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Integrative Approaches to Lower Back Pain Management

Lower back pain affects 75% of Americans, according to the American Association of Neurological Surgeons. It results in missed work and billions in healthcare costs every year.

Addressing the symptoms and underlying causes of lower back pain is crucial for effective treatment. An integrative approach to lower back pain management, which combines various modalities, can provide holistic relief and improve patients’ overall well-being. 

Modalities such as chiropractic care, physiotherapy, massage therapy, and lifestyle modifications offer complementary benefits that address both the physical and functional aspects of pain. This blog provides a comprehensive overview of each. Learn how these treatments, when effectively combined, manage and alleviate lower back pain.

Common Causes of Lower Back Pain

Lower back pain is characterized by discomfort between the end of the ribcage and the buttocks. The pain can be so severe that it interferes with a person's daily activities and overall well-being.

young man has muscle injury and a lower back pain during outdoor exercise

Common causes of lower back pain include the following:

  • Sprains & strains
  • Injuries from accidents
  • Fracture
  • Herniated disk
  • Sciatica
  • Lumbar spinal stenosis
  • Lumbar spondylosis
  • Scoliosis

Personalized treatment plans help manage pain effectively. Based on the symptoms and causes, healthcare professionals can determine the best approach for a successful outcome.

Chiropractic Care for Lower Back Pain

Chiropractic care is centered on the principle that proper spine alignment ensures that the nervous system, and therefore the whole body, operates without interference. By restoring alignment through spinal manipulation, chiropractic care alleviates lower back pain, improves mobility, and enhances the body’s natural ability to heal itself.

A 2014 study published in Global Advances in Health and Medicine found that spinal manipulative therapy (SMT) combined with exercise is a promising approach to managing lower back pain. The study reviewed data from four pragmatic trials involving more than 2,600 patients and reported clinically effective results for SMT integrated with exercise.

Common chiropractic techniques used for lower back pain relief include the following:

  • The drop table technique involves using a special table with sections that the chiropractor can drop during an adjustment.
  • The flexion–distraction technique uses a specialized table that gently distracts or stretches the spine.
  • Side posture adjustments involve positioning the patient on their side and applying a quick, precise thrust to correct misalignments in the lumbar spine.


Physiotherapy focuses on the rehabilitation and enhancement of physical function. Physiotherapists combine hands-on techniques and personalized exercise programs to reduce pain, improve mobility, and strengthen the muscles supporting the spine. They also educate patients on proper body mechanics and posture, helping them avoid future episodes of lower back pain.

Incorporating regular physical activity into one's routine is essential for maintaining long-term back health. Regular exercise strengthens the muscles, improves flexibility, and promotes overall well-being. Some targeted exercises that physiotherapists use to reduce lower back pain are the following:

Woman doing some yoga exercise
  • Child's Pose. Begin on your hands and knees, then sit back onto your heels with your arms extended forward and your forehead resting on the ground, gently stretching the lower back and hips. This exercise helps to relieve tension in the lower back and promotes relaxation.
  • Cobra. Lie face down with your hands under your shoulders, then slowly press your upper body upward, extending your spine and lifting your chest off the ground while keeping your hips on the floor. This movement helps to strengthen the lower back muscles and improve spinal flexibility.
  • Bird Dog. On your hands and knees, extend one arm forward and the opposite leg backward, maintaining a straight line from hand to foot. Alternate sides to improve stability and strengthen the core muscles. This exercise enhances balance and strengthens the lower back and abdominal muscles.
  • Bridges: Lie on your back with your knees bent and feet flat on the floor; lift your hips toward the ceiling, squeezing your glute muscles, and hold the position briefly before lowering your hips back down. Bridges help to strengthen the gluteal muscles and lower back, providing better support for the spine.
  • Knee-to-Chest Stretch: While lying on your back, pull one knee toward your chest, holding the position to stretch the lower back muscles, then switch to the other leg. This stretch alleviates tension in the lower back and improves flexibility.

Massage Therapy

Massage is a form of manual therapy. It involves manipulating the soft tissues of the body to alleviate pain and promote relaxation. Massage therapy addresses the muscular component of lower back pain, helping to decrease inflammation, reduce muscle tension, and improve circulation.

Several types of massage therapies are particularly beneficial for managing lower back pain.

  • Myofascial or Trigger-Point Therapy. This technique involves applying gentle, sustained pressure to trigger points in fascial tissues to release tightness, eliminating pain and restoring motion.
  • Swedish Massage. This classic massage technique uses long, gliding strokes and kneading to relax the muscles and improve blood flow.
  • Shiatsu. A Japanese massage technique, shiatsu involves applying pressure to specific points on the body using fingers, thumbs, and palms to alleviate pain and stiffness.

Nutrition and Lifestyle Modifications

Your eating habits significantly impact the strength of your lower back and can either promote or reduce pain. Consequently, poor dietary choices and obesity can contribute to back pain and increase the risk of developing degenerative conditions.

One effective dietary approach for managing lower back pain is adopting an anti-inflammatory diet. This diet focuses on consuming foods that help reduce inflammation in the body, which is often a contributing factor to chronic pain conditions.

Below is a table of micronutrients known for their anti-inflammatory properties, along with examples of foods rich in each.

MicronutrientFood Examples
Vitamin DFatty fish (salmon, mackerel, sardines), eggs
Omega-3 fatty acidsFlaxseeds, chia seeds, walnuts
CurcuminTurmeric root, ginger root
MagnesiumLeafy greens (spinach, kale), nuts and seeds (almonds, pumpkin seeds), whole grains (quinoa, brown rice), legumes (black beans, chickpeas)

In addition to dietary changes, several lifestyle modifications can support lower back health and help alleviate pain.

woman with healthy lifestyle doing a back stretch
  • Regularly engage in low-impact exercises such as walking, swimming, or yoga to improve strength, flexibility, and posture.
  • Practice good posture habits while sitting, standing, and lifting to prevent unnecessary strain on the lower back. Use ergonomic furniture and equipment when possible.
  • Incorporate stress-reducing activities such as meditation, deep breathing exercises, or hobbies into your daily routine. Chronic stress can contribute to muscle tension and exacerbate lower back pain.

Integrating Modalities for Comprehensive Relief

Holistic lower back pain management provides a more comprehensive approach to treatment as each modality targets different aspects of the pain. Chiropractic adjustments focus on spinal alignment, physiotherapy emphasizes muscle strengthening and mobility, massage therapy targets soft tissue tension, and lifestyle modifications address contributing factors such as posture and stress.

That said, a hodge-podge combination of modalities doesn’t make for effective treatment. A personalized treatment plan is key. Each patient's experience with lower back pain is unique, influenced by factors like their medical history, lifestyle, and the specific nature of their pain. Therefore, treatment plans must be tailored to their needs. It ensures that interventions are targeted and effective, maximizing pain relief and improving overall quality of life.


Integrative approaches to lower back pain management can effectively treat your condition, addressing both its symptoms and its underlying causes. Work closely with a team of healthcare professionals to develop a personalized treatment plan that meets your specific needs.

Zaker Chiropractic’s South Bay Pain and Wellness Center has on board a team of experienced healthcare professionals dedicated to providing exceptional back pain treatment in Torrance. Our practitioners bring years of expertise and specialized training in various disciplines. Our patients receive holistic and well-rounded treatment that addresses the diverse aspects of back pain.

Do not settle for a life full of pain. Book an appointment with us today!

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