Why Your Lower Back Pain Isn’t Going Away—And What to Do About It

You’ve stretched. You’ve iced. You’ve rested. But the nagging lower back pain still shows up, especially when you’re trying to enjoy life. If this sounds like you, you’re not alone. And trust me, it’s not all in your head.

For too long, the common advice for back pain has been: rest, ice, and pop a few painkillers. While this might offer some temporary relief, for many, it’s a frustrating cycle that never quite breaks. In fact, for most chronic low back pain, prolonged rest is often the very thing that makes it worse. From my own experience, and what I see every day, I can tell you that your back is meant to be used. Let’s break down why lower back pain lingers and what can actually help you reclaim your movement and your life.

1. The Real Reasons Your Back Pain Won’t Go Away It’s not just age. It’s often a combination of factors that, over time, conspire to keep your back in a state of discomfort. Think of your body as an intricate system; when one part isn't pulling its weight, others overcompensate, leading to strain and pain.

• Muscle imbalances and weakness: From years of sitting at a desk, commuting, or engaging in repetitive movements without proper counter-training, certain muscles become overactive and tight, while their opposing counterparts weaken and lengthen. This creates an imbalance that pulls your spine out of alignment.
• Poor core stability: This isn't just about having a "six-pack." Your core is a cylinder of muscles—including your transverse abdominis, multifidus, pelvic floor, and diaphragm—that acts as your body's natural corset, providing crucial support for your spine. Especially after childbirth, or decades without focused core training, this internal support system can become significantly weakened, leaving your lower back vulnerable.
• Restricted joint movement: Your body is designed to move fluidly. When joints in your hips, spine, or even your feet become stiff or "stuck" due to injury, inactivity, or sustained postures, the movement has to come from somewhere else. Often, that "somewhere else" is your lower back, leading to excessive strain.
• Compensation patterns: When one area of your body is weak or restricted, another area will inevitably take on extra load to perform a movement. For example, if your hips are tight, your lower back might round excessively during a squat, leading to increased stress on spinal discs and ligaments. These compensation patterns become ingrained, perpetuating the pain cycle.
• Chronic inflammation: Even after an initial injury has "healed," low-grade chronic inflammation can persist. This keeps pain signals firing, making your nervous system hypersensitive and making even minor movements feel painful. It's like an alarm system that won't turn off.

2. Why Rest and Meds Only Work Temporarily – And Why They Make Things Worse in the Long Run

This is where we need to challenge some old beliefs. While acute, severe pain might necessitate a day or two of reduced activity, prolonged rest for subacute or chronic low back pain is a recipe for disaster.

The "Rest" Trap:

• Stiffness and Weakness: Imagine a rusty hinge. If you stop using it, it only gets rustier and stiffer. The same applies to your spine and muscles. Prolonged inactivity leads to muscle atrophy and shortening, making your back even weaker and less capable of supporting itself. A systematic review published in The Spine Journal highlighted that "bed rest is not an effective treatment for acute low back pain and that patients should be advised to stay active." (van Tulder et al., 2000). Movement is generally beneficial for back pain, because our backs are meant to be used!
• Fear-Avoidance Behavior: Resting can inadvertently teach your brain that movement is dangerous, leading to a phenomenon known as "fear-avoidance." You start to avoid activities you associate with pain, which further weakens your muscles and reduces your functional capacity, creating a vicious cycle. Research consistently shows that fear-avoidance beliefs are strong predictors of chronic low back pain and disability (Leeuw et al., 2007).

The "Meds" Mask:

• Over-the-counter medications like NSAIDs (non-steroidal anti-inflammatory drugs) or muscle relaxants can certainly reduce symptoms by dulling pain signals or relaxing tight muscles. However, they do not address the underlying mechanical issues that are causing your pain. It's like putting a bandage on a leaky pipe instead of fixing the hole. Once the medication wears off, the pain often returns because the root problem remains unaddressed. Long-term reliance on these medications can also have significant side effects.

The Missing Link: Movement-Based Rehabilitation

Without movement-based rehabilitation, your body never relearns how to move pain-free. It's not just about strengthening individual muscles, but about retraining your entire movement system. This involves teaching your brain and body how to coordinate muscles effectively, restore joint mobility, and build resilience. This is where targeted exercise and functional movement come into play.

“I often hear people say, ‘It’ll go away on its own.’ And sometimes it does—but it usually comes back. Back pain often becomes a recurring issue. At first, it might only last a few days, but each time it returns, it often lasts longer and feels worse. Left unaddressed, what starts as occasional discomfort can become something that limits your movement, sleep, and quality of life. The sooner you do something about it, the more likely you are to control how often it comes back—and how bad it gets.”

My Own Journey: When Rest Wasn't Enough

I had my own bout with back pain right out of undergrad when I was sitting a lot. I remember thinking that because I had been active my whole life, it would just go away, or that I could just deal with it. I kept doing my normal activities, hoping for a change, but nothing shifted. That's when I finally went to a chiropractor, and after just a few visits, I started to feel better. That was my "aha!" moment – realizing that ignoring it or just resting wasn't the answer.

