Treatment Recommendations


  1.  Treatment Recommendations
  2.  Prenatal Treatment Recommendations
  3.  Pressure Point Therapy (Myofascial Release)
  4.  Strengthening Exercises
  5.  What More Can I Do For My Aching Back?
  6.  Low Back Pain:  Halvorson’s Clinical Practice Guideline
  7.  University of Wisconsin-Integrative Medicine-An Integrative Approach to the Treatment of Low Back Pain (2012)

ACUTE CAREIf you have a sudden onset of pain, suspect SWELLING and do the following to decrease inflammation and pain:

  • ICE—apply ice to the painful area for 10-15 minutes (every hour if needed).  Bathing with Epsom salts may also help reduce swelling.
  • EXERCISE—stay active if you can. Mild, gentle range-of-motion exercises help pump out inflammatory fluid.  Early active exercise can also inhibit the formation of scar tissue.  Stop any exercise that causes sharp pain.
  • ANTI-INFLAMMATORY Nutritional Measures—to reduce swelling—try natural anti-inflammatories (fish oils, Turmeric).  Try following the Anti-Inflammatory Diet.
  • SPINAL MANIPULATION—Spinal manipulation restores motion to the joint and the subsequent pumping effect can help reduce swelling and pain.  I have often compared the fixation in the joint to a thorn that is stuck in your foot.  If you try exercising and notice that your pain gets worse, go to the chiropractor to be assessed and treated for spinal joint dysfunction/fixation.  Manipulating the fixed joint is like pulling out the thorn.  Guidelines recommend getting manipulation within 1 month of onset of symptoms.

POST-ACUTE CARE:  Do this even when you don’t have symptoms—it is like “BRUSHING and FLOSSING” your teeth.

  • EXERCISE: Daily—walking, hiking, swimming, bicycling, dancing, yoga—try to get out and move 30-60 minutes every day.
  • STRETCHING: Daily—periodically throughout the day.  Good for the muscles and the joints.
  • PRESSURE POINT THERAPY or MYOFASCIAL RELEASE: Daily—take breaks throughout the day to massage your trouble spots.
  • NUTRITION: Eat foods that decrease inflammation and avoid foods that promote inflammation—Anti-Inflammatory Diet.
  • HEAT: Can be done on a daily basis—it is wonderful therapy for tight, achy muscles.
  • PROPER POSTURE and BODY MECHANICS: for various activities of daily living (ADLs)—including sitting, bending, and lifting.
  • CORE STRENGTHENING: 3-4 times a week.  This is essential because of the inherent weakness of the scar tissue.
  • SPINAL MANIPULATION: Can help prevent exacerbations of pain and keep the spine functioning optimally.

SPINAL MAINTENANCE:  There is no cure for tooth decay. Because of this fact, we have been taught how to take care of our teeth even when we don’t have symptoms.  There are 3 major things that we are supposed to do and they are all equally importantbrush, floss, and go to the dentist.  The brushing and flossing is to be done 2-3 times per day (and order doesn’t matter).  The goal is to never get a toothache.

Likewise, there is no cure for spinal decay.  Our spines are degenerating (or decaying) a little bit every day and no one is brushing and flossing!  I propose that there are 3 major things that we should do (again, all equally important) but in this case, I think that order DOES matter.  Remember, the fixation is like a thorn stuck in your foot.  If you start the exercise program before pulling out the thorns, you may exacerbate your symptoms.  We should start this program when we are young and do it even when we don’t have symptoms.  The goal should be to never get back pain.  The 3 things that I recommend for the health of the spine are:

  1. Go to a chiropractor and get checked and treated for spinal joint dysfunction/fixation.
  2. Do exercises that promote muscular relaxation (walking, stretching and myofascial release with the tennis balls).
  3. Do strengthening exercises to strengthen and stabilize the spine.  Start with the Founder Exercise.

Research has shown that joint manipulation done on a regular basis and in the absence of symptoms helps maintain the health and function of the spine (Senna Study on Maintenance).  Enhancing joint motion may also inhibit the progression of degeneration in the joint.