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Low Back Pain

Low back pain is a multifactorial disorder where resolution of chronic pain can only be achieved with a comprehensive approach focused on root causes. One of the most common causes of low back pain is ligament and tendon dysfunction in the sacroiliac(SI) joint. The Si joint is located on both sides of the sacrum where the ilia attach and they join via a dense network of ligaments to become the seat of the lumbar vertebrae. This location may be the densest connective tissue layer in the body. Consider its impact as it attaches or connects the upper torso to the lower limbs and hips. 

The SI joint is a weight bearing joint that is sensitive to injuries from falls on the sacrum or tailbone and repetitive and weight bearing activities. Activities that can flare or aggravate this joint include walking, running, weights, jumping, cycling, and even pregnancy. Pregnancy can aggravate this joint obviously by the additional weight gained during pregnancy, but also by the hormones that are produced to cause ligament laxity in preparation for birthing. Inactivity can also lead to dysfunction of the SI joint, due to weak muscles that attach near to this joint and function to help stabilize and support this transition point for forces applied above and below the hips.

We have consistently found that individuals with acute and chronic low back pain, that the muscles that are near or stabilize the sacroiliac joint can develop trigger points that cause referred pain patterns resembling low back pain. For example, the gluteus medius, gluteus maximus, and piriformis muscles tighten in areas along the muscles to shorten and help stabilize the sacroiliac joint. These tight areas or contracted proteins are called trigger points, and will refer pain to a location away from their original location or injury, making it difficult to diagnose pain without a trigger point focused exam. Low back pain is a multifactorial condition and requires individualized treatment protocols. Our Chronic Pain Clinic at EVND offers a multitude of solutions to meet the needs and desires of our patients.

Amniotic Liquid Allograft

Amniotic Liquid Allograft emerges as a revolutionary solution for the regeneration of tendons, ligaments, and joints, marking a significant stride in the field of regenerative medicine. Derived from the amniotic fluid, this cutting-edge therapy harnesses the potent healing properties present in the amniotic tissue, offering a non-invasive and natural alternative to traditional treatments.

One of the key benefits lies in its ability to accelerate the healing process. The amniotic liquid is rich in growth factors, cytokines, and hyaluronic acid, fostering tissue repair and promoting cell proliferation. Unlike conventional methods, Amniotic Liquid Allograft minimizes inflammation and pain, expediting recovery times and enhancing overall patient outcomes.

Furthermore, this regenerative therapy proves versatile, catering to a spectrum of orthopedic issues, from tendonitis to joint degeneration. Its non-immunogenic nature ensures compatibility, reducing the risk of rejection. As we delve into a new era of regenerative medicine, Amniotic Liquid Allograft stands as a beacon of hope for those seeking effective, natural, and transformative solutions for tendon, ligament, and joint regeneration.

Prolotherapy and Platelet Rich Plasma (PRP) therapy

Platelet-Rich Plasma (PRP) and Prolotherapy have emerged as revolutionary treatments for the regeneration of tendons, ligaments, and joints, offering hope to those grappling with chronic pain and limited mobility. PRP involves drawing a small amount of the patient’s blood, processing it to concentrate platelets, growth factors, and other healing components, and then injecting this potent mixture into the injured area. This stimulates the body’s natural healing processes, promoting tissue repair and regeneration.

On the other hand, Prolotherapy, or proliferation therapy, involves injecting a solution (often containing dextrose) into the affected ligaments or tendons, triggering a localized inflammation that prompts the body to initiate the healing cascade. Both therapies aim to address the root cause of musculoskeletal issues rather than merely alleviating symptoms. They have shown promise in treating conditions like tendonitis, osteoarthritis, and ligament injuries. By enhancing the body’s innate healing abilities, PRP and Prolotherapy offer patients a non-surgical, minimally invasive option for restoring function and reclaiming an active, pain-free life.

Chiropractic, Myopractic, and Massage Therapy

Chiropractic and Myopractic therapy have emerged as effective alternatives for the treatment of low back pain, offering patients relief and improved functionality. Chiropractic care focuses on the spine’s alignment, emphasizing the relationship between the musculoskeletal structure and the nervous system. Through manual adjustments, chiropractors correct misalignments, alleviating pressure on nerves and promoting natural healing.

Myopractic therapy, a specialized form of myofascial release, targets the fascia—a connective tissue surrounding muscles. Practitioners use hands-on techniques to release tension and restore flexibility, addressing imbalances that contribute to low back pain. Both therapies prioritize a holistic approach, considering the body as an interconnected system.

These treatments offer distinct advantages, such as non-invasiveness and drug-free pain relief. Additionally, patients often report improved mobility, reduced inflammation, and enhanced overall well-being. As complementary approaches or standalone treatments, Chiropractic and Myopractic therapy stand out as valuable options in the multifaceted landscape of low back pain management.

