Back Pain and How Physical Therapy Can Help
- Jared Cave
- Mar 3
- 14 min read
Updated: Mar 27
Introduction
For active individuals—especially athletes, golfers, and fitness enthusiasts—back pain is more than just a statistic; it poses a real barrier to performance and well-being.
If you’re suffering from back pain, you’re not alone - although sometimes it can feel like it.
In this post, we’ll go over:
Anatomical and biomechanical roots of back pain
Evidence-based prevention strategies
Effective treatment options tailored for those with active lifestyles
Our Mansfield Physical Therapy team is here to help you learn more about it and overcome those injuries.
Understanding Back Pain
Let’s break it down in simple terms, so you know what’s really going on in your body when your back starts to hurt.
Now let’s put this right out in front. I don’t want you to try to diagnose or treat your own back pain using the information in this article. Use this to help guide you in prevention techniques, and in making decisions on who to go see for help if you do have a back injury.
What’s in Your Back?
Imagine your lower back as a stack of sturdy building blocks. These blocks are your lumbar vertebrae (L1–L5), cushioned by jelly-like discs that help absorb shock.
Surrounding these blocks is a team of muscles and ligaments that work together to keep everything stable and moving smoothly. Key players include muscles like the multifidus, which helps keep each block in place, and your deep core muscles (like the transverse abdominis), which act like a natural corset to support your spine.
What Causes That Pain?
It might be the result of repetitive or heavily-loaded movements that were more than you were prepared for, or could tolerate. That could be all the extra swings you took this week at the driving range, or the extra plate you loaded on the barbell. It could also just be the product of spending too much time at your desk the last few days without getting up and moving around. Any of these could cause you to have back pain, causing pain or potentially injury to your low back. .
So, Who’s at Risk?
80% of the population develops lower back point at some point in their lives, so logic would say… most of us are at some level of risk (though not for severe injury). A study over 3 months showed that 39% of adults surveyed had an episode of back pain within the last 3 months (1).
Some of the most common risk factors (3):
Heavy physical work
Obesity
Smoking
Understanding these basics about what your back is made of, what might be applying stress, and who is most likely to get hurt can help you take steps to keep your back feeling good and functioning well.
For golfers, about 8% of golfers experience back pain for the first time each year, while about 45% of golfers with a history of back pain had aggravation of their back pain (2). Of note, there’s no way to tell for sure that golf is what caused the back pain, but we sure know it can keep you off the course!
What are the different kinds of back injuries?
There are a ton of different things that can go on in your back and cause pain… let’s go over a few of the most common ones.
Facet joint pain can be from a forceful injury that pushed your joints too far - like a car accident, a lineman playing football who always gets pushed into hyperextension when he engages another player, or a golfer who is going into a reverse spine angle trying to get a longer backswing. This pain is usually local, or radiates out to one side along the level of the injury. It will often hurt when you move into a stressful position for that joint or put too much load into it.
There are varying degrees of joint pain and injury. Spondylosis is a medical term for inflammation or joint pain in your back. Spondylolysis is a fracture of one area of the spine which can cause pain. These are fairly common and some people who have these don’t have pain (or go long periods without pain), though they can be aggravated.
Spondylolisthesis involves a fracture of that same area, along with the vertebra sliding forward on top of the one before it. This can narrow the channel your nerves run through and cause pain to radiate into your butt, groin, or down your leg(s).
Muscle Strain/Ligament sprain is essentially a severe form of those days where your back is sore after bending over too long or doing something new. Slow to move, feels tight.. But stays in one place and doesn’t have any neurological symptoms like burning or numbness.
Spinal stenosis is common in older individuals and involves narrowing of the channels for your nerves. That can be due to age-related compression fractures, development of bone spurs around the spine, or certain types of disc herniations. Central stenosis is a narrowing around the spinal cord which can affect all of the nerves going to your legs including those controlling your bowel and bladder, while lateral stenosis is where individual nerves exit and will typically affect individual nerves and areas of your leg. Rehabilitation for this often includes exercises meant to help increase the available space to decrease symptoms, and gradual return to normal activity.
Disc injuries include bulges and herniations, which are varying degrees of the disc between joints being injured and potentially extruding into space where they shouldn’t be - like pressing on a nerve. This can cause radiculopathy, where pain, burning, numbness, or weakness shows up in your legs.
Before I forget to mention this:
Tons of people have disc injuries that are not symptomatic
Disc injuries CAN HEAL. In fact, bigger disc injuries heal more completely… but that’s dependent upon whether the symptoms are tolerable enough to allow time to heal without surgery.
