Tag Archive for: back pain Portsmouth NH

Why Core Strengthening Isn’t Fixing Your Back Pain (And May Be Making It Worse)

/in /by

If you’ve ever Googled “how to fix back pain,” you’ve probably seen advice suggesting consistent movement, stretching, and core strengthening. And while that’s not wrong, it’s incomplete.

At our Portsmouth, NH physical therapy clinic, we see people every day who have been doing all the “right” core exercises—and still struggling with back pain.

Here’s why.

The Problem with Generic Core Strengthening for Back Pain

Yes, movement matters.
Yes, stretching can help.
Yes, core strengthening is important.

But only when applied at the right time and in the right way.

Jumping into generalized ab workouts—like planks, crunches, or stability exercises—too early can actually prolong your back pain or make it worse.

That’s because most back pain isn’t simply a strength issue.

Why Back Pain Is Usually a Movement Problem (Not a Weakness Problem)

One of the biggest misconceptions we hear from patients across the Seacoast NH area is:

“My back hurts because my core is weak.”

In reality, about 80% of back pain is mechanical, meaning it’s caused by the way your spine moves—not how strong it is.

While strengthening plays a role in long-term recovery, it’s not the first step.

If you’ve been focusing on core workouts and still dealing with recurring pain, this is likely why.

Why Your Ab Exercises Aren’t Working

Core exercises can:

  • Improve circulation
  • Create temporary support
  • Reduce discomfort short-term

But they don’t fix the root cause.

If your spine isn’t moving properly, adding strength on top of dysfunction can:

  • Reinforce poor movement patterns
  • Increase irritation
  • Lead to recurring flare-ups

This is why so many people in Portsmouth and surrounding areas feel stuck—doing everything right, but seeing no lasting results.

Mobility Before Stability: The Missing Link in Back Pain Treatment

At our Portsmouth physical therapy clinic, we follow a simple rule:

Mobility before stability

Before you strengthen your core, you need to:

  • Restore proper spinal movement
  • Identify the specific movement causing pain
  • Use targeted exercises based on your body

Not:

  • Random stretches
  • Generic workout plans
  • TikTok or YouTube routines

When you address the underlying mechanical issue first, your results improve dramatically—and actually last.

A Real-Life Example

One of our clients—a highly fit Marine veteran in his late 30s—had a strong core and consistent workout routine. But he still dealt with recurring back pain.

The issue wasn’t strength. It was mechanical dysfunction in his spine.

Once he focused on correcting movement patterns (instead of just strengthening), everything changed:

  • Faster recovery
  • Fewer flare-ups
  • Better day-to-day mobility (even after travel and long periods of sitting)

What This Means for You

If your core workouts aren’t fixing your back pain, you’re not alone.

And more importantly—you’re not broken.

You’re likely just missing a key step:

  • Fix movement first
  • Then build strength

When you do that, your progress doesn’t just feel temporary—it actually sticks.

Get Help for Back Pain in Portsmouth, NH

If you’re in Portsmouth, NH or the Seacoast area and tired of dealing with ongoing back pain, working with a specialist who understands mechanical back pain can make all the difference.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Back Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth.

To request your free guide to relieving back pain naturally, visit cjphysicaltherapy.com or call 603-380-7902.

Back Pain Isn’t a Rest Problem – It’s a Movement Problem

/in /by

If you’re dealing with back pain in Portsmouth, NH or the Seacoast area, your first instinct is probably to stop everything and rest. That feels logical — when something hurts, you avoid it.

But when it comes to back pain, that instinct may actually be keeping you stuck in a cycle of pain.

After more than 20 years of helping people overcome back pain at CJ Physical Therapy & Pilates in Portsmouth, NH, one of the biggest misconceptions I see is this:

Rest and passive treatments will fix the problem.

They might help temporarily — but they rarely solve the root cause.

Why Rest Feels Right — But Often Makes Back Pain Worse

When your back first “goes out,” taking a day or two to rest can help calm things down.

But after that, rest starts working against you.

Your body — especially your spine — is designed to move. Movement:

  • Keeps joints lubricated
  • Helps discs stay hydrated
  • Activates muscles
  • Regulates your nervous system

When you stop moving:

  • Muscles tighten
  • Joints stiffen
  • Pain sensitivity increases

This is why so many people in Portsmouth and surrounding Seacoast towns feel worse after prolonged rest, not better.

