Low Back Pain: Why It Keeps Coming Back
If you've ever dealt with low back pain, you've probably had this thought at some point:
"I thought this was gone."
Your back feels better for a few weeks, maybe even a few months. Then one day you're bending over to tie your shoes, picking up a laundry basket, playing golf, or getting out of your truck and suddenly it's back again.
This cycle is incredibly common, and it's one of the main reasons people eventually end up in my clinic.
The good news is that recurring low back pain doesn't mean your back is permanently damaged.
More often than not, it means the underlying issue was never fully addressed.
Why does low back pain keep returning?
One of the biggest misconceptions about back pain is that once the pain goes away, the problem is solved.
Unfortunately, that's not always the case.
Pain is often the last thing to show up and the first thing to leave.
By the time your back starts hurting, movement restrictions, strength deficits, and compensation patterns may have been present for months or even years.
Then the pain calms down, but those underlying issues remain.
Eventually, the right combination of stress, activity, poor sleep, sitting, travel, or exercise overloads the system again and the cycle repeats itself.
I see this all the time in Scottsdale and Phoenix with golfers, pickleball players, runners, gym enthusiasts, and people who spend long hours at a desk.
Not all low back pain is the same
Another reason back pain can be frustrating is that there isn't one single cause.
Sometimes the primary issue is muscular.
Sometimes it's related to the discs.
Sometimes the joints in the spine are stiff and not moving well.
Sometimes the hips aren't contributing enough, causing the back to do more work than it should.
And often it's a combination of several factors.
This is why a generic approach rarely works.
The same stretches and exercises that help one person may do very little for another.
Research published in The Lancet and The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) consistently supports individualized treatment approaches for low back pain because the drivers of symptoms vary so much from person to person.
What does the research say?
The good news is that most low back pain responds very well to conservative treatment.
Research continues to show that staying active, improving mobility, building strength, and addressing movement dysfunction are some of the most effective strategies for long-term improvement.
What's interesting is that imaging findings like disc bulges and degeneration often don't correlate very well with symptoms.
In other words, many people have abnormalities on MRI and no pain at all.
That's one of the reasons I focus heavily on how people move, not just what an image says.
How I treat low back pain at Modern Movement
Every low back pain case is different, but my goal is always the same:
Figure out why your back keeps getting irritated in the first place.
Treatment often includes a combination of:
Dry needling to reduce muscle guarding and improve mobility
Spinal manipulation or mobilization to improve joint movement
Soft tissue treatment
Hip and thoracic mobility work
Core strengthening
Progressive loading and exercise prescription
For example, one of the most common things I see is someone whose hips have become increasingly stiff over time.
As the hips lose mobility, the low back starts compensating.
Eventually the back becomes overloaded and painful.
In that situation, simply treating the back isn't enough.
We need to address the hips, restore movement, and improve strength so the problem doesn't keep returning.
That's the difference between symptom management and actually solving the issue.
The role of strength
If you've spent any amount of time in my clinic, you've probably heard me talk about strength.
That's because strength is one of the best injury prevention tools we have.
A stronger body is generally a more resilient body.
That doesn't mean everyone needs to become a powerlifter.
It simply means your body needs enough capacity to handle the demands you place on it.
Whether that's golfing three times a week, playing pickleball, lifting weights, or keeping up with your kids, your body needs to be prepared for those activities.
When it isn't, pain often becomes the warning sign.
The bottom line
Most low back pain isn't a life sentence.
And recurring back pain doesn't automatically mean something serious is wrong.
More often than not, it means there are underlying movement, mobility, or strength issues that haven't been addressed yet.
At Modern Movement Physical Therapy in Scottsdale, I focus on identifying those root causes and building a plan that not only gets people out of pain, but helps keep them out of pain.
Because feeling better is great.
Staying better is even better.
Take good care of your body, it's the only one you have.
Yours in health,
Dr. Michael Price