<>Exercise is good for low back pain -- but not all exercises are beneficial. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, patients should stop exercising and contact a doctor. Some exercises may aggravate pain. Standing toe touches, for example, put greater stress on the disks and ligaments in your spine. They can also overstretch lower back muscles and hamstrings.
<>There are numerous reasons why you may be saddled with lower back pain, says Melanie Strassberg, PT, DPT, clinical director of Professional Physical Therapy in New Rochelle, New York: Muscle strains and spasms, a herniated disc, degenerative disc disease, spinal stenosis, and osteoarthritis are just a handful. Given the wide range of causes, your doctor will need to uncover the source during a medical examination before you can find the best lower back pain relief. These are 10 other common reasons your back is hurting.
<>Another great exercise for mobilizing the lower back is the bridge, as shown in the image below. To carry out this exercise lie on your back with knees bent and your feet placed hip distance apart on the floor. Take a deep breath in and as you breathe out lift your hips off the floor until shoulders hips and knees are in a straight line. As you breathe in lower your hips to the floor. Repeat eight to twelve times.
<>An ancient mind-body practice, meditation has been found to increase pain tolerance and promote management of chronic pain in a number of small studies. In addition, a number of preliminary studies have focused specifically on the use of meditation in the management of low back pain. A 2008 study published in Pain, for example, found that an eight-week meditation program led to an improvement of pain acceptance and physical function in patients with chronic low back pain. The study included 37 older adults, with members meditating an average of 4.3 days a week for an average of 31.6 minutes a day.
<>A doctor may recommend a spinal injection to help reduce your back pain. There are different types of injections that doctors specializing in pain relief may use. For example, an injection of a corticosteroid can help relieve inflammation that is causing the pain. Depending on the kind of injection, your doctor may limit your number of doses per year to avoid possible side effects.
<>How old is your bed? You may be surprised to learn that the average life span of a mattress is less than 10 years. "There's no hard-and-fast rule," says Sean Mackey, chief of the division of pain medicine at Stanford University, "but if your mattress is sagging significantly or is more than 6 to 8 years old, I'd think about getting a new one. Something else to consider: a firm mattress may not do your back any favors, says Carmen R. Green, a physician at the University of Michigan Back & Pain Center. A number of studies over the years suggest that people with lower back pain who sleep on medium-firm mattresses do better than those with firm beds.
<>High-quality evidence shows that individual patient education of greater than two hours is more effective than no education or less-intense education for pain that persists for four weeks or more.23 Moderate-quality evidence shows that less-intense individual education and advice to stay active have small benefits and are at least as effective as other back pain interventions.23,24 It is unclear whether patient education and advice for patients with acute low back pain are cost-effective.25
<>Evidence from the small number of placebo-controlled trials does not support the use of transcutaneous electrical nerve stimulation in the routine management of chronic low back pain.36 Evidence from single lower quality trials is insufficient to accurately judge efficacy of transcutaneous electrical nerve stimulation versus other interventions for chronic low back pain or acute low back pain.10
<>Prolotherapy has been used to treat back pain for more than 50 years, according to a report by the Cochrane Database of Systematic Reviews. (6) Prolotherapy, including the specific type called PRP or dextrose/glucose prolotherapy treatments, use platelet-rich plasma and sometimes stem cells taken from your own body that contain growth factors that help heal damaged tissues.
<>Hyperlordosis (lordotic low back pain) is the second most common cause of adolescent low back pain.18,47 This condition is related to adolescent growth spurts when the axial skeleton grows faster than the surrounding soft tissue, resulting in muscular pain.55 Other causes of low back pain unique to children are vertebral endplate fractures and bacterial infection of the vertebral disk. Adolescents have weaker cartilage in the endplate of the outer annulus fibrosis, allowing avulsion and resulting in symptoms similar to a herniated vertebral disk.58 Additionally, the pediatric lumbar spine has blood vessels that traverse the vertebral bodies and supply the vertebral disk, increasing the chance of developing diskitis.51
<>Your doctor will first ask you many questions regarding the onset of the pain. (Were you lifting a heavy object and felt an immediate pain? Did the pain come on gradually?) He or she will want to know what makes the pain better or worse. The doctor will ask you questions referring to the red flag symptoms. He or she will ask if you have had the pain before. Your doctor will ask about recent illnesses and associated symptoms such as coughs, fevers, urinary difficulties, or stomach illnesses. In females, the doctor will want to know about vaginal bleeding, cramping, or discharge. Pain from the pelvis, in these cases, is frequently felt in the back.
