Your low back is a complex system: five lumbar vertebrae, the discs between them, dozens of muscles, multiple ligaments, and the SI joints connecting the spine to the pelvis. Pain can come from any of these, and they often interact — a disc problem causes muscle spasm, the spasm pulls on a joint, the joint dysfunction makes the disc worse. Treatment has to address the whole picture.
Common causes
Mechanical low back pain — joints aren't moving correctly, muscles are tight and weak in the wrong places. The most common cause. Responds well to chiropractic care.
Disc problems — bulges, herniations, or degeneration. Often involve leg pain (sciatica) but not always.
SI joint dysfunction — the joint where your spine meets your pelvis isn't moving right. Pain is usually one-sided and below the belt line.
Facet joint syndrome — the small joints at the back of the spine become inflamed or arthritic. Pain is often worse with extension and rotation.
Muscle strain — overuse or sudden injury to the lumbar musculature. Usually heals in days to weeks.
Stenosis — narrowing of the spinal canal. More common in older patients. Pain often worse with standing, better with sitting.
How Dr. Ngo evaluates low back pain
Comprehensive history first — exactly when the pain started, what triggers it, what relieves it, where it travels. Physical exam includes range of motion testing, palpation, orthopedic tests, neurological screening, and gait analysis.
Most cases can be properly diagnosed without imaging. When imaging is warranted — usually for suspected disc problems, post-trauma evaluation, or red flags — we order it.
We don't treat 'low back pain.' We treat what's actually causing yours.
Treatment approach
Treatment is matched to diagnosis. For mechanical pain, primary tools are chiropractic adjustments to restore joint mobility, soft tissue therapy for muscle spasm, and specific rehab for the deep stabilizers (transverse abdominis, multifidus, glutes).
For disc problems we add spinal decompression and use gentler adjustment techniques. For SI dysfunction we use SI-specific adjustments and address pelvic mechanics. For facet syndrome we focus on extension-control exercises and segmental mobility. For stenosis we emphasize flexion-bias movement and core endurance.
Most acute low back pain improves within 2-4 weeks. Chronic cases take longer. We give you a clear plan with milestones — if you're not improving on schedule, we change the approach.
What you can do at home
Stay moving. Bed rest beyond a day or two prolongs recovery. Walk daily if you can.
Avoid prolonged sitting. If you have a desk job, set a timer to stand every 30-45 minutes.
Sleep on your side with a pillow between your knees, or on your back with a pillow under your knees. Stomach sleeping is bad for low backs.
Don't ignore it. Pain that lasts more than a week or two, or that comes back repeatedly, is telling you something is wrong. Get it figured out.
Frequently asked questions
When should I see a chiropractor for low back pain?
If pain has lasted more than a few days, if it's keeping you from sleeping or working, if it's radiating into your leg, or if you've had recurring episodes. Don't wait for it to become chronic — early treatment is usually faster and more complete.
Will I need an X-ray or MRI?
Only if your symptoms suggest something specific that imaging would reveal. Most low back pain doesn't need imaging. Routine X-rays for every patient is overuse — we order imaging when it will change the treatment plan, not as a default.
How many visits will I need?
Acute uncomplicated cases often resolve in 4-8 visits over 3-4 weeks. Disc-related cases usually require 12-20 visits over 8-12 weeks. Chronic cases vary widely. We'll give you an honest estimate after the first visit and reassess as we go.
Is chiropractic safe for chronic low back pain?
Yes — and research consistently shows it's effective for both acute and chronic low back pain. The bigger risk in chronic cases is doing nothing or relying on long-term medication that masks symptoms without addressing the cause.
Can I keep working out with low back pain?
Depends on what you're doing and what's causing the pain. Some activities are fine; some make things worse. We'll review your typical activities at the first visit and tell you what to modify and what to avoid until you're better.