Why Physical Therapy Should Be Your First Stop for Chronic Pain—Not Your Last

Rob Letizia

By Dr. Rob Letizia | Spectrum Therapeutics of NJ – Wayne, NJ

For many people dealing with chronic pain, the road to relief looks like this: primary care visit, medication, imaging, maybe an injection… and then, finally, someone says, “Why don’t you try physical therapy?”

At that point, the pain has often become worse, the body more deconditioned, and the problem more complex. And here's the truth:

Physical therapy should be your first stop—not your last resort.

🚫 The Traditional Path Is Backwards

Most chronic pain patients go through the medical system like this:

Start with medication to mask the pain
Get an X-ray or MRI that often doesn’t match their symptoms
Try injections or rest with little or no lasting improvement
Eventually land in physical therapy, often after years of frustration

By the time they get to us, they’ve lost mobility, strength, and hope. But it doesn’t have to be this way.

✅ Physical Therapy Treats the Cause of Pain

Physical therapy isn’t about temporarily reducing pain—it’s about addressing the root cause behind it:

Imbalances in how you move
Joint stiffness and soft tissue restrictions
Weak stabilizing muscles
Nerve tension or inflammation
Faulty movement patterns from old injuries

Instead of chasing symptoms, we evaluate your entire movement system to uncover why the pain is there—and what it needs to get better long-term.

💡 Real Story from Our Clinic

We recently saw a 55-year-old man from Hawthorne who had chronic lower back pain for over a year. He’d been through painkillers, an MRI that showed a disc bulge, and two cortisone injections. Still no relief.

In just one visit, we discovered the pain wasn’t coming from his spine—it was a hip mobility issue combined with weak glutes and poor trunk control.

After 6 weeks of targeted therapy and education, he was pain-free, off all meds, and back to working out 3x/week.

This is what happens when you treat the problem, not just the pain.

🔬 MRIs Don't Always Tell the Full Story

It’s tempting to think imaging holds the answers—but research shows:

Up to 60% of people with no back pain at all show disc bulges on MRI
Rotator cuff “tears” are common in adults over 50—many without pain
Knee arthritis severity on X-ray doesn’t always correlate with symptoms

In other words, imaging often finds things that aren’t causing your pain. That’s why physical therapy starts with a movement-based approach—because how you move tells us more than what a scan shows.

🧠 Chronic Pain Is a Whole-Body Issue

Longstanding pain affects more than just joints or tissues. It changes how your brain processes sensation, how your body protects itself, and how you move through the world.

At Spectrum Therapeutics, our approach blends physical rehab with neurological retraining—so your body and brain both learn that it’s safe to move again.

🛠️ What We Do Differently at Spectrum

Our process is hands-on, focused, and completely individualized:

One-on-one sessions—no techs, no busy gyms
Detailed movement assessments
Manual therapy to reduce restrictions and activate tissue
Corrective exercises to restore joint control and muscle balance
Education and mindset work to reduce fear around movement

Whether your pain is in your back, knee, shoulder, or neck—our goal is to restore real function so you don’t have to rely on pills, injections, or surgery.