<>A large Cochrane review of 65 trials (11 237 patients) of nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors in the treatment of acute and chronic low back pain showed that NSAIDs had statistically better effects compared with placebo.51 The benefits included global improvement and less additional analgesia requirement. NSAIDs were associated with higher rate of side effects. There was no strong evidence that any one NSAID or COX-2-selective NSAID is clinically superior to the others. NSAIDs were not superior to acetaminophen, but NSAIDs had more side effects. NSAIDs were not more effective that physiotherapy or spinal manipulation for acute low back pain. COX-2-selective NSAIDs had fewer side effects than nonselective NSAIDs.51
<>For example, ginger is a natural anti-inflammatory agent. It may help reduce inflammation associated with back pain, especially helpful after strenuous activities. Consider simmering fresh ginger root slices in hot water for about 30 minutes to prepare a spicy but soothing cup of tea. Capsaicin has also shown some promise for reducing pain. It’s the active ingredient in chili peppers. You can find it in both topical cream and oral supplement forms.
<>One of the most common reasons people develop low back pain is posture. Postural problems, including spinal abnormalities, along with muscular compensations or inactivity put added pressure on the back. Although people of all ages experience low back pain — including both athletes and those who are sedentary — middle-aged to older adults (especially when they’re overweight) are most likely to develop severe symptoms and therefore can benefit from lower back pain relief treatments like chiropractic care, soft tissue therapy and regular exercise.
<>2010 — Upgraded: Section now includes discussion of that bizarre and already infamous paper in the New England Journal of Medicine (see Berman). I also make an important new point: exactly why acupuncture placebos are such a problem for low back pain patients in particular. [Section: The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.]
<>Use this movement to stretch the paraspinal muscles and strengthen the abdominal muscles. Lie on your back with your legs extended straight out. Bend the right knee up and cross it over the left side of your body. Hold in a position that allows you to feel a gentle stretch through the back and buttocks muscles for 20 seconds. Tighten your core muscles and rotate back to center. Repeat three times on each side.
<>Testimonials on health care websites reek of quackery, so publishing them has always made me a bit queasy. But my testimonials are mostly about the quality of the information I’m selling, and I hope that makes all the difference. So here’s some highlights from the kind words I’ve received over the years … plus some of the common criticisms I receive, at the end. These are all genuine testimonials, mostly received by email. In many cases I withold or change names and identifying details.
<>When you have chronic pain, it’s important to accept your limitations and adapt. “Listen to your body and learn to pace yourself,” suggests Nava. Take a break when mowing the lawn, or make several trips when carrying groceries. Take note of the activities that worsen your pain and avoid them if possible. Not only could this help your back feel better, it could also prevent the underlying condition from advancing. 
<>An accurate history and physical examination are essential for evaluating acute low back pain. Often, patients awaken with morning pain or develop pain after minor forward bending, twisting, or lifting. It is also important to note whether it is a first episode or a recurrent episode. Recurrent episodes usually are more painful with increased symptoms. Red flags are often used to distinguish a common, benign episode from a more significant problem that requires urgent workup and treatment (Table 2).5,6,8 A recent study shows that some red flags are more important than others, and that red flags overall are poor at ruling in more serious causes of low back pain.8 Patients with back pain in the primary care setting (80 percent) tend to have one or more red flags, but rarely have a serious condition.8  However, physicians should be aware of the signs and symptoms of cauda equina syndrome, major intra-abdominal pathology, infections, malignancy, and fractures (Tables 15,6  and 25,6,8). Cauda equina syndrome and infections require immediate referral. Family physicians should rely on a comprehensive clinical approach rather than solely on a checklist of red flags.
