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Low Back Pain

Almost everyone will experience low back pain sometime in their lives. Around a quarter to a third of the population are experiencing it at any given point in time. It's been noted to place a heavy burden on society due to lost time from work as well as costs associated with treatment for it. Poor emotional well-being, obesity, and smoking are all associated with a higher risk of low back pain. 

Image of low back pain

While research on low back pain has been prolific over the past three decades, there still remains no diagnostic gold standards to determine the causes for most cases. Generally, practitioners agree that the spinal joints, spinal muscles, or spinal discs are usual culprits for pain. Poor trunk muscle coordination or strength is also implicated as a cause of low back pain as it may lead to irritation to any of the former. Your history, the examination, contemporary theories, and the doctor’s clinical experience together provide clues to determine the causation of the pain as well as ruling out more serious causes of low back pain. Contrary to what you may have heard, x-ray imaging is generally unnecessary for management of most cases of low back pain. 

Very frequently, cases of low back pain are not serious and may resolve on its own within a short period of time without requiring a health care professional. However, if you’re reading this, chances are it may have yet to resolve on its own, or perhaps you’ve been dealing with chronic low back pain for a long time and the treatment you’ve been receiving has not adequately addressed the problem. Whatever it may be, if you’re in Kirkland or a neighboring city, Integrity Chiropractic provides exceptional chiropractic and massage treatment to help you get back to living life.

*Before reading on- if you are experiencing low back pain and have abnormal or loss of sensation in your inner thigh, groin, genitalia, and/or have difficulty trying to going to the bathroom, you may have a serious medical emergency. Seek medical help immediately.

Can Chiropractic or Massage Help with Low Back Pain? Here's What the Research Says

For research purposes, low back pain is typically classified as acute (less than 3 months duration) or chronic (more than 3-6 months duration). There is also low back pain associated with leg symptoms (which you may know as sciatica). While this framework is a convenient way to conduct and generalize research, it is important to understand that the presentation and experience of low back pain is very unique to the individual. 

For example, people with acute low back pain are extremely varied in practice compared to research studies. Clinically, we tend to see people with acute low back pain brought on by exercise, strenuous activity, or sudden unguarded/uncoordinated movements. This can present as low to moderate levels of pain, causing difficulties in performing certain movements or difficulty in being comfortable at rest- all the way to severe levels of pain, seizing the individual’s back, inhibiting normal function and mobility. While research patients tend to be like the former, the findings still have good implications for clinical practice. 

Man with low back pain

While the cause of low back pain isn’t always clear, it is often shown to respond well to many types of treatment in research studies. We summarize findings relevant to our scope of practice below.

Current Treatment Research Findings for Acute Low Back Pain

  • Spinal manipulation or chiropractic adjustments has been shown to be effective for reducing pain and improving function

  • Spinal manipulation or chiropractic adjustments has been shown to be better than spinal mobilization in reducing pain

  • Heat has been shown to be helpful in reducing pain

  • Exercise has shown to not be helpful in reducing pain

  • There is currently a lack of published studies for the use of massage therapy for acute low back pain

Current Treatment Research Findings for Chronic Low Back Pain

  • Many popular treatment options are comparable in reducing pain and it is highly unlikely that a single therapeutic approach will be the optimal strategy for most patients

  • Supervised exercise, spinal manipulation, and home exercise were shown to each be effective at reducing pain, and more satisfaction was reported with supervised exercise

  • Spinal manipulation has been shown to be effective alone in reducing pain but tends to perform better when combined with exercise

  • Spinal manipulation with exercise is as effective for pain relief compared to pain medication with exercise

  • Motor control exercises may help with pain for chronic low back pain but are not more effective than general exercise

  • Massage therapy has shown to produce favorable results alone and with exercise therapy

How Does Integrity Chiropractic Treat Acute Low Back Pain?

Often times, the type of acute low back pain we see at the office is brought on during seemingly inconsequential activities such as bending over to pick up a small object to more strenuous activities such as being stooped over for long periods while doing yard work. Whatever the cause, this type of back pain typically has major muscle spasm component that is influencing low back joint mechanics as well as normal motor control. Because the pain can be debilitating, it is not unusual that many patients seek urgent care and are prescribed muscle relaxants before presenting at Integrity Chiropractic.


Your Kirkland chiropractor, Dr. Wen agrees with many of the findings in research but employs a unique comprehensive treatment approach to this type of back pain by addressing the muscular, joint, and motor control aspect of the problem in a single visit in the following steps:

  1. Directly targeting the muscular component of the problem with heat and a significant amount of time (20-40 minutes) utilizing a variety of muscle release techniques that he has learned and developed over years of practice to reduce the muscle spasms

  2. Administering spinal manipulation or a chiropractic adjustment to restore joint mobility and help further relax the muscle spasms

  3. Helping restore low back movement with a series of specific exercises to "reset" the area and regain control and confidence with simple tasks


Because of this, Dr. Wen's patients often find resolution very quickly, typically in 1-3 visits. Some patients who experience this type of acute low back pain may communicate experiencing 1-2 episodes a year, and they may voluntarily elect for additional care as a way to correct the underlying dysfunctions or pre-existing low level chronic back pain that led to the current episode to prevent further episodes of debilitating pain. No matter what goals patients have, Integrity Chiropractic seeks to deliver maximum results to patients without high-pressure long-term commitments.

