How We Treat Low Back Pain


Article written by Dr. Payal Patel, PT, DPT


Through my years of practicing as a physical therapist, I have come to realize just how many people perceive their “comes out of nowhere, yet now chronic” low back pain to be normal or acceptable. Sure, if you are active and you live a busy lifestyle, you may succumb to minor aches and pains along the way that tend to relieve themselves overtime. Trust me, I’ve been through this as well. The problem occurs when we cross paths multiple times with the same injury, such as an ankle sprain or tweaking your low back. Every time we injure a body part, there is research that suggests it is harder to bounce back from that injury due to neural and mechanical changes that occur in the body as a result.

 One of the many exercises we will use to re-postion somebodys pelvis and hips

One of the many exercises we will use to re-postion somebodys pelvis and hips


The first time you hurt your back, I’m sure you were able to stretch and massage it till it got better. The second time, maybe you saw a physical therapist just until the immediate pain subsided. Now you’re left trying to figure out why your back still isn’t 100% better. Why it still tightens up on occasion or why you still have to baby it.


Here is my quick at-home checklist for assessing your back health. You may need a partner or a mirror to help you with parts of it.


1.     Can you put your feet together, bend at the waist and touch your toes?

If your hamstrings feel tight in this moment, consider the fact that they are guarding and holding onto your pelvis for dear life because it feels unstable. If your pelvis is unstable, you’ll never have that hamstring flexibility you desire, no matter how much you stretch. 

2.     When you bend forward in that same position, does the curve in your low back bend into flexion or does it stay straight as a board?

Just like any joint in our body, we should have the range and flexibility to move in all directions. We should be able to bend backwards (extension) and exaggerate the curve in our low back just as much as we should be able to bend forward and attain what is known as flexion, or curve reversal.

3.     Are you able to stand at the kitchen or bathroom counter to brush your teeth, comb your hair, wash the dishes, or any other tasks involving this position?

If this is difficult for you and you notice your back uncomfortably tightening up, your low back is most likely having a hard time stabilizing itself. It may be searching to use even the most inefficient of muscles to help at this time. This can result in a sensation of tightness or even pain.


             How We Treat Low Back Pain

At Adapt, our Physical Therapy team follows a five-step process to ensuring your back health is as optimal as possible for what your lifestyle requires. Regardless of which step you are coming in at, the goal is to always clear through step 5. 


1.     Step one ensures clearing any symptoms of Sciatica you may or may not have (pain traveling down the leg). If you don’t have this issue, it’s directly onto step two.

2.     Step two ensures making sure that your nerves are happy and that there is no tension that comes on when they are in stretched positions, such as when you bend forward to touch your toes.

3.     Step three ensures that your low back, pelvis and hips are positioned properly and allow for optimal movement. To be honest, this is where we start with treatment for most people.

4.     Step four ensures that you are able to use that optimal position to generate movement in all directions without restriction or pain.

5.     Lastly, step five ensures that you are able to tolerate added weight/load to your body, let’s say in the form of carrying a backpack, a case of water or even playing D-Line for the NFL, without pain.



At Adapt, our goal for treating low back pain is to clear this five step process, with step five being getting our patients back to the lifestyle they love and want.  Traditional physical therapy tends to discharge patients after step 2 is completed as this is generally where insurance feels is good enough. If you feel you could benefit from Adapt’s more advanced Low Back Program, contact us at by calling us at 609- 218-8200 or email to schedule your free 15 minute consultation today.

You can also schedule your FREE initial evaluation now on our online scheduling page to get started.