Low Back Pain Treatment Protocol

Understanding Low Back Pain:

A Holistic Approach to Relief and Recovery

Low back pain is one of the most common reasons people seek chiropractic care, and it can significantly impact your daily life. While some cases of low back pain result from traumatic incidents—such as a car accident, a fall, or lifting something heavy with improper form—most cases develop gradually from repetitive habits in daily life. Simple behaviors, like slouching at a computer desk, poor posture while driving, or an unsupportive sleeping position, can create strain on the lower back over time.

At Green Space Health we understand the diverse causes of low back pain, and we take a comprehensive approach to identify, treat, and prevent it. Whether your pain stems from a specific injury or years of accumulated stress, our 3-step protocol is designed to provide relief, restore function, and support long-term wellness.

In this article, we’ll explore:

Our 3 step treatment protocol
The best stretches
The best exercises
When X-rays are necessary

Remember: This blog is meant for educational purposes only, it is not medical advice. The human body is entirely too complicated to self-diagnose. If you are having concerns or want to try a new therapy, meet with a healthcare professional first.

Our 3-Step Treatment Protocol for Low Back Pain

We take a structured and comprehensive approach to treating low back pain. Our 3-step protocol is designed to address the root cause of your pain, promote recovery, and prevent future episodes, ensuring long-term results and an improved quality of life.

Step 1: Identify the Problem and Reduce Pain

The first step in our protocol focuses on accurately diagnosing the root cause of your low back pain and providing immediate relief. To do this, we use a combination of advanced diagnostic tools, including:

Orthopedic tests to assess joint and spinal stability.
Neurological tests to evaluate nerve involvement, such as sciatica or nerve impingement.
Posture analysis to identify imbalances contributing to back strain.
X-rays to visualize structural issues, such as misalignments, degeneration, or fractures.

Once the underlying cause of your pain is identified, we begin treatments on day one. These may include chiropractic adjustments, spinal decompression, soft tissue therapies, and other targeted techniques to reduce pain, inflammation, and muscle tension while promoting healing.

Step 2: Personalized Rehabilitation

After pain relief is achieved, the next step is to restore strength, stability, and mobility to the lower back and surrounding areas. We develop personalized exercise programs and implement targeted therapies to:

Strengthen core muscles that support the spine.
Improve flexibility and balance in the lower back, hips, and pelvis.
Enhance mobility to restore your ability to perform daily activities without pain.

This stage is critical for rebuilding the muscles and connective tissues that support the spine, reducing the risk of reinjury and providing a stable foundation for long-term spinal health.

Step 3: Prevention and Maintenance

Step 3 focuses on prevention and maintenance to ensure lasting results. Many patients choose to schedule periodic checkups and chiropractic adjustments as part of their ongoing care.

These visits help:

Maintain proper spinal alignment.
Address minor imbalances before they escalate into pain.
Support healthy biomechanics, reducing strain on the lower back and surrounding joints.

Routine maintenance care allows us to catch potential issues early and address them proactively, keeping you active and pain-free. At Green Space Health, our holistic approach ensures that you’re not only free from pain but also equipped with the tools and support needed to maintain your spinal health and overall vitality for years to come.

The 3 Best Stretches for Low Back Pain Relief

Stretching is a key component of managing and preventing low back pain. It helps improve flexibility, release tension, and promote better alignment in the muscles and tissues that support the spine. At Green Space Health, we recommend targeted stretches that address common sources of low back discomfort.

Here are three of the most effective stretches for relieving and preventing low back pain.

1. Hamstring Stretch

Tight hamstrings can pull on the knee joint and contribute to discomfort.

To stretch the hamstrings:

Stand with one foot on a bench or chair (hold on to something if you have balance issues)
Reach forward toward the toes of the extended leg, keeping your back straight.
Hold for 20–30 seconds, feeling a gentle stretch along the back of the thigh.

This stretch relieves tension in the hamstrings and promotes better alignment of the pelvis and spine.

2. Standing Iliopsoas Stretch

The iliopsoas (hip flexor) muscles can become tight from prolonged sitting, causing strain on the lower back.

To stretch the iliopsoas:

Stand in a lunge position with one foot forward and the other foot back, forming a 90-degree angle at the front knee.
Shift your weight slightly forward, keeping your chest upright and feeling a stretch in the front of the hip of the back leg.
Hold for 20–30 seconds, then switch sides.

This stretch improves flexibility in the hip flexors, reducing stress on the lower back and enhancing posture.

3. Seated Piriformis Stretch

The piriformis muscle, located deep in the glutes, can cause low back pain when tight, particularly if it compresses the sciatic nerve.

To stretch the piriformis:
Sit on a sturdy chair with your feet flat on the floor.
Cross one ankle over the opposite knee to form a figure-four shape.
Gently press down on the top knee with your hand while leaning slightly forward, keeping your back straight.
Hold for 20–30 seconds, then switch sides.

This stretch releases tension in the piriformis muscle, alleviating pressure on the sciatic nerve and reducing lower back pain.

