Tag Archive for: mechanical back pain

Back Pain Yard Work

How to Prevent Back Pain During Yard Work | Portsmouth, NH Physical Therapy

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How to Keep Yard Work from Throwing Out Your Back

Every spring, it happens like clockwork.

You finally get a stretch of nice weather, head outside with good intentions, and start tackling everything that’s been waiting all winter—yard cleanup, spreading mulch, pulling weeds, maybe even reorganizing the garage.

And here in Portsmouth, Hampton, and across the Seacoast, that urgency feels real after a long New England winter.

It feels good to be productive… until a day or two later when your back starts tightening up—or worse, “goes out” completely.

The frustrating part?
This happens to a lot of people every year—and most of the time, it’s completely preventable.

Why Yard Work Causes Back Pain (And Why It Feels Random)

What throws people off is that the pain usually doesn’t happen in the moment.

It shows up later—when you’re getting out of bed, standing up from a chair, or doing something simple like feeding the dog.

It feels random. But it’s not.

After a long winter, your body is deconditioned for the type of work spring demands. Even if you exercise, most people spend more time sitting and less time moving through full ranges of motion during colder months.

That leads to stiffness—especially in the hips and lower back.

Then suddenly, you’re:

  • Bending
  • Twisting
  • Lifting
  • Repeating those movements for hours

Your spine actually likes movement—but it doesn’t tolerate repetitive stress in the same direction, especially when you’re stiff.

Over time, that builds strain in the same tissues again and again. Add fatigue, and your body starts compensating.

That’s when small issues turn into full-blown back pain.

Why Common “Fixes” Don’t Work

Most people try to handle this the same way every year:

  • Resting for a few days
  • Stretching randomly
  • Taking pain medication

And while those might help temporarily, they don’t fix the real problem.

Even sources like the Mayo Clinic note that staying active and addressing movement patterns is key for managing back pain—not just resting.

The issue isn’t that your back is weak or damaged.

It’s that your body isn’t moving well under load.

So when spring hits and activity spikes, your system can’t handle the demand—and the cycle repeats.

The Step Most People Skip (That Makes the Biggest Difference)

Most people go straight into yard work cold.

No warm-up. No preparation. Just grab the rake and go.

That alone puts your back at a disadvantage.

A simple fix?

Start with a 10-minute walk.

That’s it.

It helps:

  • Increase blood flow
  • Loosen up stiff joints
  • Prepare your body for repetitive movement

It’s one of the easiest and most overlooked ways to protect your back before yard work.

What Actually Works to Protect Your Back

If you want to avoid that post-yard-work flare-up, a few small adjustments go a long way:

1. Use your hips, not your back
Instead of bending through your spine, hinge at your hips and use your legs to do the work.

2. Avoid twisting your spine
When throwing mulch or moving debris, turn your whole body instead of twisting your back.

3. Take breaks (before you feel like you need them)
Every 30 minutes, stand up straight and gently bend backward to reset your spine.

4. Don’t try to do everything in one day
This is where most people get into trouble. Pushing through fatigue is what leads to flare-ups later.

The Bigger Problem Most People Miss

If your back “goes out” every spring, it’s not bad luck—and you don’t just have a “bad back.”

It’s a pattern.

This is what we call a mechanical issue, meaning your body isn’t moving as well as it should.

It doesn’t always show up in daily life—but it becomes obvious when you add stress, like yard work, gardening, or lifting.

That’s why:

  • You feel fine while working
  • But pain shows up later

Rest and stretching don’t fix this long-term.

Improving how your body moves does.

When your joints and muscles work together the right way, your body can handle more activity—without breaking down afterward.

Stay Active in Portsmouth, NH Without Back Pain

Living on the Seacoast means staying active—whether that’s:

  • Yard work in the spring
  • Walking along the beach in Hampton
  • Golfing in Portsmouth
  • Playing with your kids or grandkids

Back pain shouldn’t be the thing that slows you down.

If it keeps showing up after activity, it’s worth figuring out why.

What To Do Next

If you’re tired of dealing with the same back pain every spring—and want to actually fix the root cause—we can help.

At CJ Physical Therapy & Pilates, we focus on one-on-one care to figure out exactly what’s causing your pain and how to correct it.

👉 Request a free discovery visit: https://cjphysicaltherapy.com/discovery-request-form/

If you’re tired of trying things that don’t last, this is where you start getting real answers.

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

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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

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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

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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.

Back Surgery Is Rarely the Answer – Here’s What to Know First

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Back Surgery Is Rarely the Answer — Here’s What to Know First

The number of times this week I’ve heard people talk excitedly about their upcoming back surgery has genuinely left me disheartened. Not because surgery never has a place — but because it highlights just how misunderstood non-surgical healing for back pain still is.

