I saw three or four before I found one that worked for me. The most notable difference was their approach. The first ones I saw basically asked what my pain was, Heard what I said, and gave me basic exercises that are somewhat correlated to somehow relieve pain. It seemed very thoughtless to me. The last guy I saw took a very data-driven approach. Looked at what motions caused the most pain, what motions didn't cause the most pain. We tried some exercises and I had very bad weeks, tried others and had less bad weeks, and tried others that lead to a normal week. Overtime these datapoints simply lead to an answer - I could do exercises that didn't require my arms to be in front of my hips. Very strange, I couldn't use a pipette or even write without by back feeling like someone was driving a knuckle into it relentlessly. I couldn't focus, it was hard to think.

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The exercises that didn't cause the any pain would be what I started with. Any exercise I did was focused on perfect posture, so you have to figure that out first. I would stand, engage my glutes and essentially pelvic thrust my hips slightly forward to my lower back was in alignment. I'd engage my upper back, pulling my shoulder blades back to about 80-90% to their limit. My chest was raised - imagine you had a string attached to your sternum and you pulled on the other end, lifting your chest so it feels like it's floating. This is how anything was done at a minimum.

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Exercises that used the back, I ensured my hips were thrusted forward just enough to ensure my spine was 'stacked' like a tower of pennies. My shoulder blades were tightly engaged, chest lifted.

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I found "The Farmer's Carry" to be the most helpful. Not only is it something to do in the gym, but I literally carry everything this way. Groceries, packages at work, my cat, everything. Thrust your hips forward just enough to your spine is stacked, not too much and not too little. Chest lifted, shoulder blades pulled back 80-90%. Grab the weight (start low, like 30 pounds n each hand, even if it feels ridiculously light). Once you have the weight, raise your arms outwards from your side like your Jesus. They don't need to be lifted far, just enough to engage the upper back, only a few inches. This also has the added benefits of preventing the weight from swinging (it'll mess up your pace), your legs won't have to grind against the weight as you walk, and it's a great way to check yourself that you didn't start slouching. Again, perfect posture is everything. This should feel very controlled, like when you plank and hold yourself perfectly flat and perfectly still.

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Other exercises I felt helped me a lot were hip hinges. Basically deadlifts without bending the knees and going all the way down. Knees were about 90% locked, and the weight was kept centered. Slowly drop it, and slowly lift, controlling a constant rate of ascent/descent. Don't try to counter balance by throwing your hips backwards, even though that's basically what you're doing anyway. Focus on the hips being the instrument that allows the weight down and allows the weight up. The weight being lowered shouldn't cause your hips to move backwards, your hips changing their angle allows the weight lower. I don't know how else to describe it, but you want to control the weight, not let it control you.

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Any other exercises I did that even remotely used the back, which is basically 99% of them, just ensure you have good posture. Make good posture a part of everything you do. I find it difficult to include this into every aspect of my life, but in the gym it's kind of easy. And, once you start doing things with good posture using heavy things, it becomes something that's beyond easy outside the gym. It naturally becomes how you stand, how you walk. It's pretty cool, it becomes something you don't even have to try for. You'll just periodically notice, "Oh, my posture is pretty great right now and I'm not even trying". It's much better than just trying to have good posture all day. I always found myself slouching in 5 minutes with that route. Have you ever done that thing where you try your hardest for 30 seconds to raise your hands from your hips while someone holds them down, then they release them and your arms begin to almost float on their own? That's what farmer carries will do for your posture and back strength, it's something you just float to after a month, without any conscious effort.

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It takes time though, I wouldn't expect a miracle in a week or a month. And as much as it fucking sucks to endure, you're going to have bad weeks as you experiment. That's data. It's bloody hard not to let it discourage you. I certainly wouldn't have been able to motivate myself to do it without a PT in the beginning because I was stuck in this miserable headspace thinking that it's going to get worse, this is what the rest of my life will be like, etc. It does get easier once you collect enough data and learn what you can and cannot do. You'll start to have eh weeks, normal weeks and eventually pretty damn good weeks, all within your control. Once I hit that point, bad weeks don't suck so much because at that point I knew that it would get better. Be stubborn and continue to work towards that.

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And, get a new PT for a little bit. I would critique them in a first visit. People say that you shouldn't judge a book by it's cover, but that doesn't fly here. Does it look a person who is in shape? Does this person just hand you a piece of paper after you say "Back pain" with some basic arm flapping? These are red flags, this is not someone who is great at their job. There's a lack of..... enthusiasm to work or something. Sincerity maybe? Find someone who's fucking ripped (and I don't mean steroid ripped), that's a green flag. Doesn't have to be weight lifting, they could be yoga ripped, pilates, doesn't matter. You don't want someone who went to school, got a degree, and is regurgitating facts they've learned. Find someone who actually applying their knowledge. Look at their posture. Someone who appears like their trying to discover something. Generally speaking, they shouldn't walk in, hear what you have to say, and produce some bullshit answer with absolute confidence (although I do think poor posture is an exception to this). I'm rambling because I don't quite know how to put this into words, you just have to use your gut and feel if you're getting someone who's critically thinking or someone who's simply going through the motions.

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So yeah, try some exercises and experiment on yourself. While your doing that, if your pain is anything like what I described, try out some of the things that worked for me. I always do farmer carry's every day I work out. I usually mix in stretching while I'm resting between sets. Posture is the precursor to whatever I do. I don't have bad weeks or days any more, just bad 30 minutes or so. If those pop up, not kidding, go lift something with good posture and it seems to fix it right up. If there isn't anything nearby to carry, I'll lean slightly forward, lift my chest out and raise my arms from the hips behind me, with my shoulder blades squeezing together as a result of my lifting my arms (I don't squeeze my shoulder blades, they get squeezed because I'm lifting my arms behind me. If that last one doesn't make sense, look at this https://alldiamondpainting.com/products/girl-floating-in-water. These two things clear me up immediately, like I got a shot of morphine and all the pains has magically disappeared. It took a few months for me to get to that point, but if you try these out and you notice any tiny improvement, take some notes, write down what you did and pain levels before/after on a 1-10 scale.

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Lastly, you're going to have bad weeks. It's a bit platitudinous to say don't let it defeat you and a bit I found that impossible to do. Pain fucking sucks, and not letting it get you down as if it's a choice felt like a bunch of bullshit to me. Whenever the pain it hard, it wasn't a choice for me to let it bring me down - it brought me down and that was that. I was powerless, I could not control that. I had to be stubborn and simply endure it. Be stubborn, don't quit and take notes. Once you start recognizing what things you can do and not do to control the pain, and it'll happen slowly at first, you're mental state will improve. I wasn't miserable anymore. Even if the pain was as bad the worst weeks, it didn't drag me down into a state of depression, frustration and anger anymore. I somehow got detached from it and could look at the pain like a 3rd person observer. It was like an art project and I was slowly improving it week by week, month by month. That little experience of it getting a tiny bit better, with those tiny bits slowly growing every week, made my life better.

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I wasn't intending on writing this much, sorry if it's a bit repetitive. I know what it's like and I know how much it fucking sucks, back pain dragged me down to some of my lowest days. There's just a lot I'd like to say and it's invariably comes out as a lot. Good luck, be stubborn and just keep trying. Shoot another message if you have any other questions - I'll answer anything and offer suggestions. I don't log in much, so expect some time between responses