A physiatrist’s holistic guide to beating tennis back pain
By Dr. Eli Finkelstein, Resurgens Orthopaedics
If you’ve ever walked off the court with a nagging ache in your lower back, you’re in good company. Back pain is among the most common complaints for recreational and competitive tennis players alike.
Too often, players respond by either pushing through the pain until it becomes something more serious or stepping away from the sport altogether. But there is a better path that can keep you on the court. That path starts with a visit to a physiatrist.
What is a physiatrist?
Physiatrists are medical doctors who focus on providing comprehensive care through patient education and rehabilitation, helping patients find relief and improve function without surgical intervention.
Physiatry is not one-size-fits-all. The guiding philosophy is whole-person, function-first care. A physiatrist doesn’t just ask “Where does it hurt?” We ask, “What does this prevent you from doing, and how do we get you back to doing it?” For a tennis player, that means understanding your game, your movement patterns, your fitness level, and your goals before putting together a plan.
A collaborative care approach
One of the most important things to understand about working with a physiatrist is that it’s a two-way relationship. Your first appointment is more than a physical exam. It’s a conversation. You’ll talk about how and when the pain started, what makes it better or worse, your training routine, your technique, and your goals. That information shapes everything that follows.
From there, your physiatrist will build a personalized treatment plan specifically for you. You may discuss treatments or remedies that you may have tried in the past, both successful and less helpful, to help guide current and future care needs that are individualized and maximize your personal recovery and healing. This plan evolves over time as your symptoms change and your function improves. It’s not a prescription handed to you on the way out the door; it’s a living roadmap that you and your physician navigate together.
The holistic treatment toolkit
A physiatrist draws from a broad and layered set of tools. For most tennis players, your plan may draw from some combination of the following:
- Physical Therapy
- Home Exercise Program
- Core Strengthening
- Anti-Inflammatory Medications
Advanced non-surgical options: When you need more
For some players, lifestyle adjustments alone don’t fully resolve the pain. This is where physiatry’s advanced non-surgical toolkit comes into play. A variety of treatment options may include:
- Epidural Steroid Injections: Targeted delivery of anti-inflammatory medication around the irritated nerve roots in the spine.
- Facet Joint Injections: May help diagnose the source of a patient’s pain and can also relieve pain and inflammation.
- Medial Branch Blocks: Diagnostic injections that identify whether facet joints are the source of pain.
- Radiofrequency Ablation (RFA): Uses heat to disrupt pain signals from facet joints, which can help treat pain that doesn’t respond to physical therapy.
Think of these interventions not as a last resort, but as a bridge: a way to reduce pain enough that you can re-engage with physical therapy, rebuild strength, and return to the court with a healthier foundation.
Your role in the partnership
The most effective treatment plans in physiatry are co-created, and that means the patient has an active and essential role to play. Here’s what being a good partner in your own care looks like:
- Listen to your body: Learn the difference between the muscle soreness of hard training and the warning signals of an injury. Pain that sharpens, radiates, or persists after rest deserves attention.
- Do the work between appointments: Your physical therapy only works if you do the exercises. Be an advocate in your own well-being and recovery. Consistency, even on days you feel fine, is what builds the durable strength your back needs.
- Communicate openly: Tell your physiatrist if something isn’t working, if symptoms change, or if life gets in the way of your treatment plan. The plan can always be adjusted, but only if your doctor knows what’s happening.
Take the first step toward back pain relief
Back pain doesn’t have to take you off the court. If you’ve been managing back pain on your own and rest isn’t helping, consider consulting a physiatrist first. You may find that the path back to the court is closer than you think, and that with the right plan and the right partnership, your best tennis may still be ahead of you. Schedule a consultation at Resurgens today at resurgens.com.