<>Conventional treatments such as NSAIDs, heat and ice, and stretching will be enough for most people—but not everyone. “If you’ve exhausted various conservative treatment options and have been in chronic pain for several months, you may be a candidate for minimally invasive spine surgery,” says Koser. There’s no reason to suffer—and you may not have to consider traditional open spine surgery at all. Minimally invasive procedures use an incision of less than one inch and require little downtime. “The muscles are spared during the procedure and are gently spaced apart, rather than being cut or torn away during traditional open spine surgery,” Koser says.
<>Paget's disease can be diagnosed on plain X-rays. However, a bone biopsy is occasionally necessary to ensure the accuracy of the diagnosis. Bone scanning is helpful to determine the extent of the disease, which can involve more than one bone area. A blood test, alkaline phosphatase, is useful for diagnosis andmonitoring response to therapy. Treatment options include aspirin, other anti-inflammatory medicines, pain medications, and medications that slow therate of bone turnover, such as calcitonin (Calcimar, Miacalcin), etidronate (Didronel), alendronate (Fosamax), risedronate (Actonel), and pamidronate (Aredia).
<>Plain X-rays are generally not considered useful in the evaluation of acute back pain, particularly in the first 30 days. In the absence of red flags, their use is discouraged. Their use is indicated if there is significant trauma, mild trauma in those older than 50 years of age, people with osteoporosis, and those with prolonged steroid use. Do not expect an X-ray to be taken.
<>Can inversion therapy help with back pain? Inversion therapy, where a person is held upside down for several minutes, is an alternative therapy for back pain. They may use gravity boots or an inversion table or chair to reduce the pressure on their spine. Evidence for the effectiveness of this technique is mixed. Learn more about the benefits and risks here. Read now
<>"Lower back pain is the most common musculoskeletal ailment in the U.S., and can often be mitigated by strengthening the core musculature," Blake Dircksen, D.P.T., C.S.C.S., a physical therapist at Bespoke Treatments New York, tells SELF. "The 'core' is a cylinder of abdominal and back muscles that wraps around the body like a corset," Dircksen explains. (The glutes are also considered a part of the core, since they connect to the pelvis and ultimately the back and abdominal muscles.) As with any muscles, by strengthening them, you will increase the amount of weight your lower back can comfortably move, which means it will be better equipped to handle the same stress from your workouts and everyday life without getting as achey.
<>Bed Rest. Bed rest should not be recommended for patients with nonspecific acute low back pain. Moderate-quality evidence suggests that bed rest is less effective at reducing pain and improving function at three to 12 weeks than advice to stay active.46 Prolonged bed rest can also cause adverse effects such as joint stiffness, muscle wasting, loss of bone mineral density, pressure ulcers, and venous thromboembolism.37
<>Even as you practice patience, a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) can help ease the pain you're pushing through. The research behind medicine guidelines for lower back pain finds that these may give slightly better relief than acetaminophen (Tylenol). Over long periods, NSAIDs can cause gastrointestinal problems, so don't take them for more than 10 days without consulting your doctor.
<>Steroids: Oral steroids can be of benefit in treating acute sciatica. Steroid injections into the epidural space have not been found to decrease duration of symptoms or improve function and are not currently recommended for the treatment of acute back pain without sciatica. Benefit in chronic pain with sciatica remains controversial. Injections into the posterior joint spaces, the facets, may be beneficial for people with pain associated with sciatica. Trigger point injections have not been proven helpful in acute back pain. Trigger point injections with a steroid and a local anesthetic may be helpful in chronic back pain. Their use remains controversial.
<>Testimonials on health care websites reek of quackery, so publishing them has always made me a bit queasy. But my testimonials are mostly about the quality of the information I’m selling, and I hope that makes all the difference. So here’s some highlights from the kind words I’ve received over the years … plus some of the common criticisms I receive, at the end. These are all genuine testimonials, mostly received by email. In many cases I withold or change names and identifying details.
