I've tried physical therapy. Why didn't it help? 

There are many treatment options advertised for back pain, even within the field of physical therapy, but the proven, most effective, treatment options supported by extensive research are:

Manual Therapy *** Specific targeted exercises *** Traction

This is where the importance of selecting a back pain specialist with extensive advanced education and experience combined with cutting edge equipment and technology comes into play. 

I can't tell you how many times a patient has come in our clinic after receiving physical therapy elsewhere that didn't help or made their back pain worse. Most of the time, they received exercise instruction and possibly traditional traction so why didn't this work? In the majority of cases there were some structural or functional problems caused by their back pain that needed to get addressed BEFORE exercising/traction. This can cause further irritation or reinforce the structural/functional issues instead of resolving the problem/pain.

Why don't all physical therapy clinics offer this level of care?

Physical therapists already have undergone a 7-8 year process to become a doctor of physical therapy but that extensive educational process has to cover a lot of ground including stroke rehab, geriatric, pediatric, orthopedic, acute hospital care, etc. This is the same reason that your family physician isn't going to offer to perform a surgery on your shoulder.

Many clinics are staffed with new grads and physical therapy assistants who have yet to pursue advanced specialization training because this is a more profitable model. It takes a very special level of dedication to complete a doctoral program and then jump back into adding special manual therapy certifications. The majority of manual therapy fellowships last 2-3 years and include extensive residency programs as well.

This advanced education and training is what makes the difference between being able to give you a cookie cutter home exercise program and being able to evaluate your functional movement patterns and clinical signs to correctly identify the source of the problem. Once the source of the problem has been properly identified, they then have the manual skills and extensive education to resolve these problems to accomplish long lasting results.