No matter how much education I share, or how much research exists showing that back surgery is not the guaranteed fix people think it is, many individuals still give up far too quickly and default to surgery.

So here I am again — speaking from clinical experience, personal experience, published research, and thousands of patient stories — to say this clearly: back surgery is rarely the only option, and it is almost never the best first option.

Why Back Surgery Often Fails to Deliver Long-Term Relief

Each year in the United States, tens of thousands of adults undergo back surgery in an effort to relieve pain. Yet even with modern surgical techniques, long-term success is far from guaranteed.

A 2023 systematic review published in the Journal of Pain Research found that approximately 15% of patients experience ongoing or recurring pain after spine surgery, commonly referred to as failed back surgery syndrome. Other peer-reviewed spine and pain studies show persistent pain rates ranging from 5–30%, depending on the procedure and patient population.

Re-operation rates are also concerning. A 2022 nationwide cohort study published in Scientific Reports found that 14–18% of patients required another back surgery within five years. For individuals who had already undergone spinal surgery, the likelihood of needing additional surgery was even higher.

Once someone enters the surgical pathway, it often becomes increasingly difficult to step off it.

The Real Risks of Back Surgery People Don’t Talk About

While these percentages may not seem overwhelming at first glance, they matter — especially when you consider the very real risks of back surgery, including:

  • Infection
  • Blood clots
  • Nerve damage
  • Adverse reactions to anesthesia
  • Incomplete or temporary pain relief

And something research doesn’t always capture: surgery cannot be undone. This reality is rarely emphasized enough during decision-making.

Why “Trying Everything” Often Isn’t Really Trying Everything

This is why exploring conservative, non-surgical back pain treatment is so important — but not in a random or unstructured way.

Many people tell me they’ve already tried physical therapy, chiropractic care, massage, acupuncture, injections, or exercise and that nothing worked. When we look closer, most have spent years cherry-picking treatments without a clear strategy.

They often repeat the same generalized approaches, layer too many treatments at once, or rely entirely on passive care to fix what is actually an active, mechanical back problem.

Passive Care Can Help — But It Isn’t Enough

Passive treatments like massage, acupuncture, and chiropractic care can be incredibly effective for calming pain and reducing inflammation. But pain relief is not the same as healing.

Without pairing passive care with precise corrective movement and tissue-specific loading strategies, relief is usually temporary — and confusing.

The Role of Modern, Non-Surgical Regenerative Therapies

In recent years, I’ve seen remarkable results using non-invasive regenerative shockwave and electromagnetic therapies to stimulate blood flow, cellular repair, and tissue regeneration in damaged muscles, tendons, ligaments, and irritated nerves.

These treatments don’t simply mask pain. They support the body’s natural healing response, improving tissue quality and reducing inflammation so meaningful recovery can occur.

When used strategically — and combined with the right movement-based care — these therapies have been a game-changer in my Portsmouth practice, helping many people avoid injections, delay or prevent surgery, and finally heal for the long term.

Most Back Pain Is Mechanical — Not Surgical

Approximately 80% of back pain is mechanical in nature. It develops gradually from how we move, sit, train, work, and recover.

Even when pain appears suddenly, the underlying problem has usually been building for years. No surgery, injection, or generic exercise program can correct poor movement patterns or faulty spinal mechanics.

Until those issues are addressed, pain tends to return — even after surgery.

Why Seeing a Back Pain Specialist Matters

After more than 23 years working with people suffering from back pain and sciatica, I can confidently say this: the difference between a generalist and a specialist is profound.

For the first decade of my career, I worked in traditional, insurance-driven physical therapy settings. I followed prescriptions, used common passive treatments, and truly believed I was doing everything right.

Everything changed when I pursued advanced specialty training and learned how to properly assess, classify, and treat mechanical back pain. That shift allowed me to help people not only get out of pain — but keep it gone and avoid surgery altogether.

Before You Say Yes to Back Surgery — Pause

If you’re dealing with persistent back pain and feel surgery is being presented as your only option — especially if you’ve already tried traditional physical therapy — please pause.

Our back pain specialists in the Seacoast focus exclusively on these problems and understand how to combine movement science with modern regenerative therapies.

Before you say yes to back surgery, make sure you’ve truly exhausted every conservative option available. Natural healing is not only possible — it is often the most effective and longest-lasting solution when done correctly.

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.

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.

sciatica

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.