Research consistently shows that staying active (in the right way) leads to faster recovery and less chronic pain.

The Real Cause of Most Back Pain

Here’s what most people aren’t told:

About 80% of back pain is mechanical.

That means it’s caused by how your spine is moving (or not moving) — not necessarily damage or injury.

Your spine is made up of multiple joints that need to work together. When even one segment isn’t moving properly:

  • Discs can become irritated
  • Nerves may get compressed
  • Surrounding muscles tighten up

Many people in Portsmouth, NH assume they need something to be “put back into place.”

But the real issue is usually poor movement patterns, not alignment.

Why Passive Treatments Don’t Last

By the time most patients come into our Portsmouth physical therapy clinic, they’ve tried:

  • Massage therapy
  • Chiropractic adjustments
  • Injections
  • General physical therapy

And they all say the same thing:

“It helped… until it didn’t.”

That’s because these treatments are often:

  • Too passive
  • Not specific enough

They may relieve symptoms temporarily, but they don’t:

  • Retrain your body
  • Correct movement dysfunction
  • Prevent the pain from coming back

Even traditional physical therapy can fall short if it relies on generic exercise programs instead of a precise diagnosis.

Movement Is Medicine — When It’s Done Right

The most effective treatment for back pain — supported by research — is:

Targeted, specific movement.

But not just any movement.

At our Portsmouth clinic, we use what we call “first-aid movements” — simple, specific exercises that:

  • Reduce pain quickly
  • Relieve pressure on discs and nerves
  • Restore normal joint motion

From there, we build a plan that includes:

  • Strength training
  • Mobility work
  • Movement retraining

This is what allows you to:

  • Get out of pain
  • Stay out of pain
  • Return to normal life without fear

Back Pain in Portsmouth, NH: It’s Not a Rest Problem

Most back pain isn’t caused by doing too much.

It’s caused by not moving well enough.

If you keep treating it with rest alone, you’ll likely stay stuck in this cycle:

Pain → Rest → Temporary Relief → Repeat

But when you start addressing the movement problem, everything changes.

You stop guessing.
You stop fearing movement.
And you finally get long-term relief.

Get Help for Back Pain in Portsmouth, NH

If you’re struggling with persistent or recurring back pain in the Portsmouth, NH or Seacoast area, the right plan can make all the difference.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Back Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth.

To request a free back pain guide or get help:
Visit: cjphysicaltherapy.com
Call: 603-380-7902

herniated disc

Herniated Discs and Cortisone Shots – What Most People Get Wrong

/in /by

Herniated Discs and Cortisone Shots: What Most People Get Wrong About Back Pain Treatment in Portsmouth, NH

If you’ve been told you have a herniated disc and that your next step might be a cortisone shot, you’re not alone. This is one of the most common treatment paths recommended for people dealing with back pain after an MRI reveals a disc bulge or herniation.

Many people assume that if their MRI shows a herniated disc and they’re experiencing pain, the logical next step is a cortisone injection. But that assumption often sends people down a path of procedures that don’t actually address the root cause of their back pain.

At our Portsmouth, NH physical therapy clinic, we frequently see patients who were advised to get injections before anyone fully explained why their pain was happening in the first place.

The truth is that cortisone shots—most commonly delivered in the spine as an epidural steroid injection (ESI)—can help in certain situations. The problem is that they are often recommended without first understanding the type of back pain someone is experiencing. When that happens, people may undergo injections that do little to solve the real problem.

Understanding when injections help begins with recognizing that not all back pain behaves the same way.

Not All Herniated Disc Pain Is the Same

When people hear the words “herniated disc,” they often imagine a serious structural injury that needs to be treated with medication or a procedure.

But the presence of a herniated disc on an MRI does not automatically mean injections are necessary. In fact, research has shown that many people have herniated discs on imaging and experience no symptoms at all.

What matters far more is how the body is responding to the disc and the type of pain it creates.

Broadly speaking, most back pain falls into two categories:

  • Inflammatory pain
  • Mechanical back pain

Both can occur with a herniated disc, but they behave very differently and respond to different treatments. Unfortunately, this distinction is rarely explained to patients, which is one reason cortisone injections are often misunderstood and overused.