<>Sometimes, however, the conditions that cause acute back pain can lead to more chronic and serious problems. Clues to a different and more serious cause include: persistent pain, pain and numbness that radiate down both the legs, bothersome pain at night plus fever, weight loss and swelling of the joints. If you experience any of these, it's important you consult a doctor who can examine you carefully, X-ray your back and perform some lab tests. Possible causes of pain in these cases could include ankylosing spondylitis or an infection or tumor of the spine.
<>You probably don't know it, but you and Paula Abdul have more in common than you think! You are both part of the 65 million Americans affected by back pain. The good news is 95 percent of cases involving back pain do not require surgical treatment. As we age, lower back pain becomes increasingly more and more common. Not to mention, muscle elasticity and bone strength decrease over time, leaving your back vulnerable to strain and injury.
<>While a PT can guide you through exercises to strengthen lower back muscles, you can take matters into your own hands by regularly stretching at home. For lower back pain relief, Strassberg says, a PT may recommend a few moves: hamstring stretch, piriformis stretch, and lower trunk rotation. Pelvic tilts and “clams” are other good targeted exercises. No luck? These are the surprising reasons your lower back pain treatment isn’t working.
<>Aquatic therapy: Aquatic therapy and exercise can also improve flexibility and decrease pain for some people with chronic low back problems. It is especially beneficial for those patients who cannot tolerate land-based physical therapy.This is because the unique properties of water often make it a safe environment for exercising a sore back, providing gentle resistance, comfort, and relaxation. Fear of pain associated with movement is a major limiting factor for rehabilitation and exercises therapy. The support and warmth of the water enables a person to gradually introduce daily exercise into their treatment.
<>Opioids are commonly prescribed for patients with severe acute low back pain; however, there is little evidence of benefit. Three studies showed no difference in pain relief or time to return to work between oral opioids and NSAIDs or acetaminophen, and there is risk of harmful dose escalation over time with opioids, especially with purer formulations.16,21 Although epidural steroid injections are not beneficial for isolated acute low back pain, they may be helpful for radicular pain that does not respond to two to six weeks of noninvasive treatment. Transforaminal injections appear to have more favorable short- and long-term benefit than traditional interlaminar injections.22
<>Another way to cure back pain fast at home is to use muscle creams and patches. You may have seen these advertised as the sticky patches that extend across your back, and they are effective to a degree. Many different companies make these types of products, but the two most popular are Ben Gay and Icy Hot. The medication in the patch or cream works to “confuse” the nerve endings in your back muscles. By making them feel hot or cold, they are distracted from the pain of the muscle tissue. In addition, the heat from these patches goes a long way toward soothing the muscles that have been strained or sprained. Large patches are probably the most convenient back pain home remedy of this type, but the cream may work better if your muscles are strained higher up on the back, to the side, or over a large area. Here are some exercises that can help make back pain better.
<>Three small higher quality trials found that systemic corticosteroids were not clinically beneficial compared with placebo when given parenterally or as a short oral taper for acute or chronic sciatica.21,28,49 With acute low back pain and a negative straight-leg raise test, no difference in pain relief through 1 month was found between a single intramuscular injection of methylprednisolone (160 mg) or placebo.23 Glucocorticosteroids are banned by the World Anti-doping Association.70
<>Free second tutorial! When you buy this tutorial, you will also get Save Yourself from Trigger Points and Myofascial Pain Syndrome! — a $1995 value. The low back pain tutorial makes the case that trigger points are a major factor in low back pain. However, trigger point therapy is not an easy skill to master — and it’s an enormous subject. PainScience.com publishes a separate tutorial about trigger point therapy. It’s offered as a free, essential companion to the low back pain tutorial. As a pair, they give you everything you need to know about helping most cases of low back pain.
