By Dr Vikrant Bhardwaj

The pain starts on Monday. By Wednesday, you take a painkiller. By Friday, you are feeling better. And by next month, you are back where you started. Sound familiar?

For many people, back pain has become a strange little cycle: pain, tablet, relief, forgetfulness — and then pain again.

The frustrating part is that once the pain disappears, we assume the problem has disappeared too. It may not have.

“I’ll manage it somehow.”

This is what people tell themselves. You bend more carefully. You avoid lifting something heavy. You sit differently for a few days.

Someone recommends a painkiller. Someone else suggests a massage. A friend sends you a video of five “miracle exercises”.

You try them. The pain settles. Life gets busy again. And then one morning, you reach for something on the floor — and there it is. That familiar pain. Again.

Low back pain is extremely common. WHO says most low back pain is “non-specific”, meaning there is not always one obvious structural problem that explains it. It can also affect movement, work, family life and quality of life.

That is why treating every episode as simply “something to make the pain go away” can miss the bigger picture.

The question is not only: “How do I stop the pain?”

It is also:

“Why does it keep interfering with my life?”

A proper assessment looks at more than the painful spot. How do you move? How long can you sit? What happens when you bend, walk or lift? Are you active or mostly sitting? What movements make the pain worse? What have you stopped doing because you are afraid the pain will return?

These questions matter because rehabilitation is not simply about chasing pain. WHO describes rehabilitation for back pain as helping people understand their pain, return to activities they value and improve their ability to function. (World Health Organization)

And physiotherapy is not just heat, massage and machines

This is one of the biggest misunderstandings.

Good rehabilitation may involve education, movement, strengthening, improving physical activity and a programme tailored to the individual. For persistent low back pain, WHO recommends a person-centred approach and a combination of appropriate non-surgical interventions rather than relying on one treatment in isolation. (World Health Organization)

So, if your back pain keeps returning, don’t simply ask:

“Which medicine should I take this time?”

Ask:

“What is my body struggling to do, and how can I safely get back to doing it?”

And remember: not every backache needs physiotherapy, and not every case is simple. New severe symptoms, significant weakness, loss of bladder or bowel control, fever, major injury or other concerning symptoms need prompt medical assessment.

For everyone else caught in the familiar pain followed by relief and return cycle, perhaps it is time to stop treating each episode as an isolated event.

Pain going away is good. Knowing how to move forward is better.

Dr Vikrant Bhardwaj, Director, Physiotherapy & Rehabilitation, Pacific OneHealth, New Delhi.