Low Back
Pain Relief
San Diego

Evidence-based chiropractic care for disc herniation, SI joint dysfunction, sciatica, and postural low back pain — from a practice that actually diagnoses the root cause first.

ACP First-Line Recommended

Most Insurance Accepted

UTC San Diego — Near UCSD

Treatment Starts Visit One

Your Back Hurts.
We Find Out Why.

Low back pain is the leading cause of disability worldwide — and one of the most undertreated conditions in San Diego, where millions of people manage it with ibuprofen and hope it goes away. It usually doesn’t. Here’s what actually works.

80%
of adults experience significant low back pain at some point in their life
31%
lower surgery rate for disc patients who chose chiropractic first (BMJ Open, 2022)
#1
recommended first-line treatment by the American College of Physicians before medication
4–6
visits for most patients with acute mechanical low back pain to feel meaningful relief

Your back has been talking to you for a while. Maybe it started as stiffness after sitting at your desk all day in Sorrento Valley, or a twinge during your Saturday surf session that never fully went away. Maybe it’s that sciatic ache that shoots down your leg whenever you sit for more than 20 minutes. Whatever it is — you’re not making it up, and it’s not just “part of getting older.”

Low back pain is almost always a mechanical problem. Something is compressing, inflamed, restricted, or imbalanced. The single biggest reason it keeps coming back is that most people treat the symptom (pain) instead of the cause (the joint, disc, or muscle dysfunction behind it).

At our UTC San Diego clinic, Dr. Loewenstein conducts a thorough orthopedic and neurological evaluation on your first visit to identify the specific source of your pain — disc, facet, SI joint, piriformis, posture, or some combination. Treatment follows diagnosis. Not the other way around.

Evidence-Based, Not One-Size-Fits-All
Technique is matched to your specific condition — flexion-distraction for discs, HVLA for facets, ART for muscle adhesions.

Honest Timeline, Defined Goals
No vague “come in three times a week forever.” You get a realistic estimate, defined milestones, and a care plan that makes sense.

Rehab Is Part of the Visit
Soft tissue work, ART, and targeted exercises are integrated — not upsold separately. The goal is a spine strong enough not to need us.

Insurance Verified Before You Come In
We confirm your exact benefits upfront so there are no billing surprises. Most major plans accepted.

7 Sources of
Low Back Pain

Most low back pain has a specific, identifiable mechanical cause. Dr. Loewenstein’s evaluation narrows this down on visit one so treatment is targeted from day one.

Lumbar Disc
Herniation
L4–L5 · L5–S1 · Radiculopathy
When the disc’s inner nucleus pushes through the outer wall and compresses a nerve root, you get that sharp, burning pain shooting down your leg. Sitting and bending forward make it worse.
Rx: Flexion-distraction · ART · Core rehab

Lumbar Facet
Syndrome
15–40% of Chronic LBP
Dull, deep aching that’s worse when you arch your back or stand for a long time. No leg pain below the knee. Often described as morning stiffness that loosens up once you get moving.
Rx: HVLA manipulation · Mobilization · Soft tissue

SI Joint
Dysfunction
Up to 25% of LBP Cases
One-sided low back and buttock pain that’s sharp when you get in and out of the car, roll over in bed, or stand on one leg. Often misdiagnosed as a disc — but no true leg neurological symptoms.
Rx: Pelvic adjusting · Drop-table · Hip rehab

Muscle Strain
& Spasm
Most Common Acute LBP
Sudden ache after lifting, a bad twist, or a long day at a desk. Diffuse, bilateral tightness — stiff and sore with movement but no shooting pain down the leg. Responds fastest to care.
Rx: Manipulation · Myofascial release · Movement coaching

Degenerative
Disc Disease
DDD · “It’s Just Arthritis”
Episodic pain with good days and bad flare-ups. Worse with prolonged sitting, triggered by minor incidents. If you’ve been told to “just live with it” — you don’t have to. DDD responds well to the right care.
Rx: Flexion-distraction · Mobilization · Core stabilization

Piriformis
Syndrome
Pseudo-Sciatica · Deep Buttock
Sciatic-like pain without a disc problem. Deep buttock ache that shoots down the leg, worse sitting cross-legged or climbing stairs. Frequently misdiagnosed as disc-related sciatica.
Rx: ART to piriformis · Hip adjustment · Stretch protocol

