What chronic back pain is
Back pain is called chronic when it lasts 12 weeks or longer, even after the original strain or injury should have settled. It may be a constant ache, or it may come and go in flares that seem to arrive with no warning. Either way, it tends to shape how you sit, sleep, work and exercise.
Most long-lasting back pain is mechanical. That means it comes from the joints, discs, muscles and ligaments of the spine rather than from a serious disease. Mechanical pain usually changes with position and activity: worse after a long drive, easier after a short walk, stiff first thing in the morning and looser by midday.
Pain that lasts this long is rarely about one structure alone. Stiff joints, guarded muscles, weak core support and habits built around protecting a sore back can all feed one another. Over time your nervous system can also become more sensitive, so ordinary movement feels more threatening than it really is.
The good news is that chronic does not mean hopeless. Many people with long-standing back pain find that a clear explanation, hands-on care and a gradual return to movement help them do more with less discomfort. The goal is not a quick trick but a plan that you understand and can carry forward.
What can cause chronic back pain
Long-lasting back pain often has more than one contributor. These are some of the most common, along with how they tend to feel.
- Stiff or irritated spinal joints
- The small facet joints along the back of the spine can become stiff and sore. This often feels like a localized ache that is worse when you lean back or twist.
- Disc irritation or bulging
- The discs between your vertebrae can become irritated or bulge with age and strain. Disc-related pain is often worse with sitting or bending and may travel into the buttock or leg.
- Muscle guarding and tension
- Muscles around a sore area may tighten to protect it and then stay tight. That can feel like a band of tension across the low back or a deep knot beside the spine.
- Long hours of sitting
- Desk work and long commutes keep the spine in one position for hours at a time. Many people notice that stiffness builds through the day and eases once they get up and move.
- An old injury that never fully settled
- A lifting strain, sports injury or fall can leave behind stiffness and altered movement habits. Sometimes the original injury healed but the way you move around it did not.
- Age-related changes
- Wear in the discs and joints is common with age and often shows up on imaging even in people without pain. It can contribute to morning stiffness and reduced flexibility.
- Weak core and hip support
- When the deep trunk and hip muscles do not share the load well, the spine can take more strain than it should. This often shows up as fatigue and aching after standing or walking.
How Dr. Okhowat evaluates and treats chronic back pain
Care begins with understanding your back, your history and your goals before any treatment starts.
A detailed history
Dr. Okhowat asks when the pain began, what eases it, what aggravates it and how it affects your days and nights. He also asks about past injuries, other health conditions and any imaging you have already had.
A hands-on examination
The exam looks at posture, how your spine and hips move, muscle tension, strength and reflexes. Simple neurological tests help show whether a nerve may be involved and whether you should be referred for imaging or a medical opinion.
A plan explained in plain language
You will hear what the findings suggest, which options make sense and roughly how progress will be measured. Nothing begins until you understand the plan and agree to it.
Hands-on treatment
Depending on your exam, care may include spinal adjustments, gentle mobilization, soft tissue work or decompression. Techniques are chosen and adjusted for your comfort, and gentler options are available if you prefer them.
Building strength and habits
Treatment is paired with corrective exercises and practical advice on sitting, lifting and sleep positions. The aim is to help you rely less on visits over time and more on what you can do yourself.
What chiropractic care may help with
Every back is different, and results vary from person to person. For many people with mechanical back pain, a conservative plan may help in these ways.
- It may ease stiffness so that getting out of bed or out of the car feels less of an effort.
- It can help improve how freely your lower and mid back bend and rotate.
- Many people find that flares become less frequent once they understand their triggers.
- Strengthening work may help your core and hips share the load the spine has been carrying.
- It offers a non-surgical, drug-free option to try alongside or before other medical care.
- A clear plan can help you return to walking, exercise and work with more confidence.
Is this right for me?
Chiropractic care is often a reasonable option for back pain that is mechanical, meaning it changes with movement and position. It also works well alongside care from your physician, physical therapist or pain specialist.
Some symptoms point to a problem that needs medical attention first. If any of the signs below apply to you, please see a physician or go to urgent care before starting chiropractic treatment.
