Physical Therapy As A Solution To Back Pain: An Interview With Tory Bishop, PT, DSc, Cert. MDT, CMTPT

Back pain impacts nearly everyone at some point. The older you get, the more likely you are to have experienced back pain and need to seek help from a medical professional to alleviate it.

It’s important, however, to understand that back pain is not a diagnosis itself, but rather a symptom of a larger issue, such as improper movements, muscle strains, infections, or acquired conditions, such as arthritis or pregnancy.

That’s what Tory Bishop, PT, DSc, Cert. MDT, CMTPT recently explained to MD TV in an interview.

Bishop, the Clinical Director for Tidewater Physical Therapy’s location in Suffolk, called physical therapy a definite solution for diagnosing and treating the driving forces causing those different types of back pain.

“For the majority of people, back pain is a result of aging, inactivity and being overweight,” Bishop said. “Weak core muscles don’t offer proper support for the spine and this can lead to stress and pain. For these people, a regimen of aerobic and core strength exercises can drastically improve the condition. But for others whose back pain is a result of something else, finding the right method of treatment is the real key.”

Bishop highlighted the following drivers of back pain in her interview.

Herniated Discs

Healthy discs are the soft, rubbery pads that separate the hard bones of the spinal column allowing the back to move, bend and absorb shock for the delicate structures of the spine, Bishop explained.

“A herniated disc occurs when a disc ruptures, or herniates, when part of the center nucleus pushes through the outer edge of the disc toward the spinal canal where the spinal cord and other nerve roots are located,” Bishop said.

Because herniated discs can be painful one day and not the next, and more in the morning than the evening, many people avoid seeing a doctor or physical therapist thinking the pain will go away. It usually gets worse.

Moving forward with physical therapy – prescribed exercises, modalities and manual therapy – is the best option to alleviate the pain and treat the underlying issue.


Another cause of back pain, Bishop said, is osteoporosis, a medical condition where bones become brittle and fragile due to a loss of tissue.

“Osteoporosis can absolutely affect the spine,” Bishop said about the metabolic problem diagnosed by a physician through a bone density scan.

Patients coming in to her clinic with back pain and an osteoporosis diagnosis “might become more and more bent forward and are unable to stand upright because the bone density is lacking,” Bishop said.

While osteoporosis can impact anyone, women in particular should be aware of the impact of it on back pain.

“One out of four post-menopausal women will suffer fromosteoporotic spinal fractures,” Bishop said. “The scary part? Eighty-percent of them we don’t even feel.”

Myofascial Pain

Myofascial pain, “myo-“ meaning “muscle” and “-fascial” meaning “connective tissue,” is a condition that compromises both structures, often presenting the pain in what Bishop described to MD TV as “trigger points.”

Bishop said “there’s long been controversy as to how myofascial pain is diagnosed because there is no laboratory result or blood work result or diagnostic imaging study that can actually detect a trigger point.”

But Bishop’s patients can definitely feel it.

Bishop defined “trigger points” as a “hypersensitive area in the muscle that is a hardened type tissue.”

Think of trigger points like a knot. Those knots are actually a spasm in the muscle. The knot, or trigger point, from the constant spasm creates a blockage for blood to flow properly around the rest of the tissue. That blockage causes cellular waste that builds up around the trigger point, which then sends pain around the body.

To relieve these trigger points, Bishop recommended “dry needling.”

Dry needling is procedure where a certified physical therapist inserts a sterile, solid filament needle into the skin and muscle of a patient and directly into a trigger point to help alleviate pain.

Specifically, in dry needling, Bishop finds the knot creating that blockage and inserts a needle to release or stop the spasm that creates the knot. With that, the blood flows through and moves the cellular waste away, eliminating pain.

There is no medication administered during the procedure, thus giving the treatment the “dry” name. While often associated with acupuncture because a similar tool is used, dry needling is strictly based on Western medicine and research.

Treating Back Pain

For each of these types of back pain, Bishop recommends seeing a doctor or physical therapist.

Non-surgical treatment is effective for more than 90 percent of patients who seek treatment.

Have back pain and want to see Bishop? Make an appointment today. Not in the Suffolk area? Find a Tidewater Physical Therapy clinic near you.

Many of the physical therapists at Tidewater Physical Therapy Inc. hold Direct Access Certification through the Virginia Board of Physical Therapy.  Bishop holds Direct Access Certification and is available to evaluate and treat patients without a prescription from a physician.  Read more about Tory and the Tidewater Suffolk Clinic