“Why does my back hurt more during physical therapy sessions?”

Increased pain during physical therapy can be due to muscle fatigue or improper form. Ensure you're performing exercises correctly and communicate discomfort to your therapist. Some soreness is normal, but severe pain isn't. Your therapist can adjust the intensity or type of exercises to better suit your needs.

Are you doing physical therapy under the care of a professional Physical Therapist? If not, I would recommend seeking out a PT to help you. If you are doing generic physical therapy exercises prescribed by your physician or based off of something that you found on the internet, it is likely not what you need. It could be causing more harm. A Physical Therapist will do an evaluation of your strength, range of motion, coordination, etc and design a plan of care that is specific to your body and your pain.

It depends. Try to think of what you are experiencing is pain, muscle strain, or just difficulty. Definitely tell your therapist so they can assess your form, muscle engagement and give your proper guidance that can make the activity most beneficial. On a few occasions that may work itself out after a few reps. However, if it increases as you go stop and let your therapist know.

May be your posture during your exercises needs to be adjusted. Please check with your PT , they can help out.

The goals of any physical therapy treatment plan are to reduce pain, increase function and provide a maintenance program for back pain and sciatica. Typically, the treatment plan is comprised of two components-active exercises and passive modalities. The exercise regimen may consist of strengthening, stretching and aerobic conditioning. Core muscle training is also a part of a good lower back pain treatment plan. It’s important that these exercises are done properly and consistently.

Passive modalities used in a physical therapy treatment plan for back pain and sciatica may include heat and cold therapy, ultrasound and transcutaneous electrical nerve stimulator (TENS) units. Heat and cold therapy are used to reduce muscle spasm, inflammation, and pain. With ultrasound, deep heating is applied to the soft tissues through sound waves. It is known not only to help relieve pain but to enhance healing. A TENS unit uses electrical stimulation to override pain signals sent to the brain. If it is successful, a TENS unit can be used long term.

All around, research has proven that physical therapy is effective for those who suffer from back pain or sciatica pain. It’s also safe. That’s why the Centers for Disease Control and Prevention (CDC) highly recommends it. “Physical therapists partner with patients, their families, and other healthcare professionals to manage pain, often reducing or eliminating the need for opioids. Research has shown that a simple education session with a physical therapist can lead to improved function, improved range of motion and decreased pain.”

Some low levels of pain when recovering from an injury is to be expected. Assuming you aren't complaining of pain with just about every exercise, I wouldn't think there is anything wrong. If every type of movement hurts, you should see a doctor. They will determine if you need an X-ray or MRI. Hopefully, you have developed a good relationship with your physical therapist where you can always communicate your level of pain and it is taken seriously. They should be able to craft an efficient program that minimizes your pain. If not, you both may not be on the same page and you may want to consider working with a different therapist.

If you are doing the exercises instructed to you by your licensed physical therapist, then you should serious discuss your concerns and symptoms with exercise with your physical therapist. When it comes to spinal instabilities, it is very important to know the specifics of your pain presentation before determining the plan of care.

Sometimes your back may hurt during the exercise if you’re stretching tight structures, but it should never feel worse for hours and you should feel that, overall, you are improving. If this is not the case, tell your therapist because the exercises may need to be modified.