back pain

When people with chronic back pain come to see Ryan Brown for physical therapy, they are often surprised at what the sessions are like.

“There is more talking than exercise sometimes,” Brown says. “We talk about their pain and how it’s affecting their quality of life. We talk about the stress and anxiety that causes.”

Only after that do they work on stretching and functional movements.

Brown is among the few dozen UPMC physical therapists to have a Primary Spine Practitioner (PSP) certification. PSP certification is an emerging specialty within physical therapy. It requires advanced training that goes above and beyond typical spine care techniques.

Because of a law called Physical Therapy Direct Access, patients can see PSPs directly, without a doctor referral. But many UPMC patients only know about PSP care because their doctor has suggested they give it a try.

“We connect with primary care doctors for each Direct Access patient,” says Shane Conley, CRS PSP program director, “The CRS PSP can help patients navigate the health care system and weigh costs, which can be challenging for many patients.”

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How Is Seeing a PSP Different Than Seeing a Physical Therapist?

“What we do is more specialized and more specific,” says Brown, facility director at UPMC Centers for Rehab Services Erie — Pine Avenue location.

He tends to work with adults who have been living with spine pain for some time. They have tried various treatments, from injections to surgery, but the pain always returns.

“They start to identify as someone with back pain, rather than as a runner or a golfer,” Brown says.

The pain robs them of their hobbies and even simple pleasures, like complete daily activities or being able to play with their grandchildren.

PSPs work closely with people to understand both pain triggers and functional goals. Every program has a pain control component and a functional component.

Sometimes the first step is working on standing up longer or getting out of a chair without being in pain. Then Brown will have patients move on to more functional exercises. These are exercises related to things they want to be able to do again, like garden or take walks.

“Everything we do is about improving quality of life,” Brown says.

PSPs Can Help With All Types of Back Pain

Though they present with many of the same injuries, each person has different responses and different needs. There isn’t one program for a herniated disc and one program for a pinched nerve. “Rarely do two people come in and get exactly the same treatment,” Brown says.

On average, most patients see a PSP for 6 t0 8 weeks. This usually works out to be 6 to 8 visits. It’s not the old model of coming 3 times a week and doing a dedicated set of exercises.

“There is more time between visits so that people can really work on the exercises at home,” he says.

There are also fewer exercises. But they are highly targeted movements, designed specifically to help the patient meet their goals.

PSPs within the UPMC’s Center for Rehab Services also work closely with mental health specialists. Chronic pain affects both mind and body. “We are here for your physical pain, but we are here for everything else too,” Brown says.

Is Seeing a PSP Right for Me?

Many patients start by seeing their primary care doctor, especially for back pain. But if you have tried other treatments and you’re still living with spine pain, a PSP may be the logical next step.

To see if there is a PSP at a UPMC Physical Therapy location near you, call 1-888-723-4277 and select option 2, or email

About UPMC Centers for Rehab Services

Whatever your therapy need – physical, occupational, or speech – UPMC Center for Rehab Services can create a personalized treatment plan for you. We have more than 70 outpatient facilities throughout western Pennsylvania, with convenient hours for your schedule. Our therapies follow the most up-to-date research for rehabilitation, and we treat numerous conditions, from arthritis and tendinitis, to injuries and symptoms related to other medical conditions.