Low Back Pain

What's actually going on

Low back pain is the most common reason people come to see me, and also one of the most misunderstood. Most low back pain is not caused by a single dramatic event. It builds over time from how you sit, how you move (or don't move), and how your body compensates for restrictions somewhere else in the chain.

The lumbar spine sits between two major structures that both demand stability and mobility: your thoracic spine above and your pelvis below. When either of those stops doing its job well, your low back picks up the slack. That's usually where the trouble starts.

Common causes

Somatic dysfunction. This is the bread and butter of what I treat. Segments in the lumbar spine or pelvis that aren't moving the way they should. The joints are there, the muscles are there, but the coordination between them has gone off. Your body splints around it, and that protective tension becomes the new problem.

Disc issues. Bulges and herniations get a lot of attention, and sometimes they matter. But here's the thing: a lot of people walking around pain-free have disc bulges on MRI. The disc finding on imaging doesn't always explain what you're feeling. Context matters.

Sacroiliac joint dysfunction. The SI joint is a common source of low back and buttock pain, especially after pregnancy, after a fall, or in people who sit for long periods. It often gets overlooked because imaging doesn't show much, but your body tells the story on exam.

Facet joint irritation. The small joints along the back of the spine can become inflamed or restricted. This tends to cause pain that's worse with extension (leaning back) and better with flexion (bending forward).

Muscle and fascial tension. The thoracolumbar fascia is a massive sheet of connective tissue that connects your low back to your glutes, your lats, and your core. When it gets tight or restricted, it can refer pain over a wide area.

How we approach it

Every low back pain patient starts with OMM. I assess the whole kinetic chain, not just the spot that hurts. That means checking your thoracic spine, your ribs, your pelvis, your hips, and your sacrum. Pain in the low back is often a symptom of something going wrong above or below.

If manual treatment alone isn't enough, we have options. Ultrasound-guided injections can target specific joints or soft tissue. Shockwave therapy works well for chronic myofascial pain. And if there's any concern about nerve involvement, we can do EMG/NCS testing to get a clear picture.

The goal is always the same: figure out what's actually causing the problem, treat it directly, and get you moving again.

When to seek care

You should come in if your back pain has lasted more than a few weeks, if it's affecting your ability to do the things you normally do, or if you notice any numbness, tingling, or weakness in your legs. Don't wait until it's unbearable. The earlier we address it, the easier it is to fix.

What you can do right now

Move. Seriously. Gentle walking is one of the best things for an aching low back. Staying still feels safer, but your body needs motion to heal. Motion is lotion.

Avoid prolonged sitting in one position. If you have a desk job, get up every 30 to 45 minutes, even if it's just for a minute.

Don't panic about imaging findings. An MRI that shows a disc bulge doesn't mean you're broken. It means you have a spine that's been used. We'll help you understand what the findings actually mean for you.