Why Back Pain Keeps Coming Back - and How Physical Therapy Can Finally Help
Back pain that improves… only to come back again and again… is one of the most common frustrations I see in my clinic in Carlsbad. You’ve tried rest, stretching, maybe medications, injections or surgery - and while they may help for a short time, the pain or stiffness often returns.
After 24+ years as a physical therapist and 20+ years specializing in spine and extremity pain using the evidence-based McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT), I’ve learned something important:
Recurring back pain almost never happens by accident - and it almost always has a reason behind it. Understanding why it keeps coming back is the first step toward finally getting relief that lasts.
Why Back Pain Often Returns
Back pain is not a single “thing” you can fix with a pill or brief rest – it’s often a posture and/or movement-related problem that involves muscles, joints, nerves, and how you use your body every day.
Muscle imbalances and weakness
When the muscles that support your spine are weak or not firing at the right time, your back joints are left to bear more stress than they should. At the same time, weakness in the muscles that support your spine are often caused by mechanical disruption or failure, such as a disc herniation. Unless the mechanical disruption or failure is remedied, flare-ups can occur.
Poor movement habits
How you bend, lift, sit, or twist can have a huge impact on spinal stress. Standard treatments often focus on pain, not the posture and/or movement patterns that actually cause the pain.
Unresolved mechanical issues
Conditions like degenerative discs, bulging or herniated discs, arthritic joints, or nerve irritation (including sciatica) can improve temporarily, but without targeted and corrective intervention they’re likely to still behave in ways that lead to recurrent pain.
Treating symptoms instead of cause
Pain relief from medications, injections, or passive therapies like heat and massage can feel good – but they don’t address the posture and/or movement causes of the pain.
Incomplete rehabilitation
After an acute episode of spine pain, flare-ups commonly occur because the health of the joint has not yet been fully restored. Postures and movements that led to the pain must be corrected.
Why “Quick Fixes” Often Fall Short
Temporary relief is exactly that – temporary. In my years of experience, I’ve seen many patients who were told things like:
“Take some anti-inflammatories,”
“Just stretch more,”
or
“You’ll outgrow it.”
Instead what happened was pain that faded… until it didn’t.
Here’s the reality: lasting improvement comes from understanding and addressing the mechanics of your pain. Pain medication doesn’t do that. Generic stretches often don’t do that. What does make a difference is a structured diagnostic process and targeted corrective intervention that focuses on posture and/or movement behavior – and that’s exactly what physical therapy provides.
How Physical Therapy Helps - Not Just for Today, But for Tomorrow
Physical therapy isn’t just about exercises. To truly stop recurrent back pain, it must include:
1. In-Depth Movement Assessment
The first step in therapy is a detailed evaluation – how your spine moves, how symptoms change with movement or position, and what patterns reveal the source of your pain.
2. Personalized Treatment Plan
Based on that assessment, you receive a customized plan tailored to your body - not a generic exercise sheet.
3. The McKenzie Method®
This internationally recognized, evidence-based approach identifies specific postures, movements and positions that help reduce and eliminate pain and restore function. Often, this includes identifying a directional preference – movements that reduce and eliminate pain and centralize symptoms closer to the spine.
The goal is not just to eliminate pain, but to help your body behave in ways that prevent pain from returning.
4. Patient Education and Self-Management
I’ll teach you what’s safe, what helps, and what to avoid so you can manage flare-ups on your own and significantly reduce the risk of recurrence.
5. Functional Reinforcement
Together, we reinforce posture and movement patterns that protect your spine during sleep and daily activities – so your spine isn’t constantly stressed by the way you lie down, sit, lift, twist, or stand.
What You Can Expect at Holland Spine Physical Therapy, Inc.
When you come in for care in Carlsbad, our process is thorough and individualized:
A 60-minute evaluation during your first visit
A detailed diagnostic process rooted in MDT principles
Education about your specific condition and what’s driving your pain
A personalized plan that includes hands-on care, corrective posture and movements, and self-management strategies
Follow-up visits that progress at your pace and focus on lasting improvement
We treat conditions including generalized low back pain, disc-related issues, sciatica, postural dysfunctions, and more - always with a view toward restoring movement and preventing recurrence.
Frequently Asked Questions About Recurring Back Pain
Why doesn’t my back pain ever fully go away?
Because many treatments ease symptoms without correcting the underlying posture and movement or mechanical problem.
Can physical therapy actually prevent future pain?
Yes - when therapy focuses on your posture and movement patterns and teaches you how to maintain improvements.
How long will it take to feel better?
Many patients see meaningful improvement within one or two visits. However, some patients require additional visits to determine the full scope of their condition.
Will physical therapy be painful?
Therapy is designed to be safe and challenging. You should not feel ongoing sharp or worsening pain.
Do I need a physician referral?
In California, many patients can begin physical therapy directly without a referral.
Ready to End the Cycle of Back Pain?
Recurring back pain doesn’t have to be your “new normal.” With the right diagnostic and treatment approach, individualized care, and patient education, you can experience relief that lasts and build confidence in your body’s ability to move well.
👉 Request an appointment online or call (760) 579-1344 to get started with Dr. Kelly Holland in Carlsbad.
Pain doesn’t have to be persistent – let’s address the cause so you can move forward with confidence.