November 17, 2025
Over the past few decades, the spine has developed a reputation that often evokes fear in patients. When healthcare providers mention "degenerative disk disease," "a bulged disk," or "your spine is out of alignment," it can be deeply unsettling. This anxiety intensifies when they add, "there's something wrong with your nerve."
Frequently, patients are labeled as having "chronic pain." While it seems straightforward, this diagnosis has widespread effects throughout the healthcare system, including physical therapy.
Such labeling creates a fixed identity for patients, leading them to believe they must live with pain indefinitely. This mindset often results in fear of movement—which ironically worsens their condition. These labels also influence healthcare provider behavior, leading to:
• Lower expectations for recovery
• Overmedicalization and increased medication use
• A focus on symptom management instead of restoring function
Despite its reputation, the spine is not the "big bad wolf." With the right approach, patients achieve significant improvement. The key is finding a physical therapist who understands the spine's complexity, identifies root causes, and isn't afraid to innovate—even after previous therapy has failed.
I've treated numerous patients with surgery scheduled after exhausting all other options. One case stands out:
A recreational hiker and runner struggled with persistent ankle pain. After completing physical therapy school, I began treating her with evidence-based ankle instability protocols. After six months, her pain lessened but significant weakness remained. I was considering discharge due to a plateau.
Then, using knowledge from a post-residency certification course, I discovered the truth: her ankle pain originated from her lumbar spine. Nerve involvement was decreasing her ankle muscle strength. A single low-back exercise produced immediate relief and improved strength.
By shifting focus to her spine, her symptoms completely resolved in one week—after over a year of pain and six months of unsuccessful treatment. Surgery had been her only remaining option.
Based on my experience as a spine specialist, here are critical insights:
You don't need back or neck pain for the spine to be the problem. Your spine can cause pain anywhere in your body.
Imaging lies. Some people have clear scans but severe pain, while others have abnormal findings and feel fine. Imaging doesn't always reveal the true cause.
Nerve irritation looks different than you think. It may present as excessive tightness, burning, cramping, or temperature changes—not just numbness and tingling. I prefer "irritated" or "angry" nerve rather than "pinched."
High-level activity is possible. Even with spine involvement, you can return to running, hiking, or whatever you love.
Get a second opinion before surgery. If an orthopedic physician recommends surgery, consult me first.
You don't have to live with spine pain. Bet on yourself and take the first step toward recovery at Vital Force Physio.
Dr. Rachel Tauber
PT, DPT, MSEd, EMR-A, CSCS, PRA, USAW-L1
This information is for educational purposes only. Please consult your Physical Therapist, Physician, or Healthcare Provider for medical advice.
