Understanding Chronic Low Back Pain: What the Evidence Says and How Physical Therapy Can Help

Low back pain is one of the most common reasons people seek medical care — and it’s also one of the most misunderstood. While most episodes of back pain improve within a few weeks, chronic low back pain (CLBP) — pain lasting longer than three months — can be complex, frustrating, and affect every part of life.

At Ryemon Rehab Physical Therapy, we take an evidence-based, whole-person approach to help patients move better, hurt less, and regain control.

🧠 What the Evidence Tells Us About Chronic Low Back Pain

Modern research has completely changed the way clinicians view back pain. Here are key takeaways from the current literature:

• It’s rarely about “damage.” Imaging (like MRIs) often shows findings such as disc bulges or degeneration, even in people with no pain at all. Studies show that these structural changes are normal age-related adaptations, not necessarily the source of symptoms.

• Pain is multi-factorial. Chronic pain is influenced by the nervous system, stress, sleep, mood, activity levels, and beliefs about pain — not just tissues. The brain can become hypersensitive over time, keeping the pain “volume knob” turned up.

• Movement is medicine. Strong evidence supports exercise and graded activity as first-line treatment. Specific exercise types — whether core stabilization, strength training, Pilates, or walking — are less important than finding something you enjoy and can do consistently.

• Passive treatments alone aren’t enough. While manual therapy, massage, or modalities can reduce pain temporarily, lasting improvement comes from combining them with active movement, education, and lifestyle change.

• Staying active leads to better outcomes. Fear of movement (kinesiophobia) can worsen pain over time. Gradual return to normal activities — even if discomfort is present — helps retrain the body and nervous system to be less sensitive.

  
  

💪 Evidence-Based Best Practices for Managing Chronic Low Back Pain

1. Individualized Exercise Programs: A personalized plan based on your goals, tolerance, and fitness level — rather than a generic “core routine” — yields the best results.

   At Ryemon Rehab, we combine strength training, mobility, and movement-retraining strategies tailored to each client.

2. Education and Pain Science: Understanding that pain does not equal harm is empowering. Education reduces fear and improves confidence in movement — a critical step in recovery.

3. Lifestyle Optimization: Sleep, nutrition, and stress management all influence how the body heals and how the nervous system interprets pain signals. Small, sustainable changes make a big impact.

4. Manual Therapy When Appropriate: Joint and soft-tissue techniques can help reduce muscle guarding, improve mobility, and prepare the body for active movement — used strategically, not as a sole treatment.

5. Consistency and Graded Exposure: The best outcomes come from steady, progressive activity — not boom-and-bust cycles of overdoing it on good days and resting excessively on bad ones.

   
   

🏃‍♂️ The Ryemon Rehab Approach

We specialize in one-on-one, in-home, and telehealth care designed around your schedule and goals. Our mission is to help you understand your pain, rebuild confidence, and return to doing what you love — without fear or unnecessary medical interventions.

Whether you’ve been dealing with low back pain for months or years, recovery is possible. The key is a personalized, evidence-based plan and a coach who listens.

💬 Ready to Move Forward?

If you’re ready to get lasting relief from chronic low back pain, schedule a free consultation to discuss your goals and see how we can help.

👉 Book your session with Dr. Jeff Ryemon, DPT, OCS (Concierge | In-Home | Telehealth | Ventura County)