Often a good fit
- Back pain that has lasted weeks or months and changes with position or activity
- Stiffness that is worse in the morning or after long periods of sitting
- Recurring flares after lifting, gardening, travel or exercise
- People who want to explore conservative care before considering injections or surgery
- Anyone already under medical care who has been cleared for hands-on treatment
See a physician first
- Loss of bladder or bowel control, or new difficulty urinating
- Numbness in the groin, buttocks or inner thighs (saddle area)
- Leg weakness that is getting worse, or a foot that drags or slaps
- Back pain with fever, chills or a recent infection
- Unexplained weight loss or a history of cancer
- Back pain after a significant fall or accident, or a suspected fracture
- Constant pain that does not change with position and is worse at night
If you have any of these, please see a physician or go to urgent care before booking. In an emergency, call 911.
How Dr. Okhowat approaches chronic back pain
Dr. Omid Okhowat earned his Doctor of Chiropractic degree from Cleveland Chiropractic College and has over 19 years of experience. Long-standing back pain is a problem to understand rather than a spot to press on, and his care starts from that idea.
He is a Diplomate of the College of Manipulative and Body Based Practices and a Fellow of the American Association of Integrative Medicine. That training centers on hands-on methods like spinal manipulation and soft tissue work, and on looking at the whole person: sleep, stress, activity and work habits, not just the sore area.
The office is on Wilshire Boulevard just west of Fairfax Avenue, a short drive from Mid Wilshire. If your exam suggests something outside the scope of chiropractic care, Dr. Okhowat will tell you so and suggest the right kind of medical follow-up.
- DC, Cleveland Chiropractic College
- AAIM Fellow
- AAIM Diplomate, Manipulative and Body Based Practices
- Over 19 years of experience
He is phenomenal. I have been having extreme back pain for a few months and have seen several chiropractors. I was about to give up on finding one who could help. Dr Okhowat figured out my issue in minutes and him and his team went above and beyond to make sure I was comfortable. Unbelievable level of service from his office and a wonderful man. Highest of recommendation.
Questions patients ask
Can a chiropractor help with chronic back pain?
Many people with long-lasting mechanical back pain find chiropractic care helpful, especially when it combines hands-on treatment with exercise and education. Clinical guidelines for low back pain list spinal manipulation among the non-drug options worth trying. Your exam will show whether it is a good fit for your situation.
How many visits will I need?
It depends on how long you have had pain, what the exam shows and how your body responds. Dr. Okhowat will give you a rough plan at the start and review your progress regularly. If you are not improving as expected, the plan changes or you are referred elsewhere.
Do I need an X-ray or MRI first?
Most people with back pain do not need imaging right away. Imaging is usually reserved for cases with red flags, significant trauma, nerve symptoms that are getting worse, or pain that is not improving with care. If you already have imaging, bring the reports to your first visit.
Will an adjustment hurt?
Most people feel pressure and movement rather than pain, and many feel looser right afterward. Some mild soreness for a day or so is common, similar to after a new workout. If you prefer not to have quick adjustments, gentler techniques are available.
Is it safe to exercise with chronic back pain?
For most mechanical back pain, staying active is helpful and long bed rest tends to slow recovery. The key is choosing the right kind and amount of activity. Your plan will include movements that suit your current tolerance and build from there.
Can chiropractic care help me avoid back surgery?
Many people with back pain improve with conservative care and never need surgery, but no one can promise that for a specific person. Some conditions do need a surgical opinion, and Dr. Okhowat will tell you if your exam points that way. Conservative care is often a sensible first step when there are no red flags.
What should I do between visits?
Keep moving within comfortable limits, take short breaks from sitting and do the exercises you were shown. Notice what makes your pain better or worse and share it at your next visit. That information helps fine-tune your plan.
Why does my back hurt more in the morning?
Morning stiffness is common with joint-related back pain because the spine has been still for hours. It usually eases as you start moving. Stiffness that lasts for hours, or pain that wakes you every night, is worth mentioning to your physician.