WHY YOUR BACK PAIN KEEPS COMING BACK EVEN AFTER TREATMENT – SAN DIEGO, CA

One of the most frustrating things I hear from patients is:

"I was feeling better for a few days... then my back went right back to hurting again."

Or:

"The pain comes and goes, but it never seems to completely stay away."

If that sounds familiar, you're not alone.

Many people experience temporary improvements from stretching, chiropractic adjustments, massage therapy, physical therapy, medications, injections, or simply resting. While these treatments may provide relief, they do not always address every factor contributing to the problem.

In many cases, one of the missing pieces is core stability.

As a Certified Spinal Decompression Doctor and Certified Pain-Free Performance Specialist (PPSC), I have spent nearly 20 years helping patients suffering from herniated discs, sciatica, degenerative disc disease, chronic neck pain, and chronic low back pain. One thing I have learned is that reducing pain and improving spinal stability are often two very different goals.

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PAIN RELIEF DOES NOT ALWAYS MEAN THE PROBLEM IS FIXED

Many patients assume that if their pain decreases, the underlying issue has healed.

Unfortunately, that is not always the case.

A patient may experience temporary symptom relief because:

✔ Inflammation decreases

✔ Muscle spasms calm down

✔ Activity levels change

✔ Medications reduce discomfort

✔ An adjustment improves mobility

✔ They avoid positions that aggravate the problem

While these can all be positive developments, they do not necessarily mean the spine is functioning optimally.

If the structures supporting the spine are not working properly, symptoms can return once normal activities resume.

This is one reason many patients experience a cycle of:

Pain → Temporary Relief → Flare-Up → Temporary Relief → Flare-Up

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STRENGTH AND STABILITY ARE NOT THE SAME THING

Many people think a strong core means having visible abdominal muscles.

In reality, some individuals with impressive strength still struggle with spinal stability.

Core stability refers to the body's ability to maintain proper spinal control during movement.

Several important muscles help support the spine, including:

✔ Multifidus

✔ Transverse Abdominis

✔ Diaphragm

✔ Pelvic Floor Muscles

✔ Gluteal Muscles

When these muscles are not functioning properly, excessive stress may be placed on the discs, joints, ligaments, and surrounding tissues.

Over time, this can contribute to recurring episodes of back pain.

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WHY YOUR BACK MAY KEEP "GOING OUT"

Many patients describe their symptoms by saying:

"My back keeps going out."

While there can be multiple causes, poor spinal stability is often part of the equation.

Common contributing factors include:

✔ Prolonged sitting

✔ Previous injuries

✔ Herniated discs

✔ Degenerative disc disease

✔ Sciatica

✔ Poor movement patterns

✔ Weakness following an injury

✔ Fear of movement after a painful episode

The result can be a spine that becomes more sensitive to everyday activities such as:

• Getting out of bed
• Bending forward
• Lifting groceries
• Golfing
• Surfing
• Working out
• Sitting for long periods

Sometimes the activity itself is not the true problem. Instead, the underlying issue may be that the spine lacks the stability necessary to tolerate the activity.

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ONE OF MY FAVORITE EXERCISES FOR CORE STABILITY

One exercise I frequently recommend to appropriate patients is the Bird Dog exercise.

I like this exercise because it focuses on teaching the body how to maintain spinal stability while the arms and legs move.

The goal is not to perform high repetitions or create muscle fatigue.

The goal is to improve control.

Basic Bird Dog Guidelines

✔ Start on hands and knees

✔ Slowly extend one arm and the opposite leg

✔ Keep your hips level

✔ Maintain a neutral spine

✔ Hold for 5–10 seconds

✔ Perform 5–10 repetitions per side

✔ Complete 1 set daily

Quality is more important than quantity.

Slow, controlled movement typically produces the best results.

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WHAT IF EXERCISE IS NOT ENOUGH?

While stability exercises can be extremely beneficial, they are not always the entire answer.

Some patients have significant structural issues that continue to generate symptoms despite doing the "right" exercises.

Examples include:

✔ Herniated discs

✔ Disc protrusions

✔ Disc extrusions

✔ Degenerative disc disease

✔ Foraminal narrowing

✔ Cervical radiculopathy

✔ Chronic sciatica

In these situations, the underlying spinal condition may need to be addressed in addition to improving stability and movement patterns.

This is why obtaining an accurate diagnosis is so important.

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THE IMPORTANCE OF A PROPER EVALUATION

At our office, we routinely evaluate patients who have already tried:

✔ Physical therapy

✔ Chiropractic care

✔ Massage therapy

✔ Acupuncture

✔ Epidural injections

✔ Medications

✔ Home exercise programs

Many of these treatments can be helpful.

However, if symptoms continue to return, it may be worth determining whether an underlying disc injury or spinal condition is contributing to the problem.

This is where a detailed consultation, examination, X-rays, and MRI review can be extremely valuable.

Not every patient is a candidate for our treatment programs, and we frequently refer patients elsewhere when we believe another approach would be more appropriate.

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WHY PATIENTS TRAVEL TO SEE US

At The Spinal Decompression & Chiropractic Center of San Diego, we specialize in helping patients suffering from:

✔ Herniated discs

✔ Bulging discs

✔ Sciatica

✔ Degenerative disc disease

✔ Neck pain

✔ Arm pain

✔ Chronic low back pain

✔ Cervical radiculopathy

Dr. Cassidy Boelk, DC is a Certified Spinal Decompression Doctor, Certified Pain-Free Performance Specialist (PPSC), Founder of the Spinal Decompression Training Academy, and a Founding Member of the American Spinal Decompression Society.

Our office exclusively utilizes the DRX9000 spinal decompression system and currently operates seven decompression units, making us one of the largest providers of Non-Surgical Spinal Decompression (NSSD) in California.

Over the years, we have helped patients from throughout San Diego County, California, and even from outside the United States who were seeking alternatives to surgery.

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SCHEDULE A NO-CHARGE CONSULTATION

If your back pain keeps improving temporarily only to flare up again, it may be time to determine whether there is an underlying issue contributing to the problem.

Dr. Cassidy Boelk, DC
Certified Spinal Decompression Doctor
Certified Pain-Free Performance Specialist (PPSC)

The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123

Phone: (619) 298-0800

Website: www.SanDiegoBackCare.com

We offer a No-Charge Consultation to help determine whether you may be a candidate for care and to discuss all available treatment options before considering surgery.