Physical therapist evaluating a patient's back pain

Back Pain Physical Therapy

Back pain is one of the top reasons people seek physical therapy, and it’s one of the most common conditions we treat. According to the National Institutes of Health, up to 80% of people will have back pain at some point in their lives. You know it all too well: a sudden twinge from lifting something the wrong way, a nagging ache, or sciatica nerve pain running down your leg. Our Doctors of Physical Therapy (DPT) get you back to it: the back nine, the workday, the yard, picking up your kid without bracing first.

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Physical therapist evaluating a patient's back pain

Assessing the reason you are experiencing back pain is the first step in addressing it with physical therapy. Back pain could be the result of many things, but often it’s a mix of muscle and joint stiffness from strength imbalances or suboptimal movement patterns. The good news is that most back pain responds well to therapeutic treatment.

At FX Physical Therapy, our DPTs start with your movement assessment. We build your plan combining manual therapy and corrective exercises. Our goal is getting you back to what the pain was interrupting, whether that’s a full round of golf, a full workday without shifting in your chair, or a long drive you don’t have to plan stops around. For a deeper look at a common back-pain trigger, read our article Spring Cleaning Injuries: Why Your Back Hurts After Yard Work.

What a Back Pain Physical Therapy Session Actually Involves

Initial evaluation (45 – 60 minutes):

Your visit starts with a conversation. First, your DPT will ask you several questions including when the pain started and what makes it better or worse? Does it radiate into your hip or leg? Maybe you’ve noticed numbness, tingling, or weakness? Ultimately, this history is what rules out serious causes before any treatment begins.

From there, your therapist will assess how you bend, rotate, and perform other movements. This shows how your hips, core, and spine are sharing the load. Your DPT may also palpate your muscles to find specific areas of tightness, spasm, or trigger points. If there’s any radiating pain, they may test your leg strength and reflexes too.

Hands-on treatment:

Physical therapist performing spinal manipulation for back pain

Depending on both what the evaluation finds and your preferences, a session might include:

  • Joint and spine mobilization: small, targeted movements to the spine and pelvis to reduce pain and restore motion
  • Myofascial release: hands-on work to the muscles and connective tissue around the low back and hips
  • Dry needling: a thin filament needle used to release specific muscle trigger points contributing to chronic low back tightness
  • Cupping: used for tight, spasming muscles that haven’t responded to other manual work

Corrective exercise:

Every session also includes movement retraining specific to what your assessment found. The goal is to stop your back from absorbing motion it shouldn’t have to.

Typical plan of care:

Most patients start at 1 to 2 visits per week. Acute strains often resolve in 4 to 6 weeks. Chronic or recurring back pain, disc-related pain, and post-surgical spine cases may take longer. Your therapist will give you a specific timeline after your evaluation.

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Conditions That Can Benefit From Physical Therapy

  • Muscle strain/acute low back pain: the most common presentation, often after lifting or a sudden movement
  • Sciatica: pain, tingling, or numbness radiating from the low back into the leg
  • Disc bulge or herniation
  • Spinal stenosis
  • Degenerative disc disease
  • SI joint dysfunction
  • Chronic postural back pain: from desk work, driving, or prolonged standing
  • Post-surgical spine pain: see our dedicated Spine Rehab program for post-operative care
  • Pregnancy-related low back and SI joint pain: see Pelvic Health, which treats this specifically
  • Golf-related back pain: often from the repetitive rotation of a golf swing, especially with limited hip or thoracic spine mobility

Who Treats You

Every evaluation and every treatment session is one-on-one with a licensed Doctor of Physical Therapy. The full visit, the same DPT, every time. No aides running your exercises. No rotating between providers who have to re-learn your back each visit. Find a location near you on our full locations page.

Safety

Physical therapy is a safe, first-line treatment for most low back pain. Our major clinical guidelines specifically recommend non-drug, movement-based care before more invasive options. Occasionally, though, back pain is a symptom of something that needs medical attention first.

Seek immediate medical care before scheduling PT if you have:

  • Loss of bowel or bladder control, or numbness in the groin/inner thighs (“saddle” area), this can indicate cauda equina syndrome, a medical emergency
  • Progressive weakness in a leg
  • Unexplained weight loss alongside back pain
  • Fever combined with back pain
  • Back pain following significant trauma (a fall, car accident)
  • A history of cancer with new-onset back pain

Physical Therapy vs. Chiropractic Care for Back Pain

A common question we get is what’s the actual difference between physical therapy and chiropractic care for back pain?

Physical therapy centers on active rehabilitation. It combines a full movement assessment with manual therapy and a progressive exercise program. These exercises are aimed at correcting the strength and movement deficits. The goal is for you to need less ongoing treatment over time.

Chiropractic care centers primarily on spinal adjustment to relieve pain and restore joint motion. It typically puts less emphasis on a structured strengthening program. Some patients continue with periodic maintenance visits.

Both approaches use manual techniques, and can help with mechanical back pain. They’re not mutually exclusive, and some patients use both. 

What to Expect Afterward

After manual therapy, it’s common to feel some soreness after your first few sessions. This is normal, and different from the pain that brought you in. For a breakdown of what’s expected, see our post Good Sore vs. Bad Sore: When to Keep Pushing.

Frequently Asked Questions

No. Maryland allows direct access to physical therapy, so you can schedule an evaluation without a physician referral. Some insurance plans may still require one for coverage purposes, so our front desk team can check your specific plan.
FX Physical Therapy is in-network with most major insurers. Coverage and any copay or deductible details depend on your specific plan. Visit our Insurance Info page or call your insurer directly to confirm your benefits.
Many patients notice improvement within the first 2 to 4 visits. Full recovery timelines vary widely, though, depending on whether the pain is a recent strain or a longer-standing, chronic issue. Your evaluating therapist will give you a specific expected timeline.
Yes. Physical therapy is a standard first-line treatment for disc-related pain and sciatica. It relieves nerve irritation through targeted exercise and manual therapy before more invasive options come into play.
Most patients feel a brief twitch or cramping sensation as the needle reaches a trigger point, followed by a release of tension. It's generally well tolerated, though some mild soreness for a day or two afterward is normal.
See the comparison section above. In short: PT combines manual therapy with a structured strengthening and movement-correction program. Chiropractic care centers more on spinal adjustment.
Yes. The repetitive rotation and asymmetric loading of a golf swing is one of the more common activity-related back pain triggers we see. This is especially true for golfers with limited hip or thoracic spine mobility. Physical therapy can address the pain itself and the swing-related mobility or stability limits that cause it to recur.
See the Safety section above, it covers the red-flag symptoms that mean you should see a doctor first.

Where to Get Back Pain Physical Therapy Near You

Every FX Physical Therapy location treats back and spine pain. See the full locations directory to find the closest clinic and request an appointment online. We’re Built to Make You Better.

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Medically reviewed by Amanda Hodgetts, PT, DPT, Cert. DN, [July 30, 2026]

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