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Low Back Pain: When to Push Through & When to Get Help

Did you know ~25% of adults in the U.S. are experiencing some version of low back pain at any given time? Up to 80% of U.S. Adults will experience low back pain through their lifetime, and it is the 5th leading reason for seeking medical treatment in the U.S. as well as one of the leading causes of disability in the workforce. Let that sink in. With all of the chronic diseases we are facing in our country (cardiovascular disease, diabetes, etc.), low back pain is still the 5th leading reason for seeking medical care! Why is that? In general, the medical system we have today is terrible at supporting acute and chronic low back pain.

Here’s how the story goes for many… they wait a few weeks (nothing wrong with that, but learn what to do in the meantime below!) to months (don’t do this) before seeking care, go to their primary doctor, who unfortunately can’t help you other than to give you meds or refer you to another provider. They then refer you to an orthopedic Dr. for whom has a 2-6 week waitlist. By the time you see them you are still in pain and have significantly reduced or stopped exercise. They either A. Order imaging, B. Give you medication C. Tell you to stop lifting and rest for 6 weeks and come back or D. (Fingers crossed) tell you to go get some PT. THEN you have another timeframe of either waiting for imaging, waiting to see a PT, waiting for your follow up in 6 weeks with the same Dr. who told you to stop doing what you love and not address the problem at hand. By this point many people are in chronic pain. For some, the pain has reduced but when they resume exercising their pain often returns.

The best way to break this cycle is to seek care directly from a doctor of physical therapy. We can help get to the root cause of the issue immediately and start working on controlling your pain, then get you back to the activity you love by the time you would have gotten to them in the first place with the whole rigamarole above. If it is not appropriate for you to see us, we will refer you to the appropriate provider.

So…. How do you know when to seek care and what can you do in the meantime? Whether you're dealing with mild stiffness or something more limiting, knowing how to manage your pain can be the difference between a quick recovery and a lingering issue.

Should You Train Through Low Back Pain?

Not all back pain means you need to stop training completely. In fact, staying active within a pain-free range is often the best approach, we will call this a pain free window below.

Generally, it is safe to continue training if:

• The pain decreases as you move.

• You can find pain-free variations of movements.

• It doesn’t limit daily activities like walking, sitting, or sleeping.

• Things return to normal within 2-4 weeks.

🚨 Time to See a Physical Therapist If:

• The pain lingers for more than 2-4 weeks without improvement.

• It worsens with movement instead of getting better.

• You feel stiff and guarded, struggling to return to normal activity.

🚫 Avoiding movement completely can actually make your pain last longer. Instead, focus on modifying movements and training around discomfort to gradually restore strength and mobility. Focus on going for walks, doing some yoga and mobility work within your tolerance, and strength training in areas or with modifications that do not cause more pain.

The Right & Wrong Way to Move Through Back Pain

Your body operates on a pain window—work inside that window, and it expands over time. Push too far outside of it, and the pain lingers longer.

✅ Do This:

• Modify movements to stay within a pain-free range.

• Work on pain free mobility and pain control exercises to help reduce the pain

• Continue training pain-free muscle groups (e.g., upper body if squatting is painful).

• Add additional cardio (walking, biking, swimming, etc.) that does not irritate your back

Watch this video explanation and see which exercises to start with! https://youtu.be/mfo0dq6UKt4?si=F8CX8D18ckEIShdu

🚫 Avoid This:

• Pushing through sharp or worsening pain.

• Total rest—this leads to stiffness, weakness, and prolonged pain.

• Poor lifting form that increases stress on the spine.

When Low Back Pain Needs Urgent Medical Attention

Most low back pain can be managed conservatively—but in some cases, it may signal something more serious that needs immediate medical evaluation.

🚑 Seek emergency care if you experience:

• Numbness/tingling or weakness down one or both legs.

• Loss of bowel/bladder control or changes in function.

• Frequent waking at night due to pain that doesn’t improve with positional changes.

These symptoms may indicate nerve compression or other serious conditionsthat require prompt medical attention.

Get Your Free Guide: Low Back Pain Prevention for Lifters

Want to train pain-free and prevent future low back injuries? Download my free e-book on Low Back Pain Prevention for Lifters, where I cover:
✔️ Pain control exercises for relief (end of e-book).
✔️ Lifting modifications to keep you training safely.
✔️ Proactive strategies to prevent flare-ups.

📩 Click here to download your free e-book now!

If your back pain has been lingering or limiting your workouts, don’t wait—schedule a free discovery call here and let’s get you back to pain-free lifting.

I work with clients all over the Montgomery County area for physical therapy including: Souderton, Hatfield, Lansdale, Montgomeryville, North Wales, Doylestown, Perkasie, Quakertown, Harleysville, Skippack, Conshohocken, and have clients that I work with solely virtually.

Stay strong,
Dr. Ryan Kalkbrenner, PT, DPT, OCS
Precision Fitness Physical Therapy - Owner