Postural & Ergonomic Low Back Pain
Desk Workers · Remote Workers · Students · The UTC/Sorrento Valley Pattern
That dull, creeping ache that builds through the workday and disappears on vacation. You know exactly what’s causing it — you sit all day. Prolonged flexed posture at a screen creates a predictable cascade: hip flexors tighten, glutes shut off, multifidus atrophies, and the lumbar discs take on compressive load they weren’t designed for. The “lower crossed syndrome” is behind most occupational low back pain in San Diego’s tech and biotech workforce. It’s fixable — but only if the ergonomics, movement patterns, and muscle imbalances are addressed together, not just the symptom.
Rx: Spinal manipulation + thoracic mobility
· Hip flexor & glute correction
· Ergonomic coaching
· Workstation setup guidance


What the Research Actually Says
The American College of Physicians recommends spinal manipulation as a first-line treatment for acute and chronic low back pain — ahead of NSAIDs, muscle relaxants, and opioids. A 2022 BMJ Open study found patients who received chiropractic care for lumbar disc herniation had a 31% lower likelihood of requiring discectomy at two-year follow-up. A 2018 JAMA study found chiropractic patients used significantly less pain medication than those receiving standard care alone.
Sources: ACP Clinical Practice Guidelines 2017 · BMJ Open 2022 · JAMA 2018

Who We Actually See
in UTC

San Diego has a uniquely high-risk low back pain population. Here’s who walks through our door — and why.

UTC San Diego
La Jolla
Sorrento Valley
Carmel Valley
Torrey Pines
University City
Del Mar
Pacific Beach
Near UCSD (92122)

What Happens When
You Come In

Every visit is built around your specific diagnosis — not a generic protocol. Here’s what the process looks like.

01
Thorough Evaluation
Posture analysis, range of motion, orthopedic testing (straight-leg raise, Kemp’s, FABER/FADIR), neurological screen. Dr. Loewenstein identifies the source — not just the location — of your pain.
02
Honest Diagnosis
You’ll leave knowing exactly what’s driving your pain and why. No vague “your back is tight.” A clear explanation in plain language, with imaging ordered if red flags warrant it.
03
Targeted Treatment
Treatment begins visit one. Technique is matched to diagnosis — flexion-distraction for disc conditions, HVLA for restricted facets, ART for muscle adhesions, drop-table for SI joint.
04
Rehab & Prevention
Core stabilization, hip activation, movement retraining, and ergonomic guidance are integrated into care — so the problem doesn’t come back the moment you stop coming in.
Flexion-Distraction Technique
A specialized motorized table gently decompresses lumbar discs and reduces intradiscal pressure. The primary evidence-based approach for disc herniation, DDD, and disc-related sciatica — without high-velocity thrusting.
Active Release Technique (ART)
Precision soft tissue therapy that breaks adhesions in muscles, tendons, and fascia. Critical for piriformis syndrome, hamstring tightness, hip flexor restriction, and the chronic muscle guarding patterns that perpetuate low back pain.
Spinal Manipulation (HVLA)
High-velocity, low-amplitude adjustments restore restricted joint motion, reduce facet joint inflammation, and stimulate mechanoreceptors that inhibit pain signals. The most studied chiropractic intervention in the literature.

Questions About
Low Back Pain

The questions patients ask before they book — answered directly.

Can chiropractic care actually help low back pain?

Yes — and extensively so. Chiropractic spinal manipulation is recommended as a first-line, non-drug treatment for low back pain by the American College of Physicians (ACP), the Agency for Healthcare Research and Quality (AHRQ), and NICE guidelines. Multiple Cochrane reviews and JAMA studies confirm that spinal manipulation provides equivalent or superior short-term pain relief and functional improvement compared to medications and physical therapy for both acute and chronic low back pain. At our UTC San Diego clinic, care is individualized to the specific cause of your pain — not a one-size-fits-all protocol — which further improves outcomes.

Can a chiropractor help a herniated disc?

Yes — for the vast majority of lumbar disc herniations. Flexion-distraction technique is specifically designed to safely treat disc conditions by gently decompressing the affected disc and reducing nerve root pressure without high-force thrusting. A 2022 study published in BMJ Open found that patients receiving chiropractic care for lumbar disc herniation had a 31% lower likelihood of requiring discectomy surgery over two years compared to those receiving other care. The key is proper assessment: Dr. Loewenstein evaluates your imaging, neurological findings, and symptom pattern to confirm chiropractic is appropriate and to select the safest technique for your specific disc condition.

