Back Pain

Low back pain is one of the most common reasons people seek physical therapy — yet many people experience ongoing or recurring back pain without a clear injury or diagnosis. Stiffness, aching, tightness, or pain with sitting, standing, or bending are extremely common, even when imaging such as MRI or X-ray shows “nothing wrong.”

At Osteopractic Physical Therapy of the Carolinas, we help patients in Fort Mill, Charlotte, and throughout the Carolinas resolve low back pain by identifying the true mechanical drivers of pain — including joint restriction, muscle overactivity, and movement inefficiency. Our hands-on approach focuses on restoring normal movement rather than simply managing symptoms.

If you’ve been told your back pain is “just tight,” “just age-related,” or that you need endless exercises — this page is for you.

What Does Low Back Pain Commonly Feel Like?

Low back pain does not always present as sharp or severe pain. Many patients report:

  • Stiffness or tightness, especially in the morning

  • Aching or pressure in the lower back

  • Pain with prolonged sitting or standing

  • Discomfort when bending, lifting, or twisting

  • Pain that improves temporarily with movement but returns later

  • A sense that the back “locks up” or feels unstable

These symptoms are often related to movement dysfunction, not structural damage.

Why Do I Have Back Pain If I Didn’t Injure Anything?

This is one of the most common questions patients ask — and one of the most misunderstood.

Low back pain often develops due to:

  • Repeated postures (sitting, driving, desk work)

  • Loss of joint mobility in the lumbar spine or hips

  • Poor load tolerance with daily activities

  • Muscle guarding and protective stiffness

  • Nervous system sensitivity over time

Pain can develop gradually without a specific injury and still be very real. In fact, many mechanical causes of back pain do not appear on imaging.

Why Is My MRI or X-Ray “Normal” If I Still Hurt?

Imaging is useful for ruling out serious pathology — but it does not assess:

  • Joint motion

  • Muscle tone or trigger points

  • Movement coordination

  • How your spine responds to load and stress

Disc bulges, arthritis, and degenerative changes are common and often painless, while joint restriction and muscle dysfunction frequently cause pain but go unseen.

At OPTC, evaluation focuses on how your spine moves, not just what it looks like.

Can Spinal Manipulation Help Low Back Pain?

Yes — spinal manipulation is one of the most effective tools for many mechanical low back pain presentations when performed appropriately.

At Osteopractic Physical Therapy of the Carolinas:

  • Patients are carefully screened

  • Manipulation is never forced

  • It is combined with soft tissue treatment and movement retraining

  • The goal is to restore motion and reduce protective muscle guarding

Many patients experience improved mobility and reduced pain after just a few targeted sessions.

How Is OPTC’s Back Pain Treatment Different?

Traditional physical therapy often relies heavily on:

  • Generalized exercises

  • Passive modalities

  • High visit frequency

At OPTC, treatment emphasizes:

  • One-on-one care with a Doctor of Physical Therapy

  • Hands-on manual therapy

  • Lumbar and hip joint mobilization or manipulation

  • Dry needling when appropriate

  • Addressing movement patterns that actually provoke pain

This approach often leads to fewer visits, better understanding, and longer-lasting results.

How Many Physical Therapy Visits Does Low Back Pain Usually Take?

There is no one-size-fits-all answer, but many uncomplicated low back pain cases improve within 3–6 focused visits when the primary drivers are correctly identified.

Our goal is not ongoing dependency, but to:

  • Restore normal movement

  • Improve confidence with activity

  • Reduce recurrence

  • Provide a clear long-term plan

Low Back Pain Physical Therapy in Fort Mill & Charlotte, NC

Osteopractic Physical Therapy of the Carolinas serves patients throughout:

  • Fort Mill, SC

  • Charlotte, NC

  • Surrounding Carolinas communities

No referral is required, and all care is delivered in a private, one-on-one setting focused on results.

FAQ

Written by Dr. Noah Zacharko, DPT
Doctor of Physical Therapy
Senior Instructor, American Academy of Manipulative Therapy’s Spinal Manipulation & Dry needling Institutes
Founder, Osteopractic Physical Therapy of the Carolinas

  • A: In most cases, gentle movement is beneficial. Prolonged rest can increase stiffness and sensitivity.n text goes here

  • A: Yes — when exercises are appropriately selected and progressed based on your presentation.

  • A: No. Many cases are related to joint stiffness, muscle guarding, or movement coordination issues.

  • A: Most patients do not need imaging unless specific red flags are present.