Strength Training, Yoga, and Pilates

Low back pain affects millions of individuals globally, often stemming from sedentary lifestyles, poor posture, or muscle imbalances. In the quest for relief, many find solace in the transformative benefits of strength training. This form of exercise goes beyond building muscle; it actively contributes to the treatment and prevention of low back pain.

Strength training targets key muscle groups, including the core, lower back, and hips. Engaging in exercises like deadlifts, squats, and planks helps fortify the supporting muscles around the spine, promoting better stability and alignment. Additionally, resistance training stimulates the release of endorphins, natural painkillers that can alleviate discomfort associated with chronic pain.

Crucially, strength training fosters flexibility and enhances joint mobility, mitigating stiffness and reducing the risk of future injuries. As muscles become more resilient, they better support the spine, lessening the burden on the lower back.

Yoga also emerges as a powerful ally in the battle against low back pain, offering holistic relief and long-term benefits. Its gentle yet effective postures enhance flexibility, strengthen core muscles, and improve posture, mitigating the root causes of discomfort. The practice also fosters mindfulness and stress reduction, addressing psychological aspects of pain. Research underscores yoga’s efficacy, making it a valuable non-pharmacological option for those seeking natural, sustainable relief from the persistent challenge of low back pain.

Like Yoga, Pilates, renowned for its core-strengthening focus, also emerges as a potent ally in combating low back pain. The method’s emphasis on controlled movements targets deep stabilizing muscles, fostering a robust core and spinal alignment. This proactive approach not only alleviates existing discomfort but also aids in preventing future issues. Pilates’ adaptability makes it suitable for various fitness levels, offering a tailored solution to individuals seeking a holistic and effective remedy for low back pain.

Incorporating a well-rounded strength training routine, yoga, or Pilates into one’s lifestyle can be a powerful ally in the fight against low back pain. Beyond the physical benefits, the mental and emotional resilience gained from regular training to build strength and the core can empower individuals to take control of their health and live pain-free lives.


Stretch therapy has emerged as a highly effective and holistic approach for alleviating low back pain, offering individuals a drug-free and non-invasive alternative to traditional treatments. Targeting the muscles, tendons, and ligaments surrounding the lower back, stretch therapy aims to improve flexibility, reduce muscle tension, and enhance overall range of motion.

One key benefit of stretch therapy is its ability to address the root causes of low back pain. Through guided and controlled stretching exercises, the therapy promotes increased blood flow to the affected area, facilitating the healing process. Additionally, it helps correct imbalances and postural issues that contribute to discomfort. Regular sessions can lead to strengthening of core muscles, providing better support to the spine and reducing the risk of future pain episodes.

Moreover, stretch therapy fosters relaxation, easing the psychological stress often associated with chronic pain. As individuals experience improved flexibility and reduced pain levels, their overall quality of life is enhanced, highlighting the multifaceted advantages of incorporating stretch therapy into a comprehensive low back pain treatment plan.

Mindfulness Training

Mindfulness therapy, an ancient practice rooted in Buddhist traditions, has emerged as a powerful tool in the modern treatment of low back pain. Chronic low back pain is a pervasive issue affecting millions worldwide, often exacerbated by stress and mental health factors. Mindfulness, with its emphasis on present-moment awareness and non-judgmental acceptance, offers relief by addressing the interconnectedness of mind and body.

Through mindfulness-based interventions like Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT), individuals learn to observe and accept their pain without falling into a cycle of negative thoughts. This heightened awareness promotes a sense of control over one’s response to pain, reducing the emotional toll and breaking the pain-stress cycle.

Research suggests that mindfulness therapy not only diminishes the severity of low back pain but also enhances overall well-being. By fostering a mind-body connection and encouraging a non-reactive stance towards discomfort, mindfulness becomes a valuable adjunct to conventional treatments, offering a holistic approach to alleviating the burden of chronic low back pain.

Tension Myositis Syndrome

In line with Mindfulness training we find the transformative work of the late Dr. John Sarno. Dr. Sarno’s therapy offers patients a unique perspective that extends beyond conventional medical practices. His groundbreaking method challenges the traditional belief that structural abnormalities are the primary cause of back pain, asserting that repressed emotions and psychological factors play a significant role. Sarno’s therapy, often referred to as Tension Myositis Syndrome (TMS) treatment, focuses on acknowledging and addressing the emotional components contributing to physical discomfort.

One notable benefit of Sarno’s approach is its non-invasive nature, sparing patients from the risks associated with surgery or extensive medication. By encouraging individuals to explore their emotions and stressors, the therapy facilitates a holistic healing process. Many patients have reported not only alleviation of back pain but also improvements in overall well-being, emphasizing the interconnectedness of the mind and body. Dr. John Sarno’s innovative method provides hope for those suffering from chronic low back pain, offering a pathway to relief that extends beyond the physical realm.