The Best Exercises for Low Back Pain

Strengthening the muscles that support the spine is essential for managing and preventing low back pain. At Green Space Health, we emphasize exercises that build stability, improve posture, and promote balanced movement. Here are four highly effective exercises for strengthening the lower back and its supporting muscles.

1. Back Extensions

Back extensions target the lower back muscles, improving spinal stability and reducing pain.

Lie face down on the floor with your hands by your sides or under your forehead for support.
Slowly lift your chest off the ground, engaging the muscles in your lower back.
Keep your legs and pelvis on the floor, and avoid arching excessively.
Hold for a few seconds, then lower yourself back down.
Repeat 10–15 times.

This exercise strengthens the erector spinae muscles, which support the spine and improve posture.

2. Glute Bridges

Weak glutes can contribute to low back pain by forcing the lower back to compensate during movements. Glute bridges strengthen the gluteal muscles, improving hip stability and reducing strain on the back.

Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
Press through your heels as you lift your hips toward the ceiling, forming a straight line from your shoulders to your knees.
Squeeze your glutes at the top, then slowly lower back down.
Repeat 10–15 times.

Glute bridges also activate the hamstrings and core, creating a strong foundation for lower back support.

3. Lateral Steps with Resistance Band

Lateral steps strengthen the glutes and hips, improving alignment and reducing stress on the lower back.

Place a resistance band around your thighs, just above your knees.
Stand with your feet hip-width apart, knees slightly bent, and chest upright.
Take a step to the side with one foot, followed by the other, keeping tension in the band.
Continue stepping laterally for 10–15 steps, then reverse direction.

This exercise improves lateral stability and addresses imbalances that can contribute to back pain.

4. Planking

Planks are a core-strengthening exercise that improves spinal stability and reduces pressure on the lower back.

Start in a forearm plank position with your elbows under your shoulders and your body in a straight line from head to heels.
Engage your core, keeping your back flat and hips level.
Hold for 20–30 seconds, gradually increasing the duration as you get stronger.

Planking strengthens the deep core muscles, including the transverse abdominis, which play a crucial role in supporting the spine.

Our Exercise Philosophy

Exercise is a non-negotiable foundation of health. Everyone should be doing some form of exercise regularly. When it comes to strength training for injury recovery or prevention there are two major components we teach our patients.

Quality Over Quantity - its not about how much weight you move, it’s about moving it properly. You would be shocked to find how effective an exercise can be with little to no resistance when done property.

Form Matters, A Lot. - focusing on the individual movements and proper form can improve the brain-body connection. The actual neurons that communicate with your muscles and brain can improve with focused movements. This is essential for your physical health.

Are X-rays Necessary for Low Back Pain?

Determining the cause of low back pain often begins with understanding whether imaging is necessary. X-rays can be a valuable tool for identifying structural issues, but they may not always be required, depending on the nature of the pain and its suspected cause.

What X-rays Can Show

X-rays are excellent for assessing structural aspects of the spine and pelvis, including:

Misalignments: X-rays can reveal spinal misalignments or abnormal curvatures, such as scoliosis, which may contribute to pain and mobility issues.
Bone Degeneration: Conditions like arthritis, disc space narrowing, or vertebral degeneration can be detected with X-rays, helping to explain chronic discomfort.
Fractures: In cases of trauma or acute injury, X-rays are essential for ruling out fractures or other bone-related issues.

While X-rays provide valuable insights into hard tissues like bones, they are less effective for evaluating soft tissue structures.

Soft Tissue Injuries and MRI

Many cases of low back pain involve soft tissues, such as muscles, ligaments, intervertebral discs, or nerves. These are better evaluated with an MRI (Magnetic Resonance Imaging), which offers detailed imaging of soft tissues. MRI is often recommended for conditions such as:

Herniated or bulging discs compressing spinal nerves.
Ligament or muscle injuries causing instability or pain.
Sciatica or other nerve-related pain originating from spinal compression.
Inflammation or fluid buildup in the lower back.

When to Consider Imaging

Not all low back pain requires imaging. Many cases can be diagnosed and treated effectively without it, especially when pain is mild or related to biomechanical imbalances. However, imaging may be necessary if:

The pain is severe, persistent, or worsening.
There is a history of trauma, such as a fall or car accident.
Symptoms include numbness, tingling, weakness, or loss of bladder/bowel control (potential signs of nerve compression).
Conservative treatments fail to provide relief.

Consult a Healthcare Professional First

At Green Space Health, we believe imaging decisions should be made based on a thorough evaluation by a healthcare professional. Through a detailed medical history, physical examination, and diagnostic tools like orthopedic and neurological tests, we determine whether imaging is necessary for your specific condition.

If imaging is recommended, we guide you through the process and clearly explain the results, ensuring you understand your diagnosis and treatment options. Remember, the first step to addressing low back pain is consulting a trusted healthcare provider who can create a personalized plan tailored to your needs.

With years of experience and tens of thousands of treatments delivered, we have refined some of the most effective, non-invasive techniques to address low back issues and achieve lasting results. At Green Space Health, we understand that your health is your greatest asset, and we would be honored to support you on your road to wellness.