Back Pain East Brunswick, NJ | One-on-One Physical Therapy

If you live in East Brunswick and back pain keeps getting in the way of your life, you are far from alone: low back pain is very common and is now the leading cause of disability worldwide.^[1] It can also be frustrating because it often comes back: in one study of 250 people who had recently recovered from an episode of low back pain, 69% had it return within 12 months.^[2]

If you have tried rest, medication, or general stretches and your pain keeps returning, it may help to look more closely at what aggravates your back and what eases it. For nearly all people with low back pain, no specific source of the pain can be pinpointed,^[1] so rather than hunting for a single cause, we look at how your symptoms respond to movements, positions, and daily habits. Here is how our assessment-based approach to back pain treatment works.

Easing a Flare-Up, and Why Back Pain Comes Back

For a recent flare-up, some simple options can ease pain while it settles. For recent back pain, the American College of Physicians recommends superficial heat, such as a heating pad, as one of its non-drug options and, if medication is wanted, anti-inflammatory drugs (NSAIDs); most people with recent back pain improve over time regardless of treatment.^[3] Rest, on the other hand, is used more often than the evidence supports; guidelines instead recommend education that supports self-management, getting back to normal activities, and exercise.^[4]

Several things are linked with back pain coming back. In people who had recently recovered from an episode, frequent awkward postures, sitting more than 5 hours a day, and having had more than two previous episodes all predicted a recurrence within a year.^[2]

A practical starting point is understanding which movements and positions aggravate your back and which ones calm it down. That is what our evaluation is designed to explore.

What a Thorough Evaluation Looks Like

At your first visit, I take the time to understand your full history and then assess how your symptoms respond to specific movements. As a McKenzie Method (Cert. MDT) certified therapist, I look for whether you have a "directional preference" — a direction of movement that consistently eases your pain. In research studies, roughly two in three people with back or neck pain showed a directional preference or centralization (pain retreating from the leg back toward the spine), while about a third showed neither. When these responses are present, they are linked with a better outlook, especially in low back pain, although research has not yet shown that they predict who will do better with one treatment than another.^[5] An X-ray or scan can't show how your pain responds to movement. Guidelines advise careful use of imaging for back pain, and in practice it is often overused.^[4] Scan findings such as disc wear and disc bulges are also common in people with no back pain at all: in a review of 33 studies, disc bulges were seen in about 30% of pain-free 20-year-olds and 84% of pain-free 80-year-olds, so a finding on a scan doesn't necessarily explain your pain.^[6]

From there, we build a plan tailored to your back, not a generic handout.

Common Types of Back Pain We Treat

• Disc-related pain — including sciatica (pain that travels from the lower back into the leg), which can happen when a herniated disc presses on a nerve root^[7]
• Pain linked to sitting, posture, or lifting — people with physically demanding jobs are among those most likely to report back pain,^[1] and long hours of sitting and frequent awkward postures have been linked with back pain coming back^[2]
• Stiffness and weakness — when your back feels stiff or weak and that limits how you move
• Recurring flare-ups — back pain that keeps coming back or comes and goes. Recurrences are common, and for a small proportion of people back pain becomes persistent^[1]

How We Treat Back Pain

Your program usually combines hands-on (manual) therapy with individualized exercise. U.S. physical therapy guidelines recommend joint mobilization, a hands-on technique, to reduce pain and disability in both recent and long-lasting low back pain.^[8] For back pain lasting more than three months, exercise therapy probably reduces pain in the short term compared with no treatment, usual care, or placebo, by about 15 points on a 0–100 pain scale on average, although its effect on day-to-day function is smaller.^[9]

Just as importantly, I teach you movements you can do at home to help manage your symptoms yourself. Guidelines recommend education that supports self-management, along with staying active and exercise, as part of initial care for back pain.^[4]

The goal is to help you feel better now and to give you the understanding and tools to manage future flare-ups. In a review of 21 randomized trials, exercise combined with education lowered the risk of an episode of low back pain by about 45% (moderate-quality evidence).^[10] It isn't a guarantee, though: in a randomized trial of 262 adults who had recently recovered from low back pain, a two-session McKenzie-based self-management program did not meaningfully reduce recurrences over the following year; it may have reduced recurrences that led people to seek care, but that result was uncertain.^[11]

True One-on-One Care in East Brunswick

Every session at Spineck Physical Therapy is one-on-one with me — never passed off to an aide, and it is the same therapist every visit. Seeing the same therapist every visit means you don't have to re-explain your history, and your program can be adjusted as your symptoms change. In a US study of insurance claims for low back pain, people who had more consistent care from the same physical therapist were less likely to have back surgery and had lower back-pain-related costs.^[12] This was an observational study, so it shows an association, not proof that continuity caused the difference.

If back pain is limiting your work, sleep, or daily life, a one-on-one evaluation is a good place to start. Call us at 551-208-3234 to schedule your evaluation and find out what aggravates, and what eases, your back pain.

References

1. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-2367. doi:10.1016/S0140-6736(18)30480-X · PubMed
2. da Silva T, Mills K, Brown BT, et al. Recurrence of low back pain is common: a prospective inception cohort study. J Physiother. 2019;65(3):159-165. doi:10.1016/j.jphys.2019.04.010 · PubMed
3. Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367 · PubMed
4. Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368-2383. doi:10.1016/S0140-6736(18)30489-6 · PubMed
5. May S, Runge N, Aina A. Centralization and directional preference: an updated systematic review with synthesis of previous evidence. Musculoskelet Sci Pract. 2018;38:53-62. doi:10.1016/j.msksp.2018.09.006 · PubMed
6. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173 · PubMed
7. van der Windt DA, Simons E, Riphagen II, et al. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain. Cochrane Database Syst Rev. 2010;(2):CD007431. doi:10.1002/14651858.CD007431.pub2 · PubMed
8. George SZ, Fritz JM, Silfies SP, et al. Interventions for the management of acute and chronic low back pain: revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1-CPG60. doi:10.2519/jospt.2021.0304 · PubMed
9. Hayden JA, Ellis J, Ogilvie R, et al. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790. doi:10.1002/14651858.CD009790.pub2 · PubMed
10. Steffens D, Maher CG, Pereira LS, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016;176(2):199-208. doi:10.1001/jamainternmed.2015.7431 · PubMed
11. de Campos TF, Pocovi NC, Maher CG, et al. An individualised self-management exercise and education program did not prevent recurrence of low back pain but may reduce care seeking: a randomised trial. J Physiother. 2020;66(3):166-173. doi:10.1016/j.jphys.2020.06.006 · PubMed
12. Magel J, Kim J, Thackeray A, et al. Associations between physical therapy continuity of care and health care utilization and costs in patients with low back pain: a retrospective cohort study. Phys Ther. 2018;98(12):990-999. doi:10.1093/ptj/pzy103 · PubMed

This article is for general education and is not a substitute for an individual evaluation by a licensed clinician.