Acupuncture has emerged as a promising therapy for the treatment of low back pain, offering a natural and holistic approach to pain management. This ancient Chinese practice involves the insertion of thin needles into specific points on the body, stimulating the flow of energy or “qi” to restore balance and promote healing.

Numerous studies have demonstrated the efficacy of acupuncture in alleviating low back pain by reducing inflammation, relaxing muscles, and triggering the release of endorphins, the body’s natural painkillers. Unlike some conventional treatments that may have side effects, acupuncture is generally safe and well-tolerated.

One of the key benefits of acupuncture is its individualized approach. Practitioners tailor the treatment to the patient’s unique symptoms and overall health, addressing not just the pain but also its underlying causes. This personalized touch contributes to its effectiveness in managing chronic low back pain, providing patients with a viable alternative or complementary therapy to conventional medical interventions. As more individuals seek holistic and integrative approaches to health, acupuncture stands out as a valuable option for those grappling with low back pain. Acupuncture combines well with all injection therapies such as PRP, Prolotherapy, and Amniotic allograft injections.

Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric Oxygen Therapy is emerging as a promising adjunctive treatment for alleviating low back pain. This non-invasive therapy involves breathing pure oxygen in a pressurized room or chamber, enhancing the body’s natural healing processes.

The benefits of HBOT for low back pain lie in its ability to reduce inflammation and promote tissue repair. The increased oxygen levels under pressure stimulate the production of growth factors and stem cells, accelerating the healing of damaged tissues in the lower back. By improving blood flow and oxygen delivery to the affected area, HBOT helps reduce pain and swelling.

Studies suggest that HBOT may be particularly beneficial for conditions like herniated discs and degenerative disc disease. Patients undergoing this therapy often report decreased pain levels and improved functionality. While further research is needed to fully understand the mechanisms at play, Hyperbaric Oxygen Therapy presents a promising avenue for individuals seeking non-invasive, complementary approaches to manage and alleviate low back pain.

Frequency Specific Microcurrent (FSM) Therapy

Frequency Specific Microcurrent (FSM) therapy emerges as a promising breakthrough in the realm of low back pain treatment. This innovative approach employs mild electrical currents at specific frequencies to target underlying physiological issues, providing notable relief for sufferers.

One key advantage of FSM therapy lies in its ability to address the root causes of low back pain. By precisely targeting tissues and cells with specific frequencies, FSM promotes cellular repair and regeneration. This not only alleviates immediate pain but fosters long-term healing. The therapy also enhances circulation and reduces inflammation, crucial factors in managing and preventing recurrent low back pain.

Unlike traditional pain management approaches, FSM therapy is non-invasive and lacks the side effects associated with medications. Patients report improved mobility and reduced reliance on painkillers, contributing to a better quality of life. As research continues to support its efficacy, Frequency Specific Microcurrent therapy stands out as a promising and holistic solution for those seeking relief from the challenges of low back pain.

Low dose naltrexone

Low dose Naltrexone (LDN) is emerging as a promising treatment for chronic low back pain, offering a novel approach to pain management. Traditionally used to treat opioid addiction at higher doses, LDN at lower doses (typically 1-4.5 mg) has shown anti-inflammatory effects, making it an attractive option for chronic pain conditions.

In the case of low back pain, LDN operates by modulating the immune system and reducing inflammation, addressing a key component of many chronic pain conditions. It acts on the body’s opioid receptors, promoting the release of endorphins and enkephalins, natural substances that help regulate pain.

What sets LDN apart is its favorable side effect profile compared to traditional pain medications. It lacks the sedative and addictive properties associated with opioids, making it a safer long-term option. Additionally, LDN may enhance the effectiveness of other pain medications, allowing for lower doses of those drugs and reducing the risk of side effects.

As research continues, low dose Naltrexone holds promise as a valuable tool in the comprehensive management of chronic low back pain, offering a novel and safer approach to improving patients’ quality of life.


CBD, or cannabidiol, has emerged as a promising natural remedy for the treatment of low back pain, offering relief without the psychoactive effects associated with its counterpart, THC. The endocannabinoid system, present in the human body, plays a crucial role in regulating various physiological processes, including pain perception. CBD interacts with this system, potentially alleviating inflammation and reducing pain signals.

Research suggests that CBD possesses anti-inflammatory properties, making it a valuable option for managing conditions like chronic low back pain, often associated with inflammation. Moreover, CBD may modulate the body’s response to pain, providing a holistic approach to pain management. Unlike traditional pharmaceuticals, CBD is generally well-tolerated and has minimal side effects, making it an attractive option for those seeking natural alternatives.

While more extensive research is needed to fully understand the mechanisms and dosage specifics, the growing body of evidence supports the idea that CBD could be a beneficial and safe adjunctive treatment for individuals grappling with the challenges of low back pain. Always consult with a healthcare professional before incorporating CBD into your pain management routine.