Low Back Pain Treatment in Livonia and Romulus, MI
Evidence-Based, Non-Surgical Care
Book Your Back Pain ConsultationContent Reviewed By: Dr. Jeremiah Shaft, D.C., L.M.T. on October 2, 2026
Michigan State Chiropractic License Number: 2301008888 (NPI: 1053360768)
- Low Back Pain Treatment At A Glance
- What Low Back Pain Actually Is, And Why It Behaves The Way It Does
- What Low Back Pain Feels Like And How It Affects Your Day
- Why Your Low Back Started Hurting In The First Place
- Warning Signs That Need Medical Attention, Not Chiropractic Care
- Your Personalized Low Back Pain Care Plan, Phase By Phase
- What The Research Actually Says About Low Back Pain Care
- Meet Your Doctor
- What Our Patients Say
- References And Medical Review
- Low Back Pain Questions We Hear Most Often
Low Back Pain Treatment At A Glance
Low back pain is pain, stiffness, or nerve irritation involving the muscles, joints, discs, ligaments, or nerves of the lumbar spine. Most cases are mechanical, triggered by lifting, long hours of sitting, repetitive bending, a sudden twist, or an auto accident, and most improve within about six weeks. First-line care is usually non-drug and active. That means staying gently mobile, targeted exercise, manual therapy such as chiropractic adjustment, soft tissue work, and heat. Imaging is not necessary for most cases. Seek urgent medical care for loss of bowel or bladder control, numbness in the groin or inner thighs, progressive leg weakness, fever, unexplained weight loss, or severe pain after a fall or crash.
What Low Back Pain Actually Is, And Why It Behaves The Way It Does
Your lower back is built from five lumbar vertebrae stacked on the sacrum, with intervertebral discs between them acting as shock absorbers, paired facet joints guiding motion at the back of each segment, and the sacroiliac joints connecting the spine to the pelvis. Layered around all of it are the erector spinae, multifidus, quadratus lumborum, psoas, and the gluteal muscles, plus ligaments and the thoracolumbar fascia. Nerve roots exit between the vertebrae through small openings called neural foramina, and the largest of them combine to form the sciatic nerve.
Low back pain happens when one or more of those structures becomes irritated, restricted, overloaded, or inflamed. The great majority of cases are what clinicians call non-specific mechanical low back pain, meaning the pain comes from how the area is moving and loading rather than from a single dangerous pathology. A smaller number involve nerve root compression from a disc herniation, lumbar spinal stenosis, spondylolisthesis, facet joint irritation, or sacroiliac joint dysfunction.
Timing matters. Acute low back pain comes on suddenly, often after a lift, an awkward movement, or an impact, and usually settles within six weeks. Subacute pain lingers between six and twelve weeks. Persistent or chronic low back pain has been present for twelve weeks or longer, and it is usually driven by more than one factor at once. Muscle guarding, reduced hip mobility, deconditioning, poor sleep, and an understandably cautious approach to movement can all keep an area sensitive long after the original tissue has calmed down.
Two myths are worth clearing up. The first is that a disc bulge on an MRI is automatically the cause of your pain. Imaging findings such as disc degeneration and disc bulges are extremely common in people with no pain at all, and they become more common with every decade of life, which is why findings have to be interpreted alongside your symptoms and exam rather than on their own. The second is that rest is the answer. Prolonged rest tends to stiffen the area and reduce tolerance for normal activity. Gentle, progressive movement is almost always part of getting better.
What Low Back Pain Feels Like And How It Affects Your Day
Low back pain does not present the same way twice. Patients describe it as sharp, dull, aching, burning, tight, or locked up, and the location can be central, on one side only, across the belt line, or spreading into the buttock and hip.