Identifying Root Causes and Risk Factors
Understanding what triggers back pain is critical to preventing and managing it effectively. In this section, we break down the main contributors into three categories: biomechanical stress, core weakness and muscle imbalances, and lifestyle habits.
Biomechanical Stress and Sports-Specific Demands
Your spine is built to sustain a heavy workload, though that’s largely dependent on how well you prepare yourself for the activities in question. Yes, repetitive motions can cause problems regardless, but typically people will rise to the level of their preparation (with a little bit of good luck mixed in, of course). This is especially true if those stresses aren’t shared appropriately.
We’ve put out a ton of information on how the hips and upper back need to move well to produce and absorb much of the rotational force of the golf swing. The same is true of weightlifting - technique is important to helping you distribute load to the correct areas, and not doing so may put you at higher risk for injury. Of note, there isn’t good available research showing that poor form is a higher risk factor, though common sense does dictate that thought.
Rapid changes in workload are also a typical cause of back injury, so increasing your weights and training volume in a way that makes sense can help minimize injury risk.
Core Strength & Muscle Balance
Your core plays a huge role in keeping your back happy and pain-free. When your deep core muscles (like the transverse abdominis) and your spinal stabilizers (like the multifidus) are strong and engaged, they help absorb force and keep your spine in a good position. But if these muscles aren’t doing their job, your lower back ends up taking on extra stress.
For example, if your core isn’t strong enough to support your movements, activities like a golf swing or a heavy deadlift might put more strain on your lower back than necessary. Over time, small imbalances can lead to tightness or discomfort. The good news? With the right exercises, you can build a stronger core and improve overall muscle balance, helping your back move and function more efficiently.
If you’re looking to start a simple core regimen, here is a video and a blog post that can help you set up a short program for yourself!
Daily Habits
Many daily habits can add up to mild stiffness or occasional discomfort in your back—but small adjustments can make a big difference. Sitting all day for work lets your hip flexors rest in a short position and shut off your glutes, so it’s good to do some exercises throughout your day to prevent any ill effects of that.
If you work at a desk, being mindful of your posture and getting up to move every so often can help keep things feeling good - and maybe do some squats or stairs to stave off the dreaded “Office Chair Butt”.
Other factors, like carrying extra weight or not getting enough movement throughout the day, can also play a role.
The key takeaway?
It’s not about avoiding certain activities or being perfect with posture—it’s about making small, sustainable changes that help your back stay strong and resilient. With a little attention to movement and strength, you can set yourself up for long-term comfort and mobility.
Prevention Strategies for a Healthy Back
Daily Mobility routines
Use a daily mobility routine that emphasizes positions you don’t otherwise get in throughout your day.
Some important moves for the “office chair butt” people mentioned above are hip and low back extension, shoulder blade and neck retraction, and overhead shoulder movements. Here's a short playlist of exercises that can be helpful!
(Yeah, I know these aren’t viral-looking videos… We use these to help our patients in Mansfield, Arlington, Grand Prairie, etc. remember how they’re supposed to do these exercises to keep the progress going when they’re at home.)
Of note, you shouldn’t just do static stretching - you’ll want to strengthen your muscles in those range so they are more used to supporting you in those positions. Exercises like bridges or marching bridges, and theraband stars can help. Here’s another short playlist:
You won’t all of a sudden develop perfect posture - that’s incredibly unlikely without a tremendous amount of work - but building your endurance in all positions will lessen the likelihood of having pain.
Use an activity-specific warm-up
This might mean doing core activation and breathing exercises before a workout involving compound lifts that will demand excellence from your core stabilizers, or a dynamic warm-up for your full body before even picking up your golf club, to make sure everything is moving well. .
Strengthening the Core and Lower Back:
There are 1000 different ways to strengthen your core. This is where your favorite online fitness or health influencer actually can help create a good program for you if you’re not already dealing with a specific injury. Here’s a video I made that helps you select an exercise that is the right difficulty for you, for each set of muscles in your core!
Proper Technique and Ergonomics:
Weightlifters:
Get a coach to help you create proper technique on your lifts
Progress load in a way that makes sense.