<>Home care is recommended for the initial treatment of low back pain. Bed rest remains of unproven value, and most experts recommend no more than two days of bed rest or decreased activity. Some people with sciatica may benefit from two to fours days of rest. Application of local ice and heat provide relief for some people and should be tried. Acetaminophen and ibuprofen are useful for controlling pain.
<>About footnotes. There are 465 footnotes in this document. Click to make them pop up without losing your place. There are two types: more interesting extra content,1Footnotes with more interesting and/or fun extra content are bold and blue, while dry footnotes (citations and such) are lightweight and gray. Type ESC to close footnotes, or re-click the number.
<>Veritas Health publishes original and accessible health related content written by more than 100 physician authors and peer-reviewed by a 16 member Medical Advisory Board. The Veritas Health platform comprising of Spine-health.com, Arthritis-health.com, Sports-health.com, and Pain-health.com, provides comprehensive information on back pain, arthritis, sports injuries, and chronic pain conditions. For more information visit Veritashealth.com.
<>CBT: If you consult a psychotherapist for cognitive behavioral therapy (CBT), your treatment may include stress management, behavioral adaptation, education, and relaxation techniques. CBT can lessen the intensity of back pain, change perceptions about levels of pain and disability, and even lift depression. The NIH considers CBT useful for relieving low back pain, citing studies that show CBT to be superior to routine care and placebo.
<>There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of pain helps determine the cause.
<>Spinal disc degeneration coupled with disease in joints of the low back can lead to spinal-canal narrowing (spinal stenosis). These changes in the disc and the joints produce symptoms and can be seen on an X-ray. A person with spinal stenosis may have pain radiating down both lower extremities while standing for a long time or walking even short distances.
<>No, the lower back pain isn't in your head. But what is in your head could be making it worse. "Fear, anxiety, and catastrophizing can amplify pain," says Mackey. "People often get swept up in thoughts like This will never get better." Because brain circuits that process pain overlap dramatically with circuits involved with emotions, panic can translate into actual pain. Cognitive-behavioral therapy helps you recognize and reframe negative thoughts. Deep breathing can help, too, as can simply shining a light on dark thoughts. "Start by accepting that you have pain," Mackey says. "Then say to yourself, It will get better."
<>Pain from spine structures, such as musculature, ligaments, facet joints, and disks, can refer to the thigh region, but rarely to areas below the knee. Pain related to the sacroiliac joint often refers to the thigh, but can also radiate below the knee. Irritation, impingement, or compression of the lumbar root often results in more leg pain than back pain. Pain from the L1-L3 nerve roots will radiate to the hip and/or thigh, whereas pain from the L4-S1 nerve roots will radiate below the knee.
<>Spinal disc degeneration coupled with disease in joints of the low back can lead to spinal-canal narrowing (spinal stenosis). These changes in the disc and the joints produce symptoms and can be seen on an X-ray. A person with spinal stenosis may have pain radiating down both lower extremities while standing for a long time or walking even short distances.
<>Chill it. Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation, says E. Anne Reicherter, PhD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. "Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes," she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice -- take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.
<>Model Zach Job is a New-York based artist and producer who is also an up-and-coming drag queen known as "Glow Job." Zach has aspirations to join a circus and thus has some training in gymnastics, silks/wall running, parkour, boxing, dance, and acro-yoga. He also swings kettlebells at New York's Mark Fisher Fitness, climbs rocks at Brooklyn Boulders, bicycles 10-20 miles every day, and plays competitive dodgeball.
<>Over-the-counter pain medications. The most common over-the-counter (OTC) medications are aspirin (e.g. Bayer), ibuprofen (e.g. Advil), naproxen (e.g. Aleve), and acetaminophen (e.g. Tylenol). Aspirin, ibuprofen, and naproxen are anti-inflammatory medicines, which alleviate low back pain caused by a swollen nerves or muscles. Acetaminophen works by interfering with pain signals sent to the brain.