Common presentations we see include:
- Dull, aching pain across the lower back that worsens as the day goes on
- Sharp pain in the lower back when standing up from a chair or getting out of the car
- Lower back stiffness in the morning that eases after 20 or 30 minutes of moving
- Pain in the lower back and hip on one side, sometimes described as sitting on a golf ball
- Pain that radiates down the leg, sometimes past the knee, with tingling, numbness, burning, or weakness in the thigh, calf, or foot
- Pain that spikes when bending forward, twisting, coughing, or sneezing
- A catching or giving way sensation with certain movements
Aggravating and easing patterns are some of the most useful information you can bring to an appointment. Disc-related irritation often feels worse with sitting, bending forward, and first thing in the morning. Facet joint and stenosis-related pain often feels worse with standing, walking, or arching backward, and better when sitting or leaning forward on a cart. Muscular and load-related pain tends to build with repetition and ease with position changes and heat. Pain that travels below the knee, or that comes with numbness and weakness, points toward nerve involvement and changes how we evaluate you.
The functional cost is what usually brings people in. Low back pain interrupts sleep and makes rolling over a two-step process. It turns a desk shift, a driving route, or a day on the line at work into something you count down. It makes lifting a toddler, loading groceries, or getting through a workout feel risky. Many patients tell us they have been managing for months with heat, stretching, and over-the-counter medication, and that the pain keeps coming back every time they return to normal activity. That repeating cycle is a signal that the underlying driver has not been addressed.
Why Your Low Back Started Hurting In The First Place
Low back pain develops when the demand placed on your spine and surrounding tissue exceeds what those tissues can currently tolerate. That can happen in one moment or accumulate quietly over months.
Mechanical and load factors. Lifting something heavy with a rounded back, lifting and twisting at the same time, repetitive bending, prolonged static postures, and sudden increases in activity are the most common triggers. Restricted hip mobility, stiff mid-back motion, and a weak or poorly coordinated deep core shift load onto the lumbar segments that can least tolerate it. Previous injuries, including auto accidents and sports injuries, often leave behind movement patterns that keep the area working harder than it should.
Lifestyle contributors. Long commutes and desk work keep the lumbar spine in sustained flexion and the hip flexors shortened. Poor sleep lowers pain tolerance and slows tissue recovery. Smoking is associated with worse disc health. Elevated body weight increases the sustained load on the lumbar spine and pelvis. Ongoing psychological stress raises muscle guarding and sensitivity, which is why the same physical load can feel very different during a hard month than it does during an easy one.
Capacity and recovery mismatch. This is the factor most often missed. Pain is not only about how much load you put on the tissue. It is about the gap between that load and the tissue’s current capacity to handle it. A weekend of yard work is not inherently dangerous. It becomes a problem when the body has spent the previous six months mostly seated. Age-related changes such as disc degeneration and facet osteoarthritis narrow the margin further, though they are a normal part of aging rather than a sentence.
Structures that can be involved include the intervertebral discs and annulus fibrosus, the facet joints, the sacroiliac joints, the lumbar nerve roots and sciatic nerve, the hip joint, and the surrounding muscles and fascia. Conditions that can produce similar symptoms include sciatica, herniated and bulging discs, lumbar spinal stenosis, spondylolisthesis, piriformis syndrome, hip joint pain and arthritis, and kidney or abdominal conditions that refer pain into the back. Sorting out which of these is actually driving your symptoms is the entire purpose of a thorough examination.
Warning Signs That Need Medical Attention, Not Chiropractic Care
Most low back pain is not dangerous. A small percentage is, and those cases need medical evaluation before any conservative care begins. Please seek emergency or urgent medical care, not a chiropractic appointment, if you have any of the following.
Go to an emergency department immediately if you have:
- Loss of bladder or bowel control, or new difficulty starting or stopping urination
- Numbness in the groin, buttocks, or inner thighs, sometimes described as a saddle pattern
- Weakness in both legs, or weakness that is clearly getting worse
- Severe back pain following a significant fall, car accident, or direct trauma
- Severe, tearing, or pulsating back and abdominal pain, particularly if you are over 60 or have a history of vascular disease
The first three signs together can indicate cauda equina syndrome, a compression of the nerve bundle at the base of the spinal cord. It is rare, and it is a surgical emergency.
