Low Back Pain Physical Therapy

“Low back pain” tells you where it hurts — not why. Disc, facet, SI joint, nerve root, muscular, or movement-pattern driven — the source matters because the treatment is completely different. At Forward, we don’t treat your MRI. We assess how you move, identify the driver, and build a program that addresses it.

The research is clear: exercise is the most effective intervention for persistent low back pain. Not rest, not passive modalities, not “core stability” in isolation. We prescribe loaded, progressive exercise matched to your tolerance and your goals — whether that’s deadlifting again, playing with your kids, or sitting through a workday without pain.

Manual therapy and dry needling reduce symptoms in the short term. Exercise changes them in the long term. We use both.

• Movement patterns — flexion, extension, rotation tolerance and motor control
• Hip and thoracic mobility — the spine compensates when neighboring joints don’t move
• Strength deficits — glutes, trunk extensors, hip flexors, and lateral chain
• Neural tension — nerve sensitivity testing when radiculopathy is suspected
• Load tolerance — what activities provoke symptoms and at what threshold
• Aerobic capacity — deconditioning is one of the strongest predictors of persistent pain

Your spine is strong. Disc bulges are normal — they show up on MRI in people with zero pain. At Forward, we don’t catastrophize your imaging. We build confidence in your body through graded exposure to load and movement. The goal isn’t to protect your back forever — it’s to build a back that doesn’t need protecting.