How many visits will it take before I feel better?

This depends on the cause, severity, and duration of your pain. For acute mechanical low back pain (strain, recent onset), many patients experience meaningful improvement within 4–6 visits over 2–3 weeks. For chronic conditions like degenerative disc disease, disc herniation, or recurrent facet syndrome, a typical initial care plan is 8–12 visits over 4–6 weeks, followed by reassessment. Research shows that benefits from chiropractic care emerge within the first 4 weeks. On your first visit, Dr. Loewenstein will give you an honest, individualized estimate — not a vague open-ended plan.

Is chiropractic safe if I have a herniated or bulging disc?

Yes. Chiropractic care for disc conditions uses flexion-distraction technique — a gentle, low-force method that decompresses the disc without the rotational or compressive forces that concern people. It is specifically designed for disc herniations and is safe even with significant disc involvement. Dr. Loewenstein will review your MRI or imaging before treatment and will not use high-velocity manipulation if there are active neurological deficits or other contraindications. An honest assessment at visit one determines the appropriate approach for your specific disc condition.

What should I expect at my first visit?

Your first visit begins with a detailed health history and symptom intake — when the pain started, what makes it better or worse, your occupation and activity level. Dr. Loewenstein then performs a physical examination including posture analysis, spinal range of motion testing, orthopedic tests (straight-leg raise, Kemp’s test, FABER/FADIR for SI joint), and a neurological screen. Based on findings, he’ll explain his clinical impression in plain language, discuss whether chiropractic is appropriate, and outline a realistic treatment plan with goals and a timeline. In most cases, treatment begins at the first visit.

Can chiropractic help me avoid back surgery?

Compelling evidence suggests yes, in many cases. The BMJ Open 2022 study showed a 31% reduction in discectomy rates at two-year follow-up for disc herniation patients who chose chiropractic care. Major clinical guidelines — including the ACP and the Joint Commission — recommend exhausting conservative care (including chiropractic) before considering surgical options for most non-emergency low back pain presentations. The exception: true cauda equina syndrome or progressive neurological deficit requires urgent surgical evaluation.

Do I need an X-ray or MRI before seeing a chiropractor?

Not necessarily. For most patients with mechanical low back pain, imaging is not required before beginning chiropractic care. Clinical guidelines actually recommend against routine imaging for non-specific low back pain — findings on X-rays and MRIs often don’t correlate with pain levels and can lead to unnecessary worry. Dr. Loewenstein will conduct a thorough clinical examination to determine the likely cause of your pain. If findings suggest a condition that warrants imaging (neurological deficits, suspected fracture, red flag symptoms), he’ll refer you for the appropriate studies and work with your radiologist’s findings.

How is chiropractic different from physical therapy for low back pain?

Both treat low back pain effectively but through different primary mechanisms. Chiropractic care focuses on restoring normal spinal joint motion, reducing nerve irritation, and addressing the root mechanical cause — often providing faster initial pain relief. Physical therapy emphasizes building strength, stability, and movement patterns to prevent recurrence. For most patients, the ideal approach integrates both: chiropractic care to restore mobility and reduce pain, combined with rehabilitation exercises to build the strength that protects the spine long-term. At our UTC San Diego clinic, every care plan includes both hands-on treatment and a home exercise component.

Can chiropractic help sciatica?

Yes. Sciatica most commonly results from lumbar disc herniation or piriformis syndrome — both respond well to chiropractic care. For disc-related sciatica, flexion-distraction decompression reduces the nuclear pressure on the affected nerve root. For piriformis syndrome (pseudo-sciatica with no disc involvement), direct soft tissue release of the piriformis muscle combined with hip rehabilitation is highly effective. Research supports chiropractic care as an effective conservative option with outcomes comparable to epidural steroid injections for many patients — without the associated risks. Dr. Loewenstein will determine the specific source of your sciatic symptoms to ensure the correct treatment approach.

Is chiropractic safe for degenerative disc disease?

Yes. Chiropractic care is well-suited for DDD and is often more effective than passive approaches like rest or isolated pain management. The goal isn’t to “reverse” degeneration (which is structural) — it’s to maintain segmental mobility, reduce compensatory joint stress, and keep you functional for as long as possible. Techniques like flexion-distraction and low-amplitude mobilization avoid excessive loading of degenerated segments while restoring joint play. Many patients with DDD find that consistent chiropractic care — even monthly maintenance visits — dramatically reduces their flare-up frequency. If you’ve been told to “just live with it,” that’s not the whole story.