Golfers:
Take golf lessons or get a TPI assessment to make sure your swing contains any high-risk movements
Monitor practice volume and intensity
Take swing videos frequently to ensure you aren’t developing any bad habits
Treatment Options for Managing Back Pain
Self-Care Strategies:
There was a period of time where the primary recommendation for any episode of back pain was…
Ice or heat
NSAIDs
Rest
This lead to an over-reliance on those strategies, the pain caused people’s stabilizer muscles to shut off, and their pain lasted longer than it might have if they'd been more proactive in their recovery.
There’s nothing wrong with ice or heat (though they should be used carefully over areas where you’re numb to avoid severe heat or cold injury), but you may not need to rest. You may just need to moderate your activity a little more and opt to go for a walk rather than going for a run or lifting heavy weights in the short term.
The body generally craves and responds well to movement, so gentle exercise like walking or simple core exercises can be very effective.
Physical Therapy and Targeted Exercises:
Figuring out exactly why your back is hurting is extremely important and can help you avoid an extra-long bout of pain, or future episodes you’d rather not go through.
We often see people once they’ve been hurting for 3-6 months and haven’t been very active, and then we have to take time to reverse the effects of all that rest (muscle weakness, loss of flexibility and strength).
Treatment often stops when the pain does, because that’s what your insurance is willing to pay for… but that’s not how we do things at MyPhysio. We work outside the insurance model to make sure you get the treatment you need, when you need it, without a ton of red tape telling you that it’s not allowed.
Performance physical therapy means your PT will work with you until you’re back doing everything you were before, without pain. (And probably with better technique and resilience than you had in the first place.)
If you squat in your workout, we squat in therapy. If you deadlift, we deadlift. If you swing a club, we swing a club.
And the best part is… your insurance company can’t tell you no!
When It’s Recommended To Seek Professional Help Immediately:
If you’ve suffered major trauma (car accident)
Losing feeling in the areas of your body that would be in contact with a saddle (inner thighs, groin)
Urinary or fecal incontinence (or feeling that you just can’t control it as well)
Pain that is worse at night
Symptoms that keep getting worse
This list is not all-encompassing but is certainly something to consider when deciding what to do about the pain you're experiencing.
Lifestyle Changes for Long-Term Back Health
Making a few lifestyle tweaks can go a long way in keeping your back feeling good over the long haul. Here are some practical strategies:
Regular Exercise and Movement
Staying active doesn’t mean you have to hit the gym hard every day; even low-impact activities like walking can make a big difference. Mix up your routine with a combination of activities that build strength, flexibility, and endurance. Whether it’s a brisk walk, a bike ride, or some light swimming, regular movement helps keep your muscles engaged and reduces the risk of stiffness from sitting too long. The key is to find activities you enjoy and stick with them consistently.
Stress Reduction and Recovery
Stress isn’t just a mental burden—it can manifest physically, and it usually hits you where you have pre-existing issues. Taking time to relax is essential for keeping your back muscles loose and supportive. Simple practices like meditation, deep breathing exercises, or yoga can help ease tension. A few minutes of mindful breathing or a short meditation session can do wonders for your overall muscle relaxation and help keep your back in a more comfortable state.
Weight Management and Nutrition
Keeping your weight in check is one of the simplest ways to reduce stress on your spine. When you carry extra weight—especially around your midsection—it forces your back to work overtime, which can lead to discomfort. Eating well not only helps manage your weight, but it also provides the nutrients your bones and muscles need to stay strong. Small changes in your diet can build a solid foundation for a healthier back.
Posture and Ergonomic Adjustments
Creating a workspace that supports good posture is a game changer. Start by setting up your desk so your chair, desk, and computer monitor are all aligned—this means keeping your feet flat on the floor, your back straight, and the top of your screen at eye level. When lifting heavy items, try to keep the load close to your body. And don’t forget about everyday habits—taking a moment to roll your shoulders back or adjust your sitting position can help prevent strain on your back over time.
By embracing these lifestyle changes, you can create a strong foundation for long-term back health and enjoy more comfort and mobility in your daily life.
Creating Your Personalized Back Health Plan with MyPhysio
At MyPhysio, we believe that taking control of your back health starts with understanding your body and setting clear, realistic goals. With the guidance of our dedicated physical therapists, you can build a routine that fits your lifestyle and keeps your back feeling its best. Here’s how we help you get started:
Assessment and Goal Setting
Your journey begins with a comprehensive 60- or 90-minute assessment. Our physical therapists at MyPhysio will work with you to pinpoint where you feel tightness or discomfort.
You might keep a journal or use a fitness app to note moments when your back feels stiff—whether it’s after long hours at the desk, a tough workout, or even when lifting heavy objects. This information will help us quickly dial in on what needs to be addressed.
