Just wanted to share a thought from a conversation I had with a colleague yesterday. We were discussing patient care and progression through pain and we started talking about home care instructions.
    Its important to realize that when you, as a patient, experience pain, its more than likely that your lifestyle is the biggest variable in the equation! To put it another way, the things you do on a daily basis are the reason you are in pain/dysfunction. All the negatives and the positives combined are resulting in pain. Which, in a way, is saying you are living an unbalanced life. 
You might ask "what do you mean unbalanced?" Thats easy! It could be a number of things leading to the imbalance. It could be your work, diet, family, stress, workouts, hobbies, relationship, etc.. Ever hear the saying "all things in moderation" or any number of variations? It couldn't be more true when looking at life. Most anything can be a positive in life as long as you don't overdo it. 
      So with that in mind when a patient comes in with back pain its not only my job to treat the specific pain at the moment, its also my job to identify the imbalances in their life that may be contributing to their current dysfunction. I can add positives, treatment and exercises, but if I don't identify and eliminate negatives, bad posture or bad diet, the cycle of dysfunction continues. 
     So the key to balance is eliminating negatives. Adding positives, home exercises etc., won't do it alone. Without identifying negatives and removing them your routine is just muddying the waters of progress. It kind of reminds me of the definition of insanity: repeating the same action expecting different results. If you want change you have to make change! I can acquire all the licenses and certifications in the world and they can only do so much for you. The real improvement comes when you make the decision to put in the work!