Why does my low back pain keep coming back?

Recurrent low back pain usually means the underlying cause was never fully addressed — only the symptom was managed until it quieted down. Common contributors to recurrence include inadequate core stabilization, unresolved joint hypomobility, hip flexor tightness, poor ergonomics, and deconditioning. A complete course of chiropractic care — not just spot treatment until pain resolves — addresses these root factors. The goal is to get you not just out of pain, but resilient enough that the same thing doesn’t happen again in three months.

Does insurance cover chiropractic care in California?

Yes, in most cases. Chiropractic care is a covered benefit under most major medical insurance plans in California — including Blue Shield, Aetna, Anthem Blue Cross, UnitedHealthcare, and most employer-sponsored PPO plans. Medicare covers chiropractic adjustments for spinal conditions. UC and CSU student health plans also cover chiropractic, including UC SHIP with a referral. Our office verifies your specific benefits before your first visit so you know exactly what to expect regarding coverage, co-pays, and deductible requirements.

Can chiropractic help me avoid pain medication long-term?

For many patients, yes. A landmark 2018 JAMA study found that patients receiving chiropractic care for low back pain used significantly less pain medication than those receiving standard care alone. By addressing the mechanical source of pain and improving spinal function, chiropractic care can meaningfully reduce reliance on both over-the-counter and prescription pain medications as a long-term management strategy. NSAIDs and muscle relaxants are useful for short-term pain reduction — but they don’t fix the joint, disc, or muscle problem causing the pain in the first place.

What are red flags in low back pain that need urgent medical attention?

A responsible chiropractor screens for red flags at every initial evaluation. The following symptoms accompanying low back pain require prompt medical evaluation — not just chiropractic care:

Loss of bladder or bowel control
Progressive lower extremity weakness
Saddle anesthesia (groin/inner thigh numbness)
Severe night pain not relieved by any position
Back pain following significant trauma
Unexplained weight loss with back pain
Back pain with fever
Known history of cancer with new back pain

These may indicate cauda equina syndrome, fracture, infection, or malignancy. Dr. Loewenstein screens for all of these at the initial visit and will refer appropriately if any are present.

How do I tell if it’s a muscle strain, disc problem, or SI joint issue?

While only a proper clinical exam can definitively identify the source, each condition follows a distinct pattern. Muscle strain: diffuse, bilateral aching that worsens with movement and improves with rest — no neurological symptoms, usually follows an identifiable incident. Disc herniation: radiating leg pain following a nerve root distribution, worse sitting and bending forward, may include tingling or numbness. Facet syndrome: unilateral, localized pain worsening with back extension and rotation, no leg symptoms below the knee. SI joint dysfunction: one-sided buttock pain that’s sharp with transitions (sitting to standing, rolling over) without true neurological signs. Dr. Loewenstein’s evaluation uses orthopedic testing, motion assessment, and neurological screening to identify the source and ensure the correct treatment approach.

Can I work out while getting chiropractic treatment for my back?

In most cases, yes — with guidance. Staying active is generally beneficial for low back pain recovery; rest and avoidance typically prolong recovery. Dr. Loewenstein will give specific guidance based on your diagnosis: disc herniation patients may need to modify certain movements (heavy deadlifts, aggressive forward flexion) in the early phase, while facet or muscle strain patients can usually continue training with modifications. The goal is to keep you moving and training while protecting the injured tissue — not to shut you down unnecessarily.

Should I see a chiropractor before trying other treatments first?

Evidence-based clinical guidelines from the ACP and other major medical bodies now recommend conservative care first — including chiropractic, heat, massage, and exercise — ahead of medication and before considering injections or surgery for most acute and chronic low back pain. Seeing a chiropractor early often produces faster recovery, reduced risk of the pain becoming chronic, lower overall healthcare costs, and decreased likelihood of needing stronger interventions later. For patients in the UTC and La Jolla area of San Diego, a chiropractic evaluation is an efficient, evidence-aligned first step.

Done Managing
the Pain?

Find out exactly what’s causing it and what it’ll take to fix it. Treatment starts on visit one.

Book an Appointment

(858) 558-3111
5151 Shoreham Place, Suite 175 · UTC San Diego, CA 92122 · Near UCSD