Understanding Spinal Pain

Low back pain is incredibly common and can be a significant problem. Understanding spinal pain is the first step in decreasing pain. In the health care community, many know low back pain is the most common cause of disability and lost work time in adults. If you are aware of this fact, you can see how important it is to take the necessary steps to achieve and maintain a healthy spine. Having a healthy spine is very important for maintaining one’s freedom and mobility as they age, as well as keeping a person’s health care costs and time away from work to a minimum. We in the Physical Therapy world might not have the fountain of youth, but we did find the best way to keep your spine healthy as you age.

Education is Important

One of the largest areas of progress that is occurring with the treatment of spinal pain is the education provided to patients to help them understand what pain is, what pain isn’t, and when to seek care. In the community, there is a lack of understanding. The presence of unhelpful beliefs about low back pain has been shown to be a large contributor to the number of people suffering from chronic spinal pain. Understanding some of the truths behind these myths is a great first step to managing them and preventing this pain from becoming a persistent or lifelong issue. An article titled “Back to Basics: 10 facts every person should know about back pain” was published in 2019 and addressed 10 of these unhelpful beliefs that commonly exist and contribute to poor outcomes. Below I highlight 3 of these unhelpful beliefs and suggest some potential options to properly address spinal pain.


The Unhelpful Beliefs Debunked

The first unhelpful beliefs I want to address is the belief that if a person injures their spine, they can expect to always have this pain and it will get worse with age. Research has shown that these beliefs are simply untrue. Advances in evidence-based practice have allowed for better management of spinal pain for people of all ages. Attending physical therapy and undergoing a plan of care that utilizes evidence-based treatment is a very effective way to treat low back pain. In addition, it has shown positive outcomes for people of all ages. Given this research, instead of subscribing to the idea that back pain will only get worse with age, I strongly suggest seeking out a physical therapist to help create a plan of care to address your pain and function.

Another Unhelpful Belief Debunked

The second unhelpful belief I would like to highlight is the belief that all back pain is due to tissue damage. Although tissue damage can be the cause of some pain, or the source of pain, persistent and chronic spinal pain is often a product of things other than tissue damage. Research has recently shown that things such as negative mindsets and expectations, fear-avoidance behaviors, and poor coping strategies are more strongly associated with persistent pain than actual tissue changes. Understanding this concept can be a huge piece of managing one’s pain and improving their outcomes. Working with health care professionals, such as physical therapists, who educate patients on pain science, utilize treatment plans to facilitate improved motion and a gradual return to function, and reinforce positive coping strategies has been shown to greatly improve a person’s pain levels and decrease the chance of developing a persistent functional disability.

Movement is Key

Lastly, I want to highlight the unhelpful belief that pain related to exercise and movement is a warning sign of harm being done to the body. Although there are times where significant amounts of pain can indicate harm is being done to your bodily tissue, we are learning that often pain is not associated with true tissue damage. That is why understanding the difference between “hurt” and “harm” is so important to improving outcomes. To ensure we are providing proper treatment, physicians, physical therapists, and other health care professionals go to great lengths to first rule out any sinister or serious sources of your pain.

Once these pain sources are ruled out, evidence has shown that graduated movements and exercise programs are healthy and safe for the spine, even if sensitivity or discomfort persists. Often when pain is present for extended periods, the body becomes more sensitive and this sensitivity can persist long after the affected tissues have healed. Understanding this concept and realizing the discomfort that’s sometimes felt with movement is more related to nervous system sensitivity than it is to actual tissue damage can help individuals effectively work towards the movement goals.

After reading this I hope you can take away a few positive messages such as back pain does not always lead to permanent disability, pain is not always a sign that your body is being harmed, and sensitivity during movement is not always an indication to stop. With the help of skilled health care providers, movement and exercise can be your vehicle back to a normal, pain-free life. If you or someone you know have been battling spinal pain for any amount of time and want to improve, consider consulting a specialized Freedom spine physical therapist.



  1. Beattie, P. F., PT, PhD, OCS, FAPTA. (n.d.). The Lumbar Spine: Physical Therapy Patient Management Using Current Evidence. Current Concepts of Orthopaedic Physical Therapy 4th Edition.

  2. O’Sullivan PB;Caneiro JP;O’Sullivan K;Lin I;Bunzli S;Wernli K;O’Keeffe M;. (n.d.). Back to basics: 10 facts every person should know about back pain. Retrieved January 18, 2021


Trenton Rehman is a Wisconsin native, growing up in West Bend and attending West Bend East high school. Trenton went on to attend Marquette University, where he graduated with two Degrees from Marquette University, including a Bachelor’s Degree in Exercise Physiology and a Doctor of Physical Therapy. During his time in the Doctorate program, Trenton was awarded the Daniel Strelnick award for his assertiveness, communication, and leadership skills in the clinic. After earning his Doctor of Physical Therapy degree, Trenton went on to complete an Orthopedic Residency through UW-Health and Meriter, where he underwent advanced training to further his manual skills and clinical knowledge in orthopedics.