At Cohen Health and Performance, I’ve had the privilege of helping countless individuals overcome chronic back pain—pain that’s persisted for months, years, or even decades. One thing I hear often is:
“I just have a bad back.”
But what does that really mean?
Rethinking the “Bad Back” Mindset
Many people are told by well-meaning professionals—or after seeing a concerning X-ray or MRI—that they’ll just have to “live with” back discomfort. But here’s the truth: imaging findings don’t always match up with pain levels.
You can have a “perfect” MRI and still feel miserable. Or, your imaging might show disc herniations or degeneration, yet you feel completely fine. So if structure alone doesn’t explain back pain, what does?
Pain is more than a picture. It’s a response. And in the case of chronic back pain, your body may be responding by stiffening up the spine to protect it—like putting a cast on a broken arm. The problem? That constant “splinting” or bracing over time can cause its own set of issues.
Why Movement Matters in Back Pain Physical Therapy
Your spine isn’t one long, fragile bone—it’s a series of small vertebrae stacked like building blocks, designed to move **segmentally**, much like a slithering snake. When your back stiffens due to prolonged discomfort or fear of movement, you lose that segmental motion. This not only limits function but also reduces the nutrition your joints and discs receive through movement.
One of the first things we focus on in **back pain physical therapy** is restoring this movement. I often teach clients a drill called spinal segmentation, where the goal is to regain control by moving one segment of the spine at a time. It doesn’t need to be perfect—it just needs to reconnect your brain to your body’s natural movement capacity.
Stability: Learning to Support Your Spine (Without Leaning on It)
Alongside restoring movement, spinal stability is just as important. Many people with long-term back pain unknowingly rely on their spine for support—even during basic daily activities—rather than using their core muscles.
A favorite exercise of ours to teach spinal stability is the bear position hold. In this position, the goal is to support your body using your abdominal muscles rather than “hanging” on your spine. We coach patients to keep their belly button from dropping and to create tension through their core—retraining them to stabilize without compressing or bracing their spine unnecessarily.
Once this is mastered, we integrate that same feeling of stability into more functional movements like squats or weightlifting, encouraging patients to “feel their abs” supporting them rather than overusing their back.
Breaking the Chronic Pain Cycle
If you’ve been dealing with back pain for a long time, you may have started to believe that nothing will change—that this is just how it is. But that belief is part of what holds people back.
At Cohen Health and Performance, we’ve found that **the most effective approach to chronic back pain is an active one**—helping you learn how to move better, build control, and load your body in a way that restores trust and function.
Back pain physical therapy isn’t about avoiding movement. It’s about restoring movement—and giving you the tools to do the things that matter to you, without fear or limitation.
Ready to Reclaim Your Life from Chronic Back Pain?
If you’re tired of being told you have a “bad back” and want to explore what’s really possible with the right plan, we’re here to help. Reach out to schedule an evaluation or check out more of our educational content on our YouTube page, where we demonstrate exercises and share strategies that have helped countless people just like you.
Let’s stop managing your pain—and start changing your story.