Back pain can affect people in a lot of different ways. The busy mother might get the pain when she is cooking dinner or helping her kids. She might get it when working and sitting at a computer all day. When you have back pain, it makes it hard to focus on much else. And let me tell you, many people with back pain feel that it is affecting their loved ones because they are grumpy. You may not be able to help others the way you want to.

3. What Actually Works: A Whole-Body Approach At Atomic Pilates & Chiropractic, we don’t just treat the symptoms; we treat the cause. We understand that your body is interconnected, and true, lasting relief comes from addressing all the contributing factors. Getting back to life, enjoying activities with your family, being able to play with your kids, getting up off the floor without having help – that's what we aim for.

• Chiropractic adjustments to realign joints and restore normal motion: Think of your spine as a series of intricately connected segments. When one or more of these segments become misaligned or restricted, it can irritate nerves and create imbalances. Chiropractic adjustments gently restore proper alignment and motion, reducing nerve interference and allowing your body to function more optimally.
• Reformer Pilates to strengthen the deep core and retrain healthy movement: Pilates, especially on the Reformer, is incredibly effective for low back pain because it focuses on building deep core strength, improving flexibility, and promoting proper posture and body mechanics. It emphasizes controlled, precise movements that re-educate your muscles on how to support your spine safely and efficiently. Research supports the efficacy of Pilates for chronic low back pain, showing improvements in pain, functional ability, and quality of life (Natour et al., 2015). Muscle release & fascial work to correct imbalances and free up stuck tissue: Our bodies are covered in fascia, a web-like connective tissue that can become tight and restricted, contributing to pain and limited movement. Targeted muscle release techniques and fascial work help to release these restrictions, improve tissue elasticity, and restore balance to your muscular system.
• Super pulsed laser therapy to reduce inflammation and speed healing: This cutting-edge therapy utilizes specific wavelengths of light to penetrate tissues and reduce inflammation, accelerate cellular repair, and promote natural healing processes. It’s a powerful tool for calming angry tissues and getting you back on track faster.
• Spinal decompression (if needed): For certain types of back pain, particularly those involving disc issues, spinal decompression can be incredibly beneficial. This gentle, non-surgical therapy helps to create negative pressure within the disc, drawing in nutrients and promoting healing.

This combination is powerful for long-term pain relief and stronger movement at any age. We integrate these modalities because we know that a multi-faceted approach yields the best and most sustainable results. Many people worry that their pain will never go away, or if they've had it reoccur, they're worried that it will continue to get worse. Our approach is designed to tackle those fears head-on.

Instead of jumping straight to medications, injections, or surgery (which should be considered last after other therapies have been exhausted), our unique approach combines Pilates, chiropractic care, laser therapy, spinal decompression if needed, and targeted muscle strengthening to truly help people get back to what they love to do.

4. How Fast Can You See Results?

Most clients begin noticing improvements within 2–4 sessions, especially when chiropractic and Pilates are combined. This integrated approach allows us to address both structural alignment and functional strength simultaneously, leading to quicker and more lasting relief. We also track progress with objective measures to ensure you're on the right path:

• Mobility screens: To assess your range of motion and identify any lingering restrictions. Strength testing: To quantify improvements in your core and supportive musculature.
• Pain and function surveys: Your subjective experience is crucial. We track your pain levels and how well you're able to perform daily activities.

"Here’s what I’ve learned—both from my own experience and from working with hundreds of people dealing with back pain: movement matters. The research is clear that staying active is one of the best things you can do, but it’s also important to listen to your body. Pushing through sharp or severe pain can make things worse, while avoiding all activity can lead to stiffness, weakness, and slower recovery. The key is to find that sweet spot—challenge your back just enough to keep it moving and strong, but not so much that you flare it up. If you're unsure where that line is, don’t guess—get help from someone who can guide you safely.

"If I could give one piece of advice to someone just starting their journey with back pain, it would be this: You can get through it. Take the right steps early to get the best results. Start walking. Find activities that don't increase your pain that you can do on a regular basis. And most importantly, get guidance from someone who can truly help you.

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References:

• Leeuw, M., Goossens, M. E., Linton, S. J., Vlaeyen, J. W., Boersma, K., & de Jong, J. R. (2007). The fear-avoidance model of chronic pain: an update and critical appraisal. Journal of Applied Biobehavioral Research, 12(1), 1-28.
• Natour, J., Cazotti, L. A., Ribeiro, L. H., Baptista, A. S., & Jones, A. (2015). Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clinical Rehabilitation, 29(1), 59-68.
• van Tulder, M. W., Koes, B. W., & Bouter, L. M. (2000). A systematic review of the efficacy of bed rest for acute low back pain. The Spine Journal, 25(14), 1678-1681.