Contact your physician promptly if you have:
- Fever, chills, or night sweats along with back pain
- Unexplained weight loss, or a personal history of cancer
- Back pain that is constant, unrelieved by any position, and worse at night
- A history of osteoporosis, long-term steroid use, or a recent minor fall with sudden severe pain, which can suggest a compression fracture
- Recent infection, IV drug use, or a suppressed immune system
- Progressive numbness or weakness in one leg, or a foot that drags or slaps when you walk
At True Health Chiropractic, screening for these findings is part of every initial evaluation. If your history or examination raises any of these concerns, we will tell you directly and refer you for medical imaging or physician evaluation rather than proceeding with treatment. Recommending care only when it is appropriate is a core part of how we practice.
Your Personalized Low Back Pain Care Plan, Phase By Phase
We do not use a standardized care plan, and we never have. After your consultation and examination, we sit down with you for a Report of Findings and explain what we found, what we believe is driving it, and what a realistic path forward looks like. From there, care follows our Regenerative Longevity Framework, a phase-driven system that moves you from symptom relief through to durable, long-term function. The pace and content of each phase depend on your exam findings, your response to care, and your goals.
Phase 1: Calm the Irritation
The goal early on is to reduce pain and protective muscle guarding enough that you can move again. Depending on your presentation, this may include gentle spinal adjusting or mobilization to restore motion at restricted segments, soft tissue work through massage therapy to release guarded muscles, superficial heat, and specific advice on positions and activities to temporarily modify. We also coach you on what to keep doing, because staying gently active during this phase is associated with better outcomes than rest. Our adjusting approaches range from light-touch, no-force techniques to traditional manual adjusting, so patients who are highly irritated or nervous about manipulation still have options.
Phase 2: Restore Motion
Once irritation settles, the focus shifts to restoring normal movement through the lumbar spine, hips, and mid-back. This typically combines chiropractic adjustments with targeted mobility work, directional preference exercises when your exam indicates them, and continued soft tissue care for the quadratus lumborum, glutes, hip flexors, and thoracolumbar fascia. Many patients notice here that pain becomes more predictable and less frequent, which is an important marker of progress even before pain is fully gone.
Phase 3: Rebuild Capacity
Reducing pain without rebuilding tolerance is how people end up back in the same place six months later. This phase is about progressive loading. We build deep core and trunk control, hip and glute strength, and hinge mechanics so your body can absorb the demands of your actual life. Exercise is the most consistently supported intervention for persistent low back pain in the research literature, and it is where long-term results are made. When appropriate, we pair this with nutritional and metabolic support, because recovery capacity, inflammation, and body composition all influence how quickly tissue responds.
Phase 4: Return to Activity and Stay There
The final phase is about confidence and durability. We progress you back to lifting, working, training, driving, or whatever your life requires, and we teach you how to manage flare-ups yourself if one happens. Some patients transition to occasional maintenance visits, some to a self-directed program, and some to a wellness plan. What that looks like for you is a conversation, not a requirement.
Adjunct technologies, used only when indicated
- Class IV laser therapy: used in some cases to support tissue recovery and reduce local inflammation, most often as an adjunct alongside manual care and exercise rather than on its own.
- Shockwave therapy: primarily used for chronic soft tissue and tendon-related complaints, including stubborn gluteal and hip-related pain that accompanies low back symptoms.
- Massage and manual soft tissue therapy: used to reduce muscle tension and improve comfort and mobility between adjustments.
- Infrared sauna: offered as a recovery and relaxation support for appropriate patients.
What The Research Actually Says About Low Back Pain Care
We think you should know what the evidence supports and where it is uncertain. Here is a plain-language summary of the research that shapes our approach.
American College of Physicians clinical practice guideline (2017). A national guideline based on a systematic review of randomized trials. It recommends that adults with acute or subacute low back pain start with non-drug treatment, including superficial heat, massage, acupuncture, or spinal manipulation, and that patients with chronic low back pain begin with options such as exercise, multidisciplinary rehabilitation, tai chi, yoga, motor control exercise, cognitive behavioral therapy, low-level laser therapy, or spinal manipulation. It applies to adults with non-specific low back pain, not to patients with red flags or significant neurological deficits. Limitation: much of the supporting evidence was graded low to moderate quality, and improvements across treatments were generally small, with no clear winner among them.