When Cortisone Shots Can Help

While cortisone injections are rarely my first recommendation, they can be helpful when pain is primarily driven by inflammation.

Inflammation is a normal part of the body’s healing process. When tissue becomes irritated or injured, the body releases chemicals that increase blood flow and begin repair.

Occasionally, however, this inflammatory response doesn’t shut off properly. When those inflammatory chemicals linger longer than necessary, they can irritate nearby tissues and create persistent “chemical” pain.

This type of pain tends to:

  • Feel constant
  • Change very little with movement or posture
  • Be described as hot, inflamed, or deeply irritated

When inflammation behaves this way, cortisone injections can help by suppressing those inflammatory chemicals and calming irritated tissue. Once inflammation settles, movement and exercise can become effective again.

However, this type of inflammatory pain is not the most common cause of back pain.

Most Herniated Disc Pain Is Mechanical

Most back pain—even when a herniated disc is involved—is mechanical in nature.

Mechanical back pain is related to how the joints, muscles, and spine move together. It often develops when certain areas of the body become stiff while others compensate, creating inefficient movement patterns and excess stress on the spine.

Many people with herniated discs notice patterns like:

  • Pain worsening when sitting too long
  • Relief when standing or walking
  • Improvement with stretching or changing positions

These patterns are important clues.

When back pain improves with movement, the most effective treatment is usually restoring proper movement patternsthrough physical therapy.

This includes:

  • Identifying mobility restrictions
  • Correcting faulty movement habits
  • Strengthening the muscles that support the spine

Herniated discs can sometimes become irritated by everyday activities like lifting awkwardly, twisting suddenly, or even coughing or sneezing. When this happens, nearby muscles and nerves may become temporarily inflamed, making the pain feel intense and alarming.

But in many cases, this irritation is temporary and part of the body’s normal response—not something that requires injections or surgery.

The bigger issue is often the mechanical stress that caused the disc irritation in the first place.

Unless that underlying problem is addressed, the disc may continue to flare up repeatedly. Once movement patterns improve and mobility restrictions are corrected, the disc bulge or herniation often becomes far less significant.

The Problem With Treating Symptoms Instead of Causes

One of the biggest limitations of cortisone injections is that they treat symptoms rather than causes.

By reducing inflammation, the injection may temporarily decrease pain. But it does not correct the movement problems or mechanical stress that contributed to the disc irritation.

In some cases, this temporary relief can even backfire. When pain is masked, people may return to activities that continue irritating the spine without realizing it.

Over time, this can reinforce the same patterns that caused the injury and increase the likelihood of repeated back pain flare-ups.

New Non-Invasive Treatment Options for Back Pain

Fortunately, newer regenerative therapies are offering alternatives to cortisone injections for calming inflammation and promoting healing.

One example is Extracorporeal Magnetotransduction Therapy (EMTT). This technology uses high-frequency magnetic energy that penetrates deep into tissue and stimulates healing at the cellular level.

It is often combined with shockwave therapy, which helps stimulate circulation and tissue repair in irritated areas.

These therapies are non-invasive treatments for back pain that work with the body’s natural healing systems rather than suppressing them.

How to Tell What Type of Back Pain You Have

If you are considering a cortisone shot or epidural steroid injection for a herniated disc, the most important step is understanding how your pain behaves.

The way your symptoms respond to movement can provide valuable clues.

If your symptoms:

Improve when you walk, stretch, or change positions
Your pain is likely mechanical in nature. In these cases, treatment focused on restoring proper movement—often through physical therapy—can be the most effective solution.

Feel constant, inflamed, and largely unaffected by movement
Inflammation may be playing a larger role, and treatments designed to calm inflammation could potentially help.

Either way, cortisone injections do not fix structural disc problems or movement dysfunction. They simply reduce inflammation.

Long-term recovery from back pain almost always requires addressing how the body moves. When those underlying issues are corrected, many people find their back pain improves without ever needing injections.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Back Pain Expert in Portsmouth, NH, writes for Seacoast Media Group.

To learn more about natural treatment options for back pain in Portsmouth, NH, or to request a free copy of her guide to relieving back pain naturally, visit www.cjphysicaltherapy.com or call 603-380-7902.