I was in physical therapy, for four months. After that I started doing exercises at home that I had to follow closely. Here is what I found out what the research says and what nobody tells you before you decide to do physical therapy and then switch to a home exercise program like I did with my home exercise program.

The injury nobody warned me about

This thing happened in a boring way. I was picking up my gym bag and I bent down then I felt something move in my back. Within one day I had an ache in my lower back that went all the way down my left leg. I could not sit without feeling this pain. My doctor said I had a lumbar disc herniation, which means I had a bulging disc that was pressing on my nerve. He sent me to see a therapist right away.

I want to make it clear that seeing a physical therapist was the thing to do. If you have an injury or your nerves are getting compressed or you just had surgery or if you have a condition that you do not know much about you should go see a doctor or a professional first. What I am talking about here happened after I saw a therapist for four months. They helped me figure out what was normal for me. Made sure I did not have any serious problems. This is not a story about not listening to my therapist. It is a story about what I did, after that.

Four months of formal physical therapy

My physical therapy program started with three sessions a week at a clinic. The first few weeks were really tough. I had a time doing a simple hip movement without straining other parts of my body. My glutes, which are supposed to help keep everything were not working like they should. My therapist said I had something called gluteal amnesia, which means my glutes had basically forgotten what to do. This is actually pretty common. I had no idea.

At first we worked on core stabilization exercises. We did some gentle nerve exercises to help my body learn how to move again. It really helped. My pain went from being almost unbearable to something I could manage. I could walk properly again. Sitting was not as painful. I was really thankful for the help I got in those few months.

After about ten weeks I felt like I was not getting any better. The sessions started to feel the same every time. I was doing the exercises over and over three times a week. My therapist was great. She had a lot of other patients to see so she could only spend a little time with me each session. Most of the time I was just lying on a mat doing the movements I had learned weeks ago without anyone supervising me. My physical therapy program was not challenging me like it used to. I was getting a little frustrated, with the physical therapy program.

“Progress was real in the beginning. But somewhere around week ten, the sessions started to feel like I was just showing up to do homework I could have done at home.”

I started researching. Specifically, I wanted to understand whether the supervised setting was still delivering value beyond what I could replicate with a well-designed home exercise program for back pain.

What the research told me

This research is really important and easy to find. A big study called Cochrane review done by Hayden and others in 2005 and updated in 2021 looked at 43 experiments with over 3,825 people who have chronic low back pain. What did they find out? Exercise therapy, whether someone is supervising you or you are doing it at home really helps reduce pain and makes it easier to move compared to not doing anything. What is important is that you do the exercises regularly and that the program is designed for your needs.

Another good study, done by Gomes-Neto and others in 2017 and published in the European Spine Journal compared two groups of people, with low back pain. One group did exercises at a clinic with a supervisor and the other group did exercises at home with a program. After 12 weeks they found out that both groups had results when it comes to pain and disability.

The people who did exercises at home had fewer dropouts and were more satisfied. The researchers think this is because exercising at home is more flexible and does not require scheduling appointments. Chronic back pain and exercise therapy are really important to talk about. Exercise therapy can be done in ways but it always helps with chronic low back pain.

Building my home exercise program

I did not just stop going to therapy and start doing things my own way. That is a difference. I asked my therapist to help me make a plan, for exercising at home as part of our last sessions together. She made a plan that got harder as I got better. She told me exactly how to do each exercise how many times to do it and how many sets to do. The plan was supposed to last for six weeks.

The core of the program was built around five evidence-based movement categories for lumbar spine rehabilitation:

The six-week turning point

By the week of the home program I felt something that I had not felt in a long time: I felt like I was in charge of my own recovery. I was getting up every morning before my family woke up. I was working out. I was doing this every day without fail which is something I could never do when I had to go to appointments and travel to get there. By the week I was able to run my first 5K since I got hurt. I did it slowly and carefully and I did not feel much pain at all maybe a two out of ten.

My ability to manage my pain got better, not physically but also mentally. This is also what the research says. A paper from 2019 in the Journal of Orthopaedic & Sports Physical Therapy found that people with musculoskeletal pain who did exercises on their own at home felt more confident in their ability to manage their pain compared to people who had to go to a clinic. This also meant that they had results in the long run.

The biggest unexpected benefit: I stopped being afraid of moving. When I was going to therapy I started to think that exercise only happened in a clinic.. When I started doing the same exercises at home on my own terms I started to feel more confident in my body’s ability to heal.

When to stay in formal physical therapy

This is the part that a lot of articles like this one do not talk about. Let me be honest with you. Doing exercises at home is not the idea for everyone. You should keep going to physical therapy sessions with a professional if any of the following things are true for you:

Do not try to manage your rehab on your own if you have:

1. had surgery or are still recovering
2. Unexplained or getting worse neurological symptoms like numbness, bladder problems or severe weakness
3. A new injury with a lot of swelling or instability
4. Osteoporosis or are at high risk of fractures
5. A condition that needs hands-on therapy that you cannot do at home
6. No way to see a professional, for check-ins
7. A history of not sticking to exercise routines without someone to hold you accountable.

PT vs home exercises: the honest comparison

Research citations

· Hayden JA et al. (2005, updated 2021). Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews. PMID: 16034851
· Gomes- Neto M et al. (2017). Stabilization exercise compared to general exercises or manual therapy for the management of low back pain. European Spine Journal, 26(12). DOI: 10.1007/s00586-017-5125-2
· Owen PJ et al. (2020). Which specific modes of exercise training are most effective for treating low back pain? British Journal of Sports Medicine, 54(21). PMID: 31843514
· Slade SC & Keating JL (2006). Unloaded movement facilitation exercise compared to no exercise or alternative therapy on outcomes for people with non-specific chronic low back pain. Journal of Manipulative and Physiological Therapeutics. PMID: 17045093

Medical disclaimer: This article reflects one individual’s personal experience and is supported by published research. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified physiotherapist or physician before starting, modifying, or stopping any rehabilitation program. Conditions vary significantly, what worked in this experience may not be appropriate for yours.