Why Your Back and Neck Pain Keeps Coming Back — And What Actually Fixes It

4. Facet Joint Dysfunction

The small joints at the back of each vertebra can become inflamed or “locked,” causing sharp localised pain that worsens with certain movements. Manual therapy — specifically joint mobilisation performed by a trained physiotherapist — is one of the most effective treatments for this condition.

What Physiotherapy Actually Involves (Most People Don’t Know)

There’s a common misconception that physiotherapy means lying under a heat lamp or using a TENS machine for twenty minutes. That’s not physiotherapy — that’s passive modality therapy, and while it has a role in short-term pain relief, it’s not what produces lasting results.

Evidence-based physiotherapy for back and neck pain includes:

Manual Therapy — Joint mobilisation and manipulation to restore normal movement in restricted spinal segments. Performed hands-on by a qualified physiotherapist.

Dry Needling — Fine needles inserted into trigger points (tight muscle knots) to release them. Particularly effective for chronic upper trapezius tightness and myofascial pain patterns.

Exercise Rehabilitation — Structured, progressive exercises that strengthen the deep spinal stabilisers (multifidus, transversus abdominis, deep neck flexors) that most people never train.

Postural Re-education — Identifying and correcting the movement habits and workstation setup that are continuously loading your spine.

Education — Understanding your condition reduces fear, improves outcomes, and prevents recurrence. A good physiotherapist explains what’s happening in your body and why.

The Role of Ergonomics — The Missing Piece

Even the best physiotherapy treatment will underperform if you return to a poorly set-up workstation every morning.

A few non-negotiable basics:

• Screen at eye level — not below, which forces chin-down and loads the cervical spine
• Chair height adjusted so hips are at 90°, feet flat on the floor
• Lumbar support maintaining the natural inward curve of the lower back
• Keyboard and mouse positioned so elbows stay at 90° with neutral wrists
• Taking a standing break every 45–60 minutes — set a reminder if needed

Small adjustments here reduce the total load on your spine by a significant margin and make physiotherapy results last considerably longer.

When Should You See a Physiotherapist?

Most people wait until the pain is 8 out of 10 before seeking treatment. By that point, the problem has typically been developing for months — and requires proportionally more time to resolve.

See a physiotherapist if:

• You have pain that has lasted more than 2 weeks
• Pain is recurring — it goes away and comes back
• You have numbness, tingling, or weakness in the arms or legs
• Pain is affecting your sleep, work, or daily activities
• You’re relying on painkillers more than once a week for the same complaint

You do not need a doctor’s referral to see a physiotherapist. You can walk in, get a thorough assessment, and leave with a clear diagnosis and treatment plan.

A Note on Surgery

Many people with disc herniations or spondylosis are told they “may need surgery” and live with anxiety about this for years. The reality is that the vast majority of spinal conditions — including most disc herniations — resolve with conservative management, of which physiotherapy is the most effective component.

Surgery has its place for a small percentage of cases, particularly where there is significant nerve compression causing progressive weakness. But it is rarely the first resort that patients fear it must be.

If you have been told surgery is an option, getting a physiotherapy assessment first is almost always the right move.

Finding the Right Clinic

The quality of physiotherapy varies enormously. Look for clinics where:

• Treatment is delivered one-on-one, not supervised from a distance
• The physiotherapist has an MPT or BPT qualification
• You receive a proper assessment before any treatment begins
• The treatment plan is explained clearly with realistic timelines
• Exercise rehabilitation is part of the program — not just passive treatments

In Delhi NCR, Anodyne Spine Clinic(Lajpat Nagar) takes this evidence-based approach to spine care — combining manual therapy, dry needling, exercise rehabilitation, and patient education to treat the cause of pain, not just its symptoms.

The Bottom Line

Back and neck pain is not something you simply have to live with. It is not an inevitable consequence of getting older or working at a desk. It is a mechanical problem — and mechanical problems have mechanical solutions.

The earlier you address it properly, the faster and more completely it resolves.