Tag Archive for: back pain physical therapy

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

A Physical Therapy Expert’s Guide to Enjoying Fall Activities Pain-Free

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A Physical Therapy Expert’s Guide to Enjoying Fall Activities Pain-Free

Fall is my favorite season-and I know it is for many of you too. Crisp air, colorful leaves, pumpkin patches, and cozy outdoor gatherings are some things that come to mind. But there’s also raking leaves, picking apples, chopping wood, and moving heavy things like hay bales or pumpkins. Any of these activities can produce unwelcome strain on your body if you’re not careful. 

Here’s a guide to enjoying all that fall has to offer-from a back pain and mechanical pain expert-so you can do as much as you want this fall season while keeping your back and joints pain-free.

  1. Rake Leaves with Care

Raking is a quintessential fall activity, but it’s also repetitive and strenuous, which can lead to back pain if done improperly. To protect yourself, begin by warming up. Just as athletes warm up before a game, you should warm up before raking. Try a brisk 5-10 minute walk around your yard or neighborhood to get your blood flowing, followed by gentle stretches for your back, shoulders, and legs. A few torso twists and arm circles will help loosen up your muscles and prepare them for the repetitive motions of raking. Next, choose a lightweight rake with a long handle that allows you to stand upright. Avoid bending forward too much, and alternate sides regularly to avoid overusing one side of your body. When bending to gather or bag leaves, squat using your legs and keep your core engaged. Avoid twisting from your waist, as this puts your spine in a vulnerable position. Instead, pivot your entire body to avoid strain. Raking for extended periods can tire out your muscles, making you more susceptible to injury, so set a timer for every 20-30 minutes and take a short break to stretch your back and shoulders.

  1. Safely Pick Up and Carry Pumpkins

Pumpkin picking is a fall favorite, but carrying heavy or awkwardly shaped pumpkins can strain your back and shoulders if you’re not careful. Here’s how to keep things safe and pain-free. First, when lifting a pumpkin, bend at your knees and use your leg muscles to power the lift. Keep the pumpkin close to your body and avoid twisting as you lift. If possible, use a cart or wagon to transport heavier pumpkins and prevent carrying strain. Many farms and pumpkin patches provide carts-take advantage of them! If you’re decorating with multiple pumpkins or other fall items, consider limiting the number of trips you make to and from your car or home to avoid repetitive strain. This advice applies to picking up and carrying anything-whether it’s hay bales, fall decorations, or putting away summer furniture.

  1. Use Good Posture When Apple and Pumpkin Picking

Apple orchards and pumpkin patches can be so much fun, but both activities involve a lot of bending, reaching, and lifting. Use these tips to protect your body. Instead of overstretching to reach that perfect apple, use a ladder or stool. Overreaching can lead to shoulder and back strains, so play it safe and keep a good base of support as you reach up. When standing or walking for extended periods in the orchard or patch, practice standing tall, with your weight evenly distributed between both feet. This not only helps reduce fatigue but also protects your lower back. Additionally, if you know you’ll be walking and standing for prolonged periods, wear good, supportive shoes. This will go a long way in helping your spine and the rest of your joints absorb the load of your body as well as those pumpkins and apples.

  1. Move Often and Stay Hydrated

All-day outdoor fall activities can wear you out, especially if you’re standing, bending, or lifting frequently. Staying mindful of your body can make a big difference. Make a point to take a stretch break every hour or so. Focus on simple movements that lengthen your spine and open up your chest and shoulders, such as reaching your arms overhead and gently twisting your torso side-to-side. Cooler weather can make you feel less thirsty, but it’s still essential to stay hydrated. Dehydration can lead to muscle stiffness, fatigue, and even unwanted spasms and cramps, increasing the risk of strains.

  1. Cool Down After Activities

Once you’ve wrapped up your fall fun, give your body a few minutes to cool down and recover properly. A little bit of post-activity care can go a long way in keeping pain at bay. After raking, decorating, or any heavy lifting, spend five minutes stretching your back, legs, and shoulders. Simple stretches like extending your spine backward or pulling your knees to your chest can help relieve tension. After a full day of physical activity, it’s tempting to sink into a couch or recliner, but try to avoid slumping immediately afterward. Instead, sit with a straight back, or go for a light walk. This can help prevent stiffness and reduce the likelihood of soreness.

Enjoy Fall the Pain-Free Way

Fall activities are a great way to enjoy the season and embrace the outdoors, but they don’t have to come with pain and strain. Taking a few preventive measures, such as warming up, being aware of your body, and using proper lifting techniques, can make a significant difference in how you feel afterward. With these tips, you’ll be ready to fully enjoy apple-picking, pumpkin patches, and all the beauty that fall has to offer-with a lot less ache. That being said, if you try every tip I’ve mentioned and don’t notice any difference in how you feel or tolerate these activities, your problem might need expert help. Reach out so we can help you find a mechanical pain expert in your area who can work with you.

