4 Reasons Your Physical Therapy Might Not Be Helping Your Low Back Pain
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If you’ve been working with a physical therapist but haven’t seen the results you expected, it might be because certain aspects of your therapy are missing or not being fully addressed. Don’t worry—it’s not about doing something wrong; it’s about ensuring the right elements are in place to support your recovery. Here are four reasons your physical therapy might not be working as well as it could, and how to adjust your approach for better results.
- Overemphasis on Passive Treatments
Many physical therapy programs focus on passive treatments, like ultrasound, electrical stimulation, or massage. While these can offer short-term relief, they don’t address the root causes of your pain. A lack of emphasis on active recovery—like strengthening, mobility training, and posture correction—can lead to a slower or incomplete recovery.
Instead of relying primarily on passive treatments, a more effective physical therapy plan should help you become actively involved in your recovery. Strengthening your muscles, improving your mobility, and learning how to move properly will provide lasting relief and help prevent future flare-ups.
- Lack of Activity Modification
If your therapy program isn't teaching you how to identify and modify pain triggers, you're missing a critical part of the healing process. Many people unknowingly continue doing activities that aggravate their pain because they don't know which movements are the problem.
Your therapy should help you pinpoint these pain triggers—whether it’s certain movements, postures, or daily tasks—and teach you how to modify them to minimize stress on your back. Without this step, even the best exercises won’t help as much as they could.
- Missing Spine Control Basics
Before jumping into strength training or mobility exercises, it’s essential to learn how to properly control your spine. Many programs skip over the importance of core stabilization and proper posture during movement, which are crucial for protecting your back.
A lack of focus on spine control can make exercises less effective or even cause further strain. By learning to brace your core, activate your glutes, and maintain neutral spine alignment, you can safely build strength and improve mobility without risking injury.
- Inappropriate Exercises for Your Condition
Not all exercises are suitable for every type of back issue. If your physical therapy includes exercises that don’t align with your specific condition—like spinal stenosis, a herniated disc, or degenerative disc disease—you may be doing more harm than good.
It’s crucial that the exercises prescribed to you are customized for your condition. If your physical therapist hasn’t adjusted exercises based on your diagnosis, you might be doing movements that are contraindicated for your specific back issue, which could slow your recovery or even worsen your symptoms.
The Bottom Line
If physical therapy hasn’t been as effective as you hoped, it’s not about doing something wrong—it's about ensuring the right components are included in your treatment plan. By addressing passive treatments, focusing on activity modification, learning to control your spine, and using exercises suited to your condition, you can get back on track toward pain relief.
About the Author
Dr. Matt Harris, DPT, MS, is a Doctor of Physical Therapy with 18+ years of experience helping people with spinal conditions. He provides straight-to-the-point back pain solutions — from recovery to lifelong lifting. No fluff. Just spine-safe training you can trust.
Having lived through his own back injuries and guided thousands of patients, Matt knows what it takes to go from pain and setbacks back to safe, confident training.
📩 Start your own recovery journey today: Get the free mini-course here.