Spinal manipulation for low back pain

Is Your Back Hurting Now?

Patients can often find themselves with a "thrown out" back. You may be one of those at home right now trying to figure out your next step. To be clear- You should not attempt to adjust your spine yourself, this might not be what you actually need and should always be left to a licensed chiropractor that does a thorough exam, like our Kirkland chiropractor, Dr. Wen. If you find yourself in a bind, he's put together a video on how you may be able to relieve it at home until you can move better to get direct care.

How Does Integrity Chiropractic Treat Chronic Low Back Pain?

Research has also demonstrated that chronic low back pain is complex and multi-factorial. Because of that, many other treatments may help with chronic low back pain, including ones not covered in our article such as acupuncture, behavioral therapy, and yoga.

From the research it is shown that spinal manipulation and exercise are beneficial for chronic low back pain sufferers. Some studies demonstrate each to be individually effective and some in combination, with better results with the latter. Furthermore, spinal manipulation tends to produce good short-term results on pain while exercise produces good long term results.


Like acute low back pain, Dr. Wen uses a comprehensive approach that includes soft tissue work and exercise to help chronic low back pain sufferers because there may be many elements to the pain, but with more heavy emphasis on exercise therapy and physical therapy to improve the flexibility, control, and strength in the back, core, and hips to make movement more efficient and reduce loads and strain to the low back, thus preventing injury. Many exercises can be done independently outside of the office for self-treatment which Dr. Wen encourages to optimize results and create more independent patients.

For patients that find self-treatment more difficult, another approach, which demonstrated favorable results in only one study to date, is to receive regular maintenance with basic spinal manipulation or chiropractic adjustments on a biweekly or monthly basis to keep chronic low back pain in control. However, many of Dr. Wen's patients find significant benefit in him providing ongoing functional maintenance that includes manual and exercise therapy to be able to go longer times between visits making their chronic back pain substantially more manageable and often allowing them to return to some activities or movements they once avoided. For this reason, many patients that continue to suffer from chronic low back pain because of prior work injuries or disc herniations are often able to obtain levels of relief they have not experienced at other chiropractic or physical therapy clinics. This can be another suitable option for patients who are not yet ready to commit to increasing their physical activity level on their own or working with a good personal trainer.


The schedule of care is a decision made between you and Dr. Wen on what is best for your goals and budget.

exercise for low back pain

There are few studies on massage therapy for chronic low back pain, and the high quality ones available have demonstrated massage to be beneficial. One study has shown Swedish, deep tissue, trigger point therapy, and neuromuscular therapy styles of massage given for an hour at a time, once a week for 10 weeks was favored when compared to acupuncture and self-care. When massage was compared to exercise alone, massage showed to be significantly better, and when the two were combined they produced favorable results. Massage also has many an element of stress reduction which help make it popular option as well.


Clearly, there are many favorable pathways that can work to manage and treat chronic low back pain depending on your preferences.

Treatment duration tends to be more variable for chronic low back pain sufferers. Chiropractic or massage treatment generally utilizes visits once to twice a week for an initial period of 4-8 weeks and then tapered down to an infrequent maintenance schedule or ceased depending on the response of the patient.

What to Expect with Massage or Soft Tissue Work for Low Back Pain

We will likely address the erector spinae muscles which consists of 3 muscles that run parallel on each side of the spine, and attach at the lower back and run all the way to the skull. Their primary function is to extend the back, help side bend, and maintain posture. We find that clinically these muscles are flared up due to poor posture, or over-exertion from bending over to pick up items.

We may also address the quadratus lumborum (QL) muscles, which attach from the top of your pelvis, lower spine, and 12th rib. The QL stabilizes the spine and pelvis, as helps to extend and side bend at the waist. Knots or tension in the QL can make performing these actions difficult.

massage for low back pain

One area patients may sometimes not think about is the iliopsoas muscle. The iliopsoas attaches from your lumbar vertebrae and to the front of your hip. Its job is to help you flex your hip and assist in motions such as a sit-up. The iliopsoas is often overactive in today's society due to sitting and may require work as well. When the Psoas muscles are tight or have trigger points they may influence low back mechanics, contributing to low back pain.

The gluteal muscles may also be the source of low back pain as they can develop trigger points that can radiate up to the lower back. The glutes are responsible in maintaining posture, balance, and returning one upright after bending over and can develop these trigger points if they are weak. The glutes attach from the broad part of your pelvis called the ilium and the lower part of the spine known as the sacrum and coccyx. They are also connected to the back extensor muscles through connective tissue called fascia. This is possibly why they can contribute to low back pain.

Lastly, the legs, front and back may be important to work on, as when certain leg muscles are tight they can pull on the pelvis, altering your biomechanics which effects the spine, causing pain in the low back.

It's Time to Take The Next Step For Your Low Back Pain

By now you should have realized that low back pain presentation is unique for every patient as each person will have variations in their skeletal, muscular, and neurological presentation that can affect the type of treatment that you will receive.


This is where a thorough examination and thorough treatment that is personalized for your body can ensure that you get optimal results quickly and are put on a clear path to achievable long-term improvement.


Dr. Frank Wen is your local and expert chiropractor in Kirkland and a past low back pain sufferer himself. We invite you to schedule your First Chiropractic Visit with Dr. Wen today and stop wondering what it's like to live without low back pain and start getting back to living your life again!


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