Back Surgery

Back Surgery: Why it fails and do you need it

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Approximately 500,000 Americans undergo back surgery to relieve their pain every year, and according to the Agency for Healthcare Research and Quality (AHTQ), this costs approximately $11 billion annually.

But what if I told you that only 5% of people undergoing back surgery actually need it – and worse – for many folks the pain ends up coming back. The American Society of Anesthesiologists estimates that 20-40% of back surgeries fail. If you’ve had repeated back surgery your risk of failure increases. Failed back surgery is so common that it’s gotten its own name – “Failed Back Surgery Syndrome” – which occurs when you experience continued pain in your neck, back, or limbs following any spine surgery meant to reduce pain.

So why then do we continue spending so much money on back surgery when the majority of people don’t actually need it – and when half the surgeries fail?

Back pain can be excruciating, debilitating, and have a significant impact on your quality of life and happiness.

If you’re in this situation, and told by a well-respected surgeon that surgery is your best option of taking your pain away and getting you back to living your life again, odds are good you will take that opportunity. And most of the time – surgery does take your pain away – initially that is.

But what surgeons don’t tell you is that your pain has a high likelihood of returning.

If you’ve had one “successful surgery” – you assume the next will go the same. But as mentioned above – the more back surgeries you have – the more likely they are to fail – and the vicious cycle begins.

So when should you get back surgery?

If you’ve had an accident or trauma that has resulted in major damage to your spine – you need surgery.

If you have urgent compromise to one of your spinal nerves you also need surgery. But let me preface “urgent”.

Your symptoms will be progressive and severe.

Signs might include problems with your bowel and bladder, sudden and worsening foot drop (loss of strength and ability to lift your foot and toes), walking will be difficult and progressively worsen, and nothing will take your pain away – medication and rest will barely touch your symptoms.

These cases are rare – but do require surgery to quickly decompress your nerve before permanent damage ensues.

But 70-80% of the time, back pain is what we call non-specific or mechanical.

And surgery is not recommended – and rarely works for this type or back pain.

Mechanical back pain can be acute and last for a few days, or can be chronic and come and go. You might have nerve pain with numbness and shooting pain down your leg, but it won’t be urgent like the situation described previously. The pain you feel is typically caused by irritation to soft tissue structures, discs, muscles, and joints. But the root cause of this irritation is from something different – and that is what we need to care about.

It’s why 50% of back surgeries fail.

Let me explain…

When you get an MRI to see “what’s causing” your back pain – it will typically show some form of bulging disc, degenerative discs, or lumbar stenosis. You will likely be told that these findings are what’s causing compression and irritation to your nerves.

They might try injections and medication first, but when that doesn’t work, they’ll recommend surgery. But here’s the catch. These findings show up in 60-80% of all MRI’s when you’re over the age of 50. But not everyone with these “abnormalities” has back pain.

In other words, you can have two people of the same age, with equal-looking MRI’s, and one will have pain while the other doesn’t.

How does that happen?

What research has shown over the years is that what shows up in your images rarely correlates with what’s causing your back pain.It’s why so many back surgeries fail – because we are messing with “abnormal” findings that are in fact – quite normal for your age. So if the structures aren’t the problem – then what is?

Most back pain comes from poor movement habits and lifestyle.

Over time, repeated, unbalanced movements will exacerbate or cause irritation to these structures that are considered “findings”. But you can’t fix your back problem by only addressing where the symptoms are.

You have to address the root cause. This is typically some combination of restoring full and free mobility in your spinal joints and balancing out flexibility and strength. When you move correctly – these structures are no longer bothered – and neither is your back.

I know what you’re thinking – this sounds way too simple and perhaps you’ve already tried physical therapy or something similar and it didn’t work. Sadly, not everyone understands – or even agrees – with the concept of mechanical back pain in the way I’ve just explained it.

But trust me, when you find someone who does, you’ll be amazed at how easy it is to fix your own back. You can then keep the pain gone – without ever having to see the inside an operating room.

Back surgery can be costly – both to your bank account and mental well being.

That’s a lot of money to risk when there’s only a 50% chance of the surgery working. There’s an even better chance that your pain will come back. If there’s a complication of any kind, then you’re looking at more surgeries. This is an almost certain loss in quality of life.

It’s worth it to do your due diligence. Find a movement specialist who understands mechanical back pain and can keep you out of the operating room.

If you’re dealing with back pain now and want to learn more…

We will be talking all about this and more in our upcoming Masterclass for Back Pain & Sciatica Sufferers.

The Masterclass is free – and happening on January 24th from 6-7 pm via zoom. Reserve your seat HERE – spaces are limited – and there’s a limited number of spots left.