<>Heat/ice therapy. Heat from a warm bath, hot water bottle, electric heating pad, or chemical or adhesive heat wraps can relax tense muscles and improve blood flow. Increased blood flow brings nutrients and oxygen that muscles need to heal and stay healthy. If the low back is painful due to inflammation, ice or cold packs can be used to reduce swelling. It’s important to protect the skin while applying heat and ice to prevent tissue damage.
<>Medication: If back pain keeps you from normal daily activities, your doctor can help by recommending or prescribing pain medications. Over-the-counter painkillers such as Tylenol, aspirin, or NSAIDs -- such as ketoprofen, ibuprofen (Advil, Motrin), and naproxen (Aleve) -- can be helpful. For severe pain, your doctor may prescribe prescription strength anti-inflammatories/pain medicines or may prefer to prescribe a short-term combination of opioid (narcotic) and acetaminophen medications such as Vicodin or Percocet. Some doctors also prescribe muscle relaxants. But beware, some of these medications have a direct effect on the brain and often cause drowsiness.
<>2011 — Major update: Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really been cleaned up in general, making it significantly easier for me to update the tutorial — which will translate into more good content for readers. Care for more detail? Really? Here’s the full announcement.
<>Doctors lack the skills and knowledge needed to care for most common aches, pains, and injury problems, especially the chronic cases, and even the best are poor substitutes for physical therapists. This has been proven in a number of studies, like Stockard et al, who found that 82% of medical graduates “failed to demonstrate basic competency in musculoskeletal medicine.” It’s just not their thing, and people with joint or meaty body pain should take their family doctor’s advice with a grain of salt. See The Medical Blind Spot for Aches, Pains & Injuries: Most physicians are unqualified to care for many common pain and injury problems, especially the more stubborn and tricky ones.
<>For instance, there’s good evidence that educational tutorials are actually effective medicine for pain.?Dear BF, Gandy M, Karin E, et al. The Pain Course: A Randomised Controlled Trial Examining an Internet-Delivered Pain Management Program when Provided with Different Levels of Clinician Support. Pain. 2015 May. PubMed #26039902. Researchers tested a series of web-based pain management tutorials on a group of adults with chronic pain. They all experienced reductions in disability, anxiety, and average pain levels at the end of the eight week experiment as well as three months down the line. “While face-to-face pain management programs are important, many adults with chronic pain can benefit from programs delivered via the internet, and many of them do not need a lot of contact with a clinician in order to benefit.” Good information is good medicine!
<>Exercise is the foundation of chronic back pain treatment. It’s one of the first treatments you should try under the guidance of your physician and spine physical therapist. However, the same set of exercises doesn’t work for everyone, says Nava. The exercises have to be tailored to your specific symptoms and condition. Maintaining the exercise routine at home is also a big part of success.
<>Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back (lumbar radiculopathy) causes pain that goes down the leg. Epidural injections are also used to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy, which causes pain.
<>AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
<>As part of your exercise routine, you may want to consider doing yoga regularly for lower back pain relief. One study of over 960 people with low back pain found that those who completed a 12-week yoga program experienced greater improvements in back function and reduced pain compared to controls who did not participate. (4) There’s even evidence that mindfulness meditation, often practiced in some form with yoga, can also help people deal with chronic back pain more effectively. (5)
<>Stretching. Almost everyone can benefit from stretching muscles in the low back, buttocks, hips, and legs (especially the hamstring muscles). These muscles support the weight of the upper body. The more mobile these muscles are the more the back can move without injury. It is typically advised to start small—stretch for 20 to 30 seconds and stop a stretch if it causes pain.
<>Transcutaneous electrical nerve stimulator (TENS) machines are small, battery-powered devices that transmit low-voltage electrical currents through electrodes that are attached to your skin. Considered very safe, TENS machines, according to one theory, work by scrambling the message of pain to the brain — literally blocking it. Another theory suggests that the electrical impulses cause a release of endorphins that override the sensation of pain. Many back pain patients have had success with TENS machines, though their effectiveness has not been clearly proven in controlled studies. Ask your doctor or physical therapist if this therapy might be right for you.

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Medical Disclaimer: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any exercise program.

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