World Health Organization guideline on chronic primary low back pain (2023). An international guideline covering 37 interventions. It issued recommendations in favor of structured exercise programs, education and self-management, spinal manipulative therapy, massage, acupuncture, psychological therapies such as cognitive behavioral therapy, and NSAIDs. It advised against routine use of lumbar belts and supports, traction, and opioid medication. It applies to community-dwelling adults, including adults over 60, with chronic primary low back pain. Limitation: these are conditional recommendations, the estimated net benefit ranged from trivial to moderate, and evidence in older adults was judged uncertain because so few trials included them.
Systematic review and meta-analysis of spinal manipulative therapy, BMJ (Rubinstein et al., 2019). A pooled analysis of 47 randomized trials including 9,211 adults. It found that spinal manipulative therapy produced effects on pain and function similar to other guideline-recommended treatments such as exercise and NSAIDs, and better short-term function than treatments guidelines do not recommend. It applies to adults with chronic non-specific low back pain, with or without referred pain. Trials studying sciatica exclusively were excluded. Limitation: trial quality varied, the benefits were modest, and while no serious adverse events appeared in the trials, the authors note that serious events have been reported elsewhere and that patients should be informed of them.
Cochrane review of exercise therapy for chronic low back pain (Hayden et al., 2021). One of the largest Cochrane reviews ever published, covering 249 trials and 24,486 participants. It concluded that exercise probably reduces pain compared with no treatment or usual care, with an average improvement of roughly 15 points on a 0 to 100 pain scale at three months, alongside smaller improvements in function. A companion analysis found Pilates, McKenzie method, and functional restoration slightly ahead of other exercise types, though all types outperformed minimal treatment. It applies to adults whose low back pain has lasted 12 weeks or longer. Limitation: many included trials were small with methodological weaknesses, and effects compared with other active treatments were small.
Imaging findings in people without pain, AJNR (Brinjikji et al., 2015). A systematic review of 33 studies covering 3,110 people with no back pain at all. Disc degeneration was present in 37% of pain-free 20-year-olds and 96% of pain-free 80-year-olds, and disc bulges in 30% and 84% of those groups respectively. It applies to how imaging results should be interpreted for everyone. Limitation: this does not mean imaging findings never matter. It means a finding on a scan has to be matched to your symptoms and examination, and imaging remains essential when red flags are present or surgical decisions are being made.
Across all of it, one honest theme repeats. No single treatment is dramatically better than the others for most people, the average effects are moderate rather than miraculous, and the best outcomes come from combining hands-on care with active rehabilitation and a clear understanding of your own condition. That is the approach we build our plans around.
Meet Your Doctor
Dr. Jeremiah Shaft, DC — Clinic Director
Dr. Jeremiah M. Shaft, D.C. is a chiropractor, regenerative health practitioner, and entrepreneur…
Dr. Christopher Lee, DC — Chiropractor
Dr. Christopher G. Lee, D.C. brings more than 30 years of clinical experience to our team…
Dr. Alonda Walker, DC — Chiropractor
Dr. Alonda Walker, D.C. is a Detroit native with a deep commitment to natural, drug-free, non-surgical chiropractic care…
What Our Patients Say
References And Medical Review
- Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine. 2017;166(7):514-530. doi:10.7326/M16-2367
- World Health Organization. WHO Guideline for Non-Surgical Management of Chronic Primary Low Back Pain in Adults in Primary and Community Care Settings. Geneva: World Health Organization; 2023.
- Rubinstein SM, de Zoete A, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019;364:l689. doi:10.1136/bmj.l689
- Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews. 2021;9:CD009790. doi:10.1002/14651858.CD009790.pub2
- Hayden JA, Ellis J, Ogilvie R, et al. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. Journal of Physiotherapy. 2021;67(4):252-262.
- Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology. 2015;36(4):811-816. doi:10.3174/ajnr.A4173
- National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. NICE guideline NG59. 2016, updated 2020.
- Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018;391(10137):2368-2383.
Medically reviewed by: Dr. Jeremiah Shaft, D.C., L.M.T., Doctor of Chiropractic and Clinic Director, True Health Chiropractic. Michigan Chiropractic License No. 2301008888, NPI 1053360768, regulated by the Michigan Board of Chiropractic, Michigan Department of Licensing and Regulatory Affairs.
Reviewed for: clinical accuracy, patient safety, service appropriateness, and scope-of-practice accuracy.
Last reviewed: September 16, 2026. This page is reviewed at least annually or whenever relevant guidelines change.
Chiropractic care may help when your pain is related to joint restriction, muscle tension, altered movement patterns, or certain types of nerve irritation. Major guidelines, including those from the American College of Physicians and the World Health Organization, list spinal manipulative therapy among the non-drug options for both recent and long-standing low back pain. It is not appropriate for every case, which is why we evaluate first and recommend care only when the findings support it.
Most acute low back pain improves substantially within two to six weeks, though it is common for symptoms to fluctuate along the way. Pain that has been present for months usually takes longer to change because more than one factor is involved. After your examination, we give you a realistic timeline based on your findings rather than a generic estimate, and we reassess as we go.
Pain that persists despite rest is a good reason to get evaluated rather than to wait longer. Extended rest tends to reduce mobility and tolerance for activity, which can make the problem harder to resolve. An examination can identify whether joint restriction, disc irritation, nerve involvement, or a strength and capacity deficit is keeping the area sensitive, and that determines what actually needs to change.
Pain travelling into the buttock, thigh, calf, or foot can indicate irritation of a lumbar nerve root, often called sciatica, and it may involve a disc herniation, spinal stenosis, or referred pain from the sacroiliac or hip joint. We test for numbness, reflex changes, muscle weakness, and movement patterns to determine which. Leg symptoms with progressive weakness, or with any bowel or bladder changes, require urgent medical evaluation instead.
Every person is different, this is decided on a case by case basis. We may recommend imaging when your history or examination suggests it would change the plan, when red flags are present, or when symptoms are not responding as expected.
Many disc-related cases improve with conservative care over a period of weeks to months, and most people with lumbar disc herniation never need surgery. Non-surgical care focuses on reducing nerve irritation, restoring movement, and progressively rebuilding tolerance. Surgical referral becomes appropriate when there is progressive neurological deficit, cauda equina syndrome, or severe symptoms that have not responded to a reasonable course of conservative care.
Prolonged sitting keeps the lumbar spine in a sustained flexed position, loads the discs steadily, shortens the hip flexors, and lets the glutes and deep core go quiet. The result is stiffness that shows up when you stand, and a back doing work the hips should be sharing. Workstation adjustments and regular position changes help, and pairing them with targeted hip and core work addresses the underlying capacity problem.
In most cases, some form of movement is not only safe but beneficial, though the specific activities may need temporary modification. Exercise has the most consistent research support of any single intervention for persistent low back pain. What matters is choosing the right loading for your current stage and progressing it sensibly, which is something we build into your plan rather than leaving you to guess.
Yes. We evaluate low back pain related to auto accidents and whiplash-type injuries, and our team can discuss auto insurance coverage, claim details, and documentation before or during your visit. Michigan auto policies commonly cover this care.
No referral is required. You can contact either office directly, and our team will verify your insurance benefits before your first visit so there are no surprises.
Low Back Pain Questions We Hear Most Often
Book Back Pain Treatment In Livonia Or Romulus
Back Pain treatment should not keep you guessing about what your body needs. At True Health Chiropractic, we start with a detailed evaluation, explain what we find, and recommend care only when we believe it fits your situation. Book an appointment to discuss your symptoms and the next best step. Same-day appointments and walk-ins are available when scheduling allows, and our team can answer questions before your first visit.