Back Pain
Most back pain treatment is passive. Rest, ice, and wait. That is not what happens here.
Assessment-led rehabilitation that identifies what is driving your back pain and builds the capacity to reduce and manage it — not just temporarily suppress it.
Conditions
What we treat.
Disc herniation with or without nerve involvement. Assessment determines the degree of neural irritation, appropriate loading strategy, and realistic recovery timeline.
Nerve pain radiating from the lumbar spine into the leg. Differentiated clinically from referred pain. Neural desensitization and progressive loading — not prolonged rest.
Joint-mediated low back pain, often worse with extension and rotation. Responds to manual therapy and targeted loading of the surrounding musculature.
Sacroiliac pain — often misattributed to other sources. Assessment identifies the joint as the driver and programs accordingly.
The most common presentation. Pain without a specific structural diagnosis. Responds well to graded loading, movement retraining, and load management.
Sudden onset back pain from a specific event. Managed with early movement and progressive reloading — avoiding the prolonged rest that leads to deconditioning.
Mid-back pain related to posture, thoracic mobility, or upper body loading patterns. Common in desk workers and overhead athletes.
Recovery following discectomy, spinal decompression, or fusion. Staged rehabilitation within surgical constraints, progressive return to full function.
Why it keeps coming back
What passive treatment does not do.
Most back pain patients have already tried something. Massage reduces the pain for a day or two. Chiropractic adjustments provide short-term relief. Anti-inflammatories bring the acute episode down. Rest makes it tolerable. And then it comes back.
It comes back because none of those approaches addresses the underlying deficit. Back pain is almost never just a structural problem — it is a capacity problem. The tissue cannot tolerate the load being placed on it. Passive treatment reduces the symptom without rebuilding the capacity. The load returns. The pain returns.
The intervention that resolves back pain long-term is progressive loading — controlled, targeted, dosed correctly for the tissue's current state. Assessment identifies what the tissue can tolerate and what it needs. Treatment builds from there.
Read more: Why Physical Therapy Didn't Work The First Time →
The approach
How back rehabilitation works here.
Thorough assessment
Movement screen, neural testing, pain behavior analysis, load history, and functional demands. The assessment answers what is driving the pain — not just where it is.
Active rehabilitation
Movement begins in session one. The type, range, and load is calibrated to your clinical findings — but passive-only treatment is not the model here. You leave with a program to do between sessions.
Load management
Not what to stop — what to modify. Most activities can continue in some form during rehabilitation. The program establishes what your back can currently tolerate and progresses that tolerance systematically.
Education
You leave understanding why it happened, what maintains it, and how to prevent recurrence. Back pain that is understood is back pain that is far less likely to return.
Who we see
Three kinds of back pain patients.
The desk worker with chronic pain.
Pain that builds through the workday. Worse after sitting, better with walking — until it isn't. Has tried stretching, massage, and ergonomic adjustments. Still returns. The problem is not posture — it is capacity. The spine has not been loaded progressively in years. Assessment and targeted loading changes this.
The athlete with an acute back injury.
Something happened under load — a deadlift, a tackle, a carry. Now the back is acutely painful and training is impossible. The question is how quickly to get back and whether to train through it. Assessment determines the injury type, the appropriate management, and a realistic return-to-training timeline.
The patient who has tried everything.
Multiple providers, multiple diagnoses, no lasting resolution. Often told to live with it. The missing piece is almost always the same: no one built a systematic loading progression. The pain responds to treatment but returns because the capacity was never rebuilt. That is what changes here.
Case example
What recovery looks like.
A 38-year-old software engineer presented with two years of recurring low back pain. Previous management: multiple chiropractic courses, two physiotherapy courses with generic exercise programs, repeated massage therapy. Temporary relief after each, return of pain within four to eight weeks.
Assessment: significant posterior chain strength deficit, inability to perform a single controlled hip hinge under bodyweight without lumbar flexion compensation, fear-avoidance behavior around bending and lifting. No structural pathology on imaging. Pain was capacity-driven.
Treatment: progressive hip hinge and posterior chain loading, movement pattern correction, gradual return to gym-based loading. At session eight, the patient was deadlifting 80kg without pain. At session twelve, full discharge with a self-managed maintenance program. No recurrence at six-month follow-up.
Case presented with patient consent. Identifying details modified.
Questions
Common back pain questions.
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Do I need imaging before starting?
In most cases, no. Clinical examination identifies what is driving the pain and guides treatment. If imaging is indicated — to rule out a specific pathology — we will recommend it. Bring any existing scans; they provide useful context but are not a prerequisite. Read more: Do You Need an MRI Before Physical Therapy? →
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Is exercise safe if I am in pain?
Yes — and for most presentations, movement is part of the treatment. The type, range, and load is guided by what assessment finds. Rest as the primary strategy typically prolongs back pain rather than resolves it. Session one establishes what movement is appropriate and builds from there. Read more: Can You Keep Training While Injured? →
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What is the difference between physiotherapy and chiropractic?
Physiotherapy here is focused on building capacity — restoring movement, rebuilding strength, and addressing the factors that caused the pain. The goal is long-term resolution, not symptom management through repeated visits. Manual therapy is one tool used in service of that goal, not the primary treatment.
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Can I come in during a flare-up?
Yes. A flare-up provides clinical information that is useful for assessment. Treatment during an acute episode focuses on pain reduction and identifying what provoked the flare — often the most important data for building a long-term plan.
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What if the pain has been there for years?
Chronic back pain responds to rehabilitation — sometimes more slowly than acute presentations, but it responds. Assessment identifies what is maintaining the pain, what capacity deficits exist, and what a realistic progression looks like. Duration alone does not determine outcome.
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How many sessions will I need?
This cannot be answered accurately before assessment. It depends on the condition type, how long it has been present, your current load tolerance, and your return-to-activity goals. Acute presentations with a clear mechanical driver can resolve in 6–8 sessions. Chronic presentations with multiple contributing factors take longer. After session one, you will have an honest estimate — not a number designed to fill a schedule.
More questions? See the full FAQ →
Book an assessment
Find out what is actually driving your back pain.
Assessment + treatment from session one. $750 MXN. Zona Rio, Tijuana.