize the pain keeps coming back. That’s often because the joint being mobilized provides only temporary relief, while the root cause isn’t being addressed. Chiropractic adjustments also aren’t very specific. Your spine often needs precise movements, in a specific direction, repeated over time. When it comes to disc or nerve problems, it can take thousands of reps of the right movement to resolve the irritation and get the pain to stop. A chiropractic adjustment can sometimes disrupt that carefully prescribed movement plan – and then you’re back at square one.

This all might sound a bit “technical” to you, and that’s because it is. It’s also why so many people still suffer from back pain despite trying everything.

But don’t overthink it. Ask yourself: Is chiropractic care still helping? Are you relying on the adjustments less and less? If yes, you’re on the right track. If not, it may be time for a new approach.

What to Do Instead

There’s no one-size-fits-all solution for back pain. But successful treatment usually starts by asking better questions and taking the time to uncover the real root cause.

Is it your muscles? Your joints? A disc? A nerve? Or the way your brain and nervous system have adapted over time?

A thorough, mechanically based assessment often reveals things that X-rays and MRIs miss. In fact, imaging can sometimes lead to too much information – and send you down a path of unnecessary treatments that should be reserved as a last resort.

Once the true source of your problem is found, a plan that emphasizes active movement, education, and progressive activity is far more effective than passive treatments or rest alone. Passive treatments can help reduce symptoms quickly, but long-term success depends on learning how to care for your back with the right tools, the right guidance, and the right movements.

If your back pain isn’t going away – even after rest, PT, or chiropractic – it’s not a sign that you’re broken or destined for surgery. It could just mean the true cause of your pain hasn’t been found yet.

If you’re tired of chasing quick fixes and want real answers, we can help. Schedule a free Discovery Visit to uncover the root cause of your back pain and find out if we’re the right fit to help you get lasting 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.

Back MRI

Are your Back MRI results reliable? Research says otherwise.

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Whenever pain flares up – one of the most popular questions and concerns I get from clients is whether or not they need an MRI. When you have persistent pain that won’t go away, or shooting pain or numbness down your arm or leg, it’s scary. It makes sense to get a look inside with an MRI, right?

Not necessarily.

MRI’s are an amazing technological advancement that will literally show you everything that is going on in your spine. But what we now know from research is that all those findings on an MRI don’t always correlate with what’s actually causing your pain.

One notable study was the Lancet series – three published papers that investigated how MRI findings related to the treatment of back pain. Martin Underwood, MD, co-author of the Lancet series, and professor at Warwick Medical School, is quoted in The Guardian saying: “If you get into the business of treating disc degeneration because it has shown up on an MRI, the likelihood is that, in most of those people, it is not contributing to their back pain.”

Let me explain.

When it comes to back problems – or joint problems in general – what most people don’t realize is that 70-80% of all spine and musculoskeletal problems are what we call “mechanical” in nature. That means your pain has to do with the way you move, bad postural habits learned over the years, or muscular and joint imbalances like weakness and poor flexibility. Many of these mechanical “wear and tear” problems don’t show up until your 40’s, 50’s or 60’s – which coincidentally is also the time that things like disc degeneration and other age-related changes show up on an MRI.

What it’s important to understand is that disc degeneration, arthritis, and bulging discs are ALL a normal part of aging, but they often get blamed for problems they don’t actually cause. In other words, the source of your pain is often a movement dysfunction learned and repeated over time that is irritating you – not the age-related changes themselves. The best way to figure out if your problem is movement-related vs structure-related is… well… with a movement assessment… NOT an MRI.

So how does movement testing work and why is it more reliable than an MRI? 

This is a great question and not one that is easily explained… but I’m going to try!

When your back, neck or joint pain is mechanical in nature – one of the most important things to look at and pay attention to is how your pain behaves. Not necessarily where it’s located. With pain – the most important thing to determine is how it reacts against certain triggers and with different activities.

Does your pain come and go? Do you have good days and bad days? Can you change positions and influence your pain?

When your pain is variable, it’s the most reliable sign that your pain is “mechanical” in nature. It also means you don’t need surgery or any kind of procedure to fix it. In fact, a procedure or surgery could leave you feeling worse off than before. Let’s say you “cut out” the structure – or inject it to make it numb – your movement problem hasn’t gone away and it’s only a matter of time before it starts aggravating something else.