Are you local to Portsmouth, NH? If so, consider speaking to one of my specialists in a Free Discovery Session. This 30-min session is a designed to: 1. Make sure we can help you 2. Make sure you’re a good fit for what we do 3. Make sure we’re a good fit for you. Click here to speak with a specialist.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, call 603-380-7902, or CLICK HERE to get a free guide for preventing back pain.

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.

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.

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.

Exercise-induced Leg Soreness or Sciatica? How to Tell the Difference.

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It’s that time of year – when people set goals and take action to improve their health, get back in shape, and ramp up exercise routines.

But what happens when your body isn’t ready for what your mind has planned? How can you tell if the soreness you feel is “good pain” – or a problem brewing?

This concept is particularly confusing when it comes to leg pain. Whether it’s ramping up your strength training, more frequent Peloton rides, or getting back to running/jogging… These activities will make your legs sore. The problem, however, is that leg soreness can mimic a common (and sneaky) condition called “sciatica” – that if missed or ignored – could completely derail you from your health and fitness goals. So it’s important you know the difference and what to watch out for – especially if you have a history of sciatica or back pain. 

Here are some key things you to look out for – that will help you tell the difference between normal leg soreness from exercise – versus sciatic pain that’s caused from your back:

Exercise-induced leg soreness…

With exercise-induced leg soreness – you’ll typically feel pain deep in your muscles (especially those you specifically worked on) – and your legs may feel tender to touch or even “swollen”. This type of soreness comes from challenging your muscles beyond their usual capacity – something you want to do during exercise. The soreness is caused by microscopic damage to your muscle fibers – triggering an inflammatory response. This inflammatory response then triggers a repair phase in the area of the “damaged tissue” (aka your muscles). It’s in this repair phase that your body builds back stronger muscles – so that they’re more resilient the next time you exercise. 

Another key characteristic of exercise-induced leg soreness is that it will typically occur anywhere from 24-72 hours after the activity. This phenomenon is known as “DOMS” (delayed onset muscle soreness) and it will usually dissipate in a similar amount of time. The soreness you feel from DOMS is often felt symmetrically (in both legs) – because most exercises are done using both sides of your body. But even if you’ve done an activity that favors one leg over another – the pain you experience during the DOMS period will occur when you’re moving or stretching the affected muscles – and not so much during periods of rest.

Now let’s look at sciatica…

Sciatica is a problem that comes from your spine and that causes pain in your buttock and/or leg. In between each vertebrae (the bones that make up your spine) are small spaces that allow the nerves originating from your spinal cord to exit. These nerves control everything from sensation, to pain, to muscle strength. If the nerves in your lower back get irritated – or structures around those nerves get irritated (for example, bulging discs) – anything in your leg (or butt) that those irritated nerves “touch” can also be affected. This is the phenomenon known as sciatica.

The tricky part about sciatica is that the timeline of your pain – and the feeling you experience – can be very similar to the leg soreness you get from exercise. Just like exercise-induced leg soreness – sciatic pain can include a deep ache in your muscles, tenderness to touch, and a feeling of swelling. People often describe to me a feeling of “heaviness” in their leg when they are experiencing a sciatic episode. Sciatic pain can also come on 24-72 hours after exercising or activity.

But with sciatica – one of the most important factors you need to pay attention to is how your pain behaves. Leg soreness from exercise arrives in a fairly predictable manner – and leaves in a fairly predictable manner. And you generally won’t have much pain at rest.

Sciatica, on the other hand, is more unpredictable.

Although it can come on in the same time frame as exercise-induced leg soreness – it won’t just “go away” in the same, predictable amount of time. Pain from sciatica can linger – particularly at rest – and with activities such as sitting, driving, standing too long, or walking. It can end up in just one leg even though it started in both – and it tends to come and go. For example – you’ll think it’s better – only to suddenly wake up with a sore leg again – or bend the wrong way and have the pain annoyingly return. And finally – sciatic pain won’t go away completely with stretching or massage (although it’s tempting to think it did). 

But one of the most important things to notice about the behavior of sciatic pain versus exercise-induced leg pain is whether or not numbness or tingling is present. It’s possible to have sciatic pain without numbness and tingling – but it’s not possible to have it with healthy, exercise-induced leg soreness. That’s because only nerve irritation can cause the sensation of numbness and tingling in your leg. And speaking of nerve irritation… If your leg soreness “goes away” – but you’re left with a lingering back ache – your leg pain was almost certainly a sciatic episode that has temporarily resolved – and it’s only a matter of time before it returns with a vengeance.

