If your lower back, mid-back, or upper back pain keeps coming back, temporary relief isn't the answer — identifying the source is. Disc pressure, joint dysfunction, muscle imbalance, postural loading. Dr. Nave finds the structural driver and builds a care plan with a defined graduation date.
Low back pain from a disc herniation is treated differently than pain from facet syndrome, SI joint dysfunction, or muscle imbalance. The exam tells us which — and that determines everything about the plan.
The annulus fibrosus weakens from repetitive loading or injury — the nucleus herniates outward and compresses the adjacent nerve root. Produces one-sided low back pain that may radiate into the leg. Worse with sitting, forward bending, and coughing.
Exam signs
Primary
Flexion Distraction Therapy
Pumping traction reduces intradiscal pressure and encourages the nucleus to retract away from the nerve root.
Support
McKenzie Method + Neural Flossing
Extension-biased exercise to centralize pain. Nerve mobilization to restore sciatic nerve glide.
Phase 3
Core Stabilization
Dead bug, bird dog, and pallof press progressions to protect the disc from re-injury under daily loads.
Facet joints guide movement at each spinal level. When inflamed or fixated, they produce sharp, localized pain — classically worse with extension (standing, leaning back) and relieved by flexion (sitting, bending forward). Pain typically stays local without traveling down the leg.
Exam signs
Primary
Spinal Manipulation / Mobilization
HVLA adjustment or graded mobilization to restore joint glide and interrupt the pain-spasm cycle. Activator used for patients who prefer no "cracking."
Soft Tissue
IASTM + Trigger Point Release
FAKTR protocol targets the multifidus and erector spinae guarding that develops around inflamed facet joints.
Prolonged sitting shortens the hip flexors and weakens the gluteus maximus — creating an anterior pelvic tilt that compresses the lumbar facets and increases disc pressure at L4-L5 and L5-S1. The low back absorbs forces the glutes were designed to handle.
Exam signs
Phase 1
Inhibit + Lengthen
Soft tissue work and stretching for tight hip flexors and lumbar extensors before loading.
Phase 2
Activate + Strengthen
Glute bridge progressions and hip hinge motor patterning to restore load transfer through the posterior chain.
Phase 3
Integrate into Movement
Deadlift pattern, single-leg work, and ergonomic coaching to make the correction durable in daily life.
The sacroiliac joint transfers load between the spine and lower extremities. When hypomobile or hypermobile, it produces one-sided low back and buttock pain just below the PSIS — often mistaken for disc pain. Worsens going up stairs, rolling over in bed, or with unilateral loading like running.
Exam signs
Primary
SI Joint Manipulation + Drop Table
Specific pelvic adjustment to restore sacroiliac mobility. For hypermobile joints, treatment focuses on stability rather than manipulation.
Stabilization
Gluteal + Pelvic Coordination
The SI joint is stabilized by force closure from the glutes, piriformis, and biceps femoris. We train these muscles to provide stability that ligaments alone can't.
Most patients with upper back pain have never had the thoracic spine properly examined. It's a region that gets overlooked — but it's directly involved in shoulder mechanics, cervicogenic headaches, and the long-term health of the lower spine.
The most common driver of upper back pain in desk workers. Tight pec minor and upper traps paired with weak deep neck flexors and rhomboids creates a pattern of thoracic hypomobility, rounded shoulders, and persistent upper back fatigue. The thoracic spine stops moving — the joints above and below it pay the price.
Approach
T-spine manipulation, pec minor / upper trap release, and progressive rhomboid/mid-trap activation. The goal is restoring movement where it's been absent — not just treating where it hurts.
Ribs articulate with the thoracic vertebrae at costovertebral joints. When these joints fixate — from trauma, poor posture, or prolonged static loading — they produce sharp, catch-like pain with deep breathing, rotation, or reaching. Often mistaken for pleurisy or referred cardiac pain. It responds very well to targeted mobilization.
Approach
Costovertebral joint manipulation with drop table or diversified technique. Often resolves significantly within 2–4 visits once the joint is moving correctly.
Less common than lumbar disc herniation — the rib cage provides protection — but thoracic disc pathology does occur, particularly in adults with osteoporosis, prior thoracic trauma, or significant degenerative history. It presents as mid-back pain that may radiate around the rib cage or into the chest wall. Red flag screening is a core part of the initial evaluation.
Approach
Conservative mobilization and postural retraining where appropriate. Cases with neurological findings or suspected cord compression are referred for imaging and specialist evaluation.