Take home point…

MRI’s are a super powerful and amazing diagnostic tool – but their results when it comes to diagnosing neck, back, or joint pain MUST be taken with a grain of salt – and should absolutely be coupled with an expert mechanical joint evaluation before you decide on a treatment plan.

Because if you are dealing with chronic, long-standing aches and pains that have come and gone over the years – or have recently gotten worse – there is a 70-80% chance that it is a mechanical problem finally catching up to you and not a structural problem.

Figure out the root source of your neck, back, or joint pain by seeing a movement expert who specializes in mechanical pain FIRST. Because when you automatically assume that you need an MRI first, and you base your whole treatment plan off of those results – you can end up down a rabbit hole of unnecessary medical procedures or surgery that ultimately won’t give you the long-term relief you’re looking for.

Are you local to Portsmouth, NH?

Consider speaking to one of our specialists 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 Hamstring Isn’t Healing – 3 Signs It’s Something Else

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Hamstring Pain is common – especially in active adults over 40.

But what’s less commonly talked about is how often a hamstring injury is misdiagnosed. If you’ve been stretching, foam rolling, and rehabbing your “hamstring strain” for weeks or months with little to no improvement – there’s a good chance your pain isn’t coming from your hamstring at all.

That’s because certain types of back problems can mimic hamstring pain almost perfectly. And if you don’t recognize the signs, you may end up chasing the wrong problem for far too long.

So how can you tell when your hamstring isn’t healing because it’s not really your hamstring?

Let’s take a look at what a true hamstring strain typically looks like – and then go over three clear signs that something else is actually going on.

What a true hamstring injury looks like:

A hamstring strain usually happens suddenly – often during an explosive movement like sprinting or lunging. You’ll feel a sharp pain in the back of your thigh, and possibly notice swelling, bruising, or tenderness. In the early stages, walking or bending your knee might be difficult. But with the right combination of rest, movement, and strengthening – most hamstring injuries heal well and don’t linger – especially when properly diagnosed and rehabbed.

If your pain doesn’t follow that pattern – or seems to be sticking around far longer than expected – there’s a good chance your spine is actually to blame.

Here are three key signs your “hamstring strain” might be something else entirely:

1. The pain never really goes away

A true muscle injury will hurt when it’s injured – but it heals. If your pain feels dull, achy, and persistent – especially after long periods of sitting or standing still – that’s a red flag.

This type of pain often stems from nerve irritation in the lower back, not muscle damage in your leg. It’s common for certain spinal problems to refer pain down the back of the thigh, which is why this gets misdiagnosed so often. But unlike a muscle strain, nerve-related pain doesn’t improve with time or basic rehab – and may even get worse with certain types of movement or exercise.

2. You notice tingling, numbness, or odd sensations

Muscles don’t cause tingling. Nerves do. So if your hamstring injury is accompanied by numbness, tingling, or an odd “buzzing” feeling in your butt or leg – it’s almost certainly a nerve issue. The sciatic nerve, which originates in your lower spine, travels right through the area where most people feel hamstring tightness. When that nerve gets irritated, it can create sensations that feel like they are coming from your hamstring – but aren’t.

If you’re experiencing these kinds of nerve symptoms – it’s a strong indicator that your spine (not your hamstring) is the real source of the problem – and it needs to be addressed.

3. Your pain travels below your knee

This one’s especially important. Your hamstrings attach just above and behind the knee – so any pain you feel below your knee can’t be coming from your hamstring.

If your discomfort travels down your calf or even into your heel, the likely culprit is your spine. Research shows that as much as 40% of lower leg pain originates from the lower back – even when there’s no actual back pain. So it’s very possible to have a perfectly healthy hamstring – but still feel pain there due to a nerve referral from your spine.

What to do next

If any of these signs sound familiar – don’t keep treating your hamstring like a muscle strain – it won’t help – and could even worsen your problem. Plus, the longer you focus on the wrong issue, the longer it will take to get better.

Instead, seek out a physical therapy specialist who understands how to properly screen and assess your spine. They’ll be able to figure out if your lingering hamstring pain is related to a problem in your lower back. And once you identify the true root of your pain – you can finally get the treatment you need – and get back to doing the activities you love.