Why Chronic Back Pain Isn’t “Just Age”: What PT Reveals

“Must be getting old.”We hear that a lot in our clinic—especially from patients dealing with nagging or persistent back pain. It's an easy thing to say when you're stiff in the morning or when your back twinges during a workout. But here’s the truth:

Chronic back pain is not an inevitable part of aging—and you don’t have to live with it.

At Nashville Physical Therapy & Performance, we help active adults uncover the real reasons behind their back pain. Spoiler alert: it's rarely just about your age. It's about how you're moving, how you're recovering, and how your body is adapting (or not) to your lifestyle.

Let’s break down why blaming age is a myth—and what physical therapy can reveal (and fix) instead.

“It’s Just Age” Is a Misleading Diagnosis

Yes, our bodies do change over time. Muscle mass decreases. Discs in the spine naturally lose hydration. Joints get a little stiffer. But these are normal age-related changes—not automatic causes of pain.

A large portion of adults over 40 show degenerative changes on MRIs (like disc bulges or arthritis) without having any symptoms. One widely cited study by Brinjikji et al. (2015) found that up to 80% of asymptomatic adults in their 50s had disc degeneration visible on imaging.¹

Translation? Just because your spine looks different with age doesn’t mean it should hurt.

So what’s actually behind the pain?

The Real Causes of Chronic Back Pain (That Have Nothing to Do with Age)

Most of the back pain we treat in the clinic isn’t caused by serious damage or “wear and tear”—it’s caused by how you move, sit, lift, and train day in and day out. And the good news? These factors are modifiable.

1. Weak or Imbalanced Core Muscles

Your “core” includes more than just abs—it’s your entire trunk and pelvic stabilizing system. If those muscles aren’t doing their job, your back picks up the slack.

🟢 PT fix: Core stability training, movement retraining, and improving motor control during daily tasks.

2. Poor Movement Patterns

Rounding your back to lift, sitting with poor posture, or compensating with one side more than the other can create repetitive stress.

🟢 PT fix: We assess how you move through squats, bends, and daily activities and coach you to move better and with less strain.

3. Sedentary Lifestyle

Sitting all day shortens hip flexors, weakens glutes, and stiffens the spine—ingredients for back pain.

🟢 PT fix: Mobility work, hip strengthening, and ergonomic education to break up long sitting spells.

4. Training Errors

Increasing load or volume too quickly in the gym or on a run without adequate recovery can cause flare-ups.

🟢 PT fix: We help you adjust your training schedule and build a resilient base so you don’t overdo it.

5. Stress and Pain Sensitization

Chronic stress can heighten your sensitivity to pain. The longer you’ve had pain, the more your nervous system “remembers” it.

🟢 PT fix: Gentle movement, education, and a graded return to activity can help retrain your body and brain.

What PT Reveals That Imaging Doesn’t

One of the most frustrating things for patients is getting imaging (like an MRI or X-ray) that shows “age-related changes” but offers no clear answers—or solutions.

That’s where a thorough physical therapy evaluation shines.

At Nashville PT, we look at:

• How you move, stand, and lift

• Muscle strength and endurance

• Joint and soft tissue mobility

• Functional movement patterns

• Lifestyle and training habits
  

We put this all together to create a custom plan to help you move better, feel stronger, and stop the cycle of pain.

Why Our Model Works (and Why It’s Different)

At Nashville Physical Therapy & Performance, we believe you deserve better than cookie-cutter PT or rushed appointments.

Here's what makes our cash-based, one-on-one model ideal for treating chronic back pain:

• 60-minute sessions focused entirely on you

• No insurance restrictions limiting your care or exercises

• A customized plan tailored to your body, your goals, and your lifestyle

• Access to strength training, mobility work, manual therapy, and dry needling—all in one place
  

We don’t just chase pain relief—we build resilience and get you back to doing what you love without fear of reinjury.

Stop Accepting Pain as “Normal”

Age is not a diagnosis. Pain is not something to just “put up with.” And movement is almost always the best medicine.

If your back pain is keeping you from enjoying your workouts, your work, or your weekends—it’s time to do something about it.

Don’t wait for it to get worse. Schedule a PT evaluation with our expert team at Nashville PT and see what’s really behind your back pain.

References

1. Brinjikji, W., Luetmer, P. H., Comstock, B., et al. (2015). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology, 36(4), 811–816. https://doi.org/10.3174/ajnr.A4173

2. Saragiotto, B. T., Maher, C. G., Yamato, T. P., et al. (2016). Motor control exercise for chronic non-specific low-back pain. Cochrane Database of Systematic Reviews, Issue 1. https://doi.org/10.1002/14651858.CD012004

3. Clark, B. C., & Thomas, J. S. (2021). Neuromuscular Contributions to Low Back Pain and Restoration of Function. Physical Therapy, 101(6). https://doi.org/10.1093/ptj/pzab066