Disc herniations — whether in the lumbar or thoracic spine — have a structural mechanism. The nucleus pulposus has migrated through the annular fibers and is now compressing adjacent tissue. Rest reduces acute inflammation, but it doesn't address the mechanics that caused the herniation or the deconditioning that follows it.
The evidence-supported approach involves reducing intradiscal pressure through flexion-distraction or decompression, centralizing symptoms with directional preference exercise (McKenzie), and then progressing through a stabilization phase that protects the disc long-term. That's the plan we build from the exam.
If disc pain is radiating down the leg, see our sciatica page →Reduce pressure on the disc
Flexion distraction, decompression positioning, and activity modification to reduce load on the compromised segment.
Centralize symptoms
McKenzie-based directional preference exercise to move pain from the extremity back toward the spine — a reliable indicator of disc recovery.
Build stability around the segment
Progressive core and posterior chain work to protect the disc from re-injury under the loads of daily life.
Most patients who come in for back pain have seen multiple providers. They've been told to "rest," handed a stretch sheet, or had a prescription filled. But the structural source was never properly identified — so the treatment wasn't targeted at anything specific.
The first visit at Quality Life Chiropractic is a 60-minute intake. We measure range of motion, run orthopedic and neurological tests, assess posture and movement patterns, and order imaging only when it will actually change the treatment decision. You leave the first visit with a clear picture of what's driving your pain.
On Day 2, you come back for a 45-minute report of findings. That's when we walk through the diagnosis, the written care plan with visit frequency and phase benchmarks, and a realistic graduation target. No guessing. No open-ended treatment.
Health history + symptom mapping
When it started, what makes it worse or better, prior care, imaging history. We want the full picture — not just the chief complaint.
Orthopedic + neurological exam
Straight leg raise, Kemp's test, FABER/FADIR, deep tendon reflexes, myotomal strength testing. These differentiate disc from facet from SI from referral patterns.
Functional movement + posture assessment
How you move matters as much as what hurts. We assess movement patterns that are loading your spine incorrectly — this is what makes the plan specific to you.
Imaging — only when it changes the plan
We don't order X-rays reflexively. If exam findings suggest structural instability, significant disc pathology, or red flags, we'll coordinate imaging. Otherwise, we start with care and re-evaluate.
Day 2: full report + phased care plan
You come back for a 45-minute report of findings. We walk through what we found, what it means, and a written plan with expected phases, visit frequency, and a graduation target.
Not every technique is right for every patient. The plan is built from the exam findings, not a standard protocol.
Specialized table decompression that reduces intradiscal pressure. First-line for lumbar disc herniations and radicular symptoms. Also used for thoracic disc pathology at appropriate segments.
High-velocity, low-amplitude adjustment to restore joint mobility and interrupt pain-spasm cycles — applied to lumbar, thoracic, and cervicothoracic junction as indicated by the exam.
Instrument-assisted low-force adjustment. Same outcome as manual manipulation without the rotation — preferred for acute disc presentations and patients who want no "cracking."
Instrument-assisted soft tissue mobilization using the FAKTR protocol. Breaks down scar tissue and fascial restrictions in the paraspinal muscles and thoracic fascia during functional movement.
Targeted programming to address the specific muscular imbalances identified in the exam. Based on HMS principles — every exercise has a reason tied to the exam findings.
Directional preference assessment and extension-biased exercise for disc-related pain. One of the most evidence-supported approaches for centralizing and resolving radicular symptoms.
An anonymized case study showing the full arc — evaluation findings, phased plan, and measurable outcomes over 12 weeks of structured back pain care.
Low Back Pain Case Study
L4-L5 disc herniation → 12-week phased plan → graduation
Back pain is often part of a bigger pattern. Many patients dealing with back pain also present with sciatica, neck tension, or postural dysfunction that spans the full spine. If you're dealing with more than one issue, explore sciatica treatment in Overland Park, learn about the conditions and approach at our Overland Park chiropractic clinic, or see the full list of conditions we treat at QLC.
Your Provider
Dr. Nave is a Doctor of Chiropractic practicing in Overland Park, KS. He focuses on identifying the structural source of pain and building evidence-informed, time-bound care plans — not open-ended adjustments.
View Dr. Nave's background →If you're dealing with back pain and want a clear plan, the next step is a proper evaluation. At Quality Life Chiropractic in Overland Park, we identify the root issue — lower back, upper back, or disc — and build a structured plan to fix it.
Quality Life Chiropractic · 7102 College Blvd, Overland Park, KS 66210 · (913) 488-3233