So there you have it – next time you notice leg pain after exercising – pay attention to how your pain behaves.

How long does it last? Does it come and go? Is it only in one leg vs both? Do you have any numbness? Does it linger or return with mundane activities such as sitting or standing?  If the answer to any of these questions is “yes” – and especially if you’ve got a history of back pain – you must consider that it could be sciatica. To make sure – seek out the help of a mechanical back pain specialist who can tell you for certain.

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.

How Ignoring Back pain could ruin your New Year’s Goals

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Now is the time when people shift their focus to the New Year and start thinking about new and exciting goals for themselves.

According to statista.com – the three most popular New Year’s goals are 1) doing more exercise and improving their fitness, 2) losing weight, and 3) saving money.

Would you be surprised to know that if you are currently suffering from back pain – and you continue to ignore it – it could significantly impact your chances of success at achieving any of these goals?

Let me explain.

Let’s start with doing more exercise and improving fitness. Most people think that if they start exercising more – especially their core – it will solve their back problem. Not necessarily. While the research studies show (overwhelmingly) that exercise is one of the best treatments for back pain – what they don’t reveal is that there are typically some key things that must be in place in order for exercise to be effective. For example, you must have good mobility before you start focusing on stability (or strengthening). If you’ve got a stiff back, general exercise could be all you need, and you’ll notice improvement. But you won’t know until you get going and by then it could be too late.

What if your back is stiff because it’s compensating for something – say a bulging disc or muscle weakness?

If that’s the case, and you go all in with an exercise program in January, it’s only a matter of time (usually about 3 months in) before your back becomes worse, forcing you to abort your grand plan for the new year. When stability is there for a compensatory reason, it’s important to figure that out before adding more exercise or strengthening to the mix. This is one way back pain could derail your New Year’s resolution of doing more exercise and improving your fitness.

Say you want to lose weight. This is a fabulous goal. And if you’ve got back pain, losing weight will surely help. But once again, it’s critical to understand why you’ve got back pain in the first place. For example, being overweight is rarely the cause of back pain. A few extra pounds can certainly exacerbate your back problem, but it doesn’t usually cause back pain all on its own. The most common causes of back pain are mechanical (movement) problems.

In other words – bad movement habits such as sitting all the time, bending and rotating too much, or having terrible posture can all lead to back pain slowly over time.

If you lose weight, but never correct these mechanical/movement problems, your back pain isn’t going to improve. When it comes to the process of losing weight, in addition to watching your diet, more exercise is often incorporated into a weight loss plan. If you’ve got back pain, it’s more than likely due to poor movement habits. More exercise will not address these, and worse, could exacerbate the problem. If your back pain increases, not only will you not want to exercise, but you could be more inclined to sit at home and eat more – completely derailing your New Year’s resolution of losing weight.

Finally – we come to saving money. What on earth could back pain have to do with this? Well, you’ve probably heard the saying: “If you think wellness is expensive, try illness”. And this couldn’t be truer. When you ignore back pain, it’s only going to get more expensive to address later. As back pain worsens, you’ll have less willpower to bear it, and you’ll be more likely to opt for expensive fixes such as outpatient procedures and surgery. Not to mention the rehab that needs to take place afterwards for an optimal recovery and the expensive tests that need to take place before-hand to ensure you’re ready for surgery.

When you ignore a back problem it’s only a matter of time before it becomes unbearable.

And when we’re desperate, we make poor decisions, which often leads to more money spent than necessary. All that money (and more) that you set out to save as part of your New Year’s goals eventually goes to waste. Instead, get in front of your back pain. For 80% of back pain cases, there is a natural, movement-based solution. Natural solutions are far less expensive – and much safer long term compared to something like surgery. While the impact of ignoring back pain may seem indirect when it comes to a New Year’s resolution of saving money – it will impact you in some way – at some point – in a monetary way if you don’t address it now.

When you’ve got back pain (or any pain for that matter) that isn’t going away, it’s your body trying to tell you something. Don’t ignore it. It’s only a matter of time before it gets worse and starts to derail more than just your New Year’s goals.

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

Black Friday

6 Reasons NOT to miss our Black Friday Flash Sale

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

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

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

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

Now if saving BIG wasn’t enough…

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

1. Without your Health – you have nothing

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

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

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

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

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

3. Help with your New Year’s Resolutions!

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

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

4. This only happens ONCE per year

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

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

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

5. Try Out Services You’ve Been Curious About

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

6. Recession-proof your Health

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

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

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

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

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