Most low back pain isn't random. It's the result of disc pressure, joint dysfunction, or muscular imbalance — often all three compounding each other. Dr. Nave measures first, then builds a care plan with a defined graduation date.
Low back pain from a disc injury is treated differently than low back pain from facet syndrome or muscle imbalance. The exam tells us which one — 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, 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. Produces aching, fatigue-type pain that worsens through the day.
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 (fixated) or hypermobile, it produces one-sided low back and buttock pain just below the PSIS — often mistaken for disc pain. Characteristically 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 who come in for low back pain have seen multiple providers. They've been told to "rest," given a stretch sheet, or had a prescription filled. But the structural source was never properly identified.
The first visit at Quality Life is a 60-minute intake. We're measuring range of motion, running orthopedic and neurological tests, assessing posture and movement patterns, and ordering imaging only when it will change the treatment decision. You leave with a clear picture of what's driving your pain.
See the full patient process →Health history + symptom mapping
When it started, what makes it worse/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 the 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, not a standard protocol.
Specialized table decompression that reduces intradiscal pressure. First-line for disc herniations and radicular symptoms.
High-velocity, low-amplitude adjustment to restore joint mobility and interrupt pain-spasm cycles. Diversified technique for most facet restrictions.
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 during functional movement.
Targeted programming to address the specific muscular imbalances identified in the exam. Based on HMS (Human Movement Specialist) principles — every exercise has a reason.
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.
Low Back Pain Case Study
L4-L5 disc herniation → 12-week phased plan → graduation
Book a 60-minute structural evaluation in Overland Park. You'll leave with a clear picture of what's driving your pain and a written plan to address it.
Quality Life Chiropractic · 7102 College Blvd, Overland Park, KS 66210 · (913) 488-3233