Together, we’ll set clear goals that lead you right back to your typical exercise program or sport, and lay out what we need to do to achieve them.
Designing a Balanced Exercise Routine
Once we’ve identified your needs, we help you create a balanced routine that covers all the key areas:
Warm-Ups: We start with simple movements and dynamic stretches to gently loosen your back and hips.
Core and Full Body Strengthening: Exercises like planks and bird dogs target your deep core muscles, providing the support your spine needs.
Stretching: Tailored stretches focus on your back and surrounding muscles to keep everything flexible and resilient.
Recovery: Cooling down and light mobility drills round off your workout, ensuring your body recovers well.
At MyPhysio, our approach is all about gradual progress. We work with you to build your endurance and strength in manageable steps, keeping you motivated without overwhelming you.
Taking a Multidisciplinary Approach
Remember, you don’t have to go it alone. Our physical therapists at MyPhysio are here to offer expert advice every step of the way.
We collaborate with personal trainers and sports medicine experts when needed to tailor a back health plan that fits your unique situation.
This multidisciplinary support ensures you’re performing the right exercises correctly and addressing any issues early on—so you can enjoy a stronger, more comfortable back.
By combining a thorough assessment, a balanced exercise routine, and bringing your new physical therapist at MyPhysio into your existing team (doctors, fitness trainers, etc.), you can create a personalized plan that keeps your back strong and ready for whatever life brings.
Conclusion
Back pain is an extremely common thing affecting a large number of Americans every year, and it's exceedingly common for these people to undergo unnecessary imaging, and even unnecessary surgery as a result.
Recovering from back pain can take time, but often the best thing to do is continue moving. Being proactive is really helpful in maintaining a healthy back, and if you aren’t already working to build up your strength and flexibility on a daily or weekly basis, it’s a great place to start!
At MyPhysio we help active adults, golfers, and athletes recover from back pain through performance physical therapy. We offer 1-on-1 physical therapy sessions with a consistent provider, video-based home programs to help you get work done at home, and easy methods of contact between sessions so you can ask your PT questions.
If you need help getting back out there, you can schedule a free call at https://www.myphysiotx.com/contact-us to figure out if we’re the right fit for you.
FAQs:
Do I have to stop working out?
Not necessarily - but you may have to change how you do things. Adding support like using machines, decreasing the amount of weight you use, and slowing down your tempo are all things that might help. If you’re a runner and that makes it worse, cross training with swimming or an elliptical may be helpful to keep you moving. It’s important to check with a healthcare provider to make sure it’s still safe, though!
Do I always need an MRI for back pain?
It’s pretty well known at this point that MRI is ordered too early and too often for back pain patients, and can actually cause MORE disability because the findings affect people mentally even if they’re not related to the symptoms they’re having. It’s often a good idea to go to PT first, with the exception of some very serious symptoms listed earlier in this blog article.
Why does my back hurt when I play golf?
In a lot of cases it’s related to your swing mechanics, which may be influenced by a lack of flexibility or stability in other areas of your body. Most of the golfers we see with back pain benefit from a combination of going through performance PT and golf lessons with an instructor of their choice.
I have an old MRI with a bulging disc… is that why I hurt?
This can be contributing, but you should know that tons of people with no history of symptoms at all have unusual MRI findings that sometimes lead to unnecessary surgery or other medical expenses. (4)
Resources:
Available resources to quote: golf specific lower back pain
Lucas JW, Connor EM, Bose J. Back, lower limb, and upper limb pain among U.S. adults, 2019. NCHS Data Brief, no 415. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi.org/10.15620/cdc:107894
Lindsay DM, Vandervoort AA. Golf-related low back pain: a review of causative factors and prevention strategies. Asian J Sports Med. 2014 Dec;5(4):e24289. doi: 10.5812/asjsm.24289. Epub 2014 Nov 10. PMID: 25741420; PMCID: PMC4335481.
Shiri R, Falah-Hassani K, Heliövaara M, Solovieva S, Amiri S, Lallukka T, Burdorf A, Husgafvel-Pursiainen K, Viikari-Juntura E. Risk Factors for Low Back Pain: A Population-Based Longitudinal Study. Arthritis Care Res (Hoboken). 2019 Feb;71(2):290-299. doi: 10.1002/acr.23710. PMID: 30044543.
Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994 Jul 14;331(2):69-73. doi: 10.1056/NEJM199407143310201. PMID: 8208267.
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