Back Pain
The lower back twinges when you stand up. Bending is hard. Maybe it pulls into the leg, maybe it's a dull, constant ache that hasn't gone away for weeks. Maybe you've taken painkillers, tried heat patches, rested — and it isn't getting better.
Back pain is the single leading cause of physical disability worldwide. In 2020 it affected 619 million people, and around 90% of all cases are non-specific — meaning there is no dangerous underlying disease, but rather a mechanical dysfunction of the spine and surrounding musculature (GBD 2021, Lancet Rheumatol, 2023). And that is exactly what can be treated.
At American Chiropractic Haus in Munich-Bogenhausen, we look specifically for the cause of your back pain — and treat it. No referral needed. Same-week appointments available.
What to do about lower back pain?
The first step is not treatment — it is finding the cause. Back pain is a symptom, not a diagnosis. The same complaint can come from a restricted facet joint, an overloaded disc, a dysfunction of the sacroiliac joint (SIJ), tense musculature or poor posture — often several at once.
With us, every treatment begins with a thorough examination: case history, orthopaedic and neurological tests, assessment of the entire spine, the pelvis and overall posture. Only once it is clear where the pain is coming from does targeted treatment begin.
The good news: the vast majority of back pain — whether acute or chronic, whether from the joint, the disc or the musculature — can be treated conservatively, without surgery and without long-term medication.
What types of back pain are there?
Non-specific (mechanical) back pain
By far the most common — around 90% of all cases. There is no single structural cause such as a disc herniation, but rather an interplay of restricted joints, muscular tension and faulty loading. It sounds harmless but can be very painful. Usually responds very well to chiropractic treatment.
Acute back pain
Sudden onset, often after a movement, a lift, or with no identifiable trigger. The classic "lumbago" belongs here. Acute back pain is usually mechanical and often responds quickly to treatment. → More on our Acute Back Pain page
Chronic back pain
Pain lasting longer than twelve weeks or recurring repeatedly. Here it is not only about acute relief, but about the long-term restoration of mobility and function — and the question of which loading and postural patterns keep the pain going.
Pain radiating into the leg (sciatica)
When pain pulls from the lower back into the buttock or leg, the sciatic nerve is often involved — irritated by a disc, a restricted SIJ or tense musculature. → More on our sciatica page
Disc-related back pain
A bulging or herniated disc can cause pain in the back and the leg. Most disc herniations can be treated conservatively — surgery is needed less often than many think. → More on our disc herniation page
Upper back and neck pain
Tension and restrictions of the thoracic and cervical spine — frequently from prolonged sitting and screen work. → More on our neck pain page
Red flags — when to see a doctor first
The vast majority of back pain is mechanical and benign. But some signs require medical assessment first — not a chiropractic appointment:
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Paralysis, true sensory loss or strength loss in a leg → neurological assessment
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Numbness in the saddle region or problems with urination / bowel movement → emergency (cauda equina syndrome), immediately to the emergency department
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Back pain with unintended weight loss, loss of appetite or night sweats → medical assessment
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Severe, non-movement-related night pain → medical assessment
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Back pain after a fall or accident → exclude fracture
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Back pain with fever → exclude infection
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Personal or family history of cancer or inflammatory disease (e.g. rheumatic conditions) → medical assessment first
In these cases, medical assessment is required first — not a chiropractic appointment.
Important: if there is a reason for imaging (trauma, osteoporosis risk, red flag symptoms), we work closely with your doctor to establish clarity before beginning treatment — or we adapt our methods to be safe.
What to do about acute back pain — immediately
What helps in the short term
Stay moving — this is the most important point. The old advice of bed rest is outdated; gentle movement promotes healing. Heat relaxes the musculature. Find positions that ease the pain, and temporarily reduce the movements that provoke it, without stopping entirely.
What does not help
Days of rest and bed rest — they weaken the musculature and prolong the symptoms. Painkiller-only therapy without addressing the cause. And ignoring recurring episodes in the hope it "will just go away" — with recurring pain especially, early clarification of the cause is worthwhile.
What almost nobody does — but should
Have the cause assessed instead of just dampening the symptom. Someone on their third bout of lumbago in a year does not have a painkiller problem, but a mechanical problem that can be treated.
What's involved in behind back pain?
The interplay of joint, disc and muscle
The lumbar spine bears much of the body's weight while also allowing movement in all directions. When individual facet joints become restricted, the movement pattern changes: other segments and the surrounding musculature have to compensate, tense up, and a vicious cycle of pain, guarded posture and further restriction develops. Chiropractic treatment addresses exactly this point — restoring normal joint function and mobility.
The role of the pelvis and the SIJ
The sacroiliac joint connects the spine and the pelvis and is a frequently overlooked source of lower back pain. A dysfunction here can cause pain that mimics a disc problem. This is why we always examine the entire pelvis as well.
Posture, sitting and modern daily life
Prolonged sitting, screen work and lack of movement are the most common loading factors for the lower back. They lead to muscular imbalances and altered posture. A large part of treatment therefore aims not just at acute relief, but at correcting these underlying patterns.
Why the pain comes back
An important, honestly stated fact: around 70% of people who recover from an episode of back pain experience the next one within a year (GBD 2021, Lancet Rheumatol, 2023). A single treatment can have a powerful effect — but without addressing the cause, the pain often returns. This is precisely why we work with a treatment plan, not single appointments.
How does a chiropractor in Munich treat back pain?
What does the research say?
Rubinstein et al., BMJ, 2019 (PMID 30867144) — Systematic review and meta-analysis: for chronic back pain, chiropractic spinal manipulative therapy (SMT) is as effective as the standard therapies recommended in clinical guidelines — with a comparable safety profile. The observed adverse events were predominantly musculoskeletal, transient and mild to moderate.
de Zoete, Rubinstein et al., Cochrane Database Syst Rev, 2026 (PMID 41494147) — Updated Cochrane review of spinal manipulation for chronic back pain — the most current systematic assessment of the evidence.
Gevers-Montoro et al., JOSPT, 2025 — Network meta-analysis: the effectiveness of spinal manipulation does not depend on whether a specific vertebra is targeted for "putting back in place." This argues against the widespread idea that there is one restricted vertebra that must be "reset" — the effect arises through the nervous system, not through a single mechanical point.
GBD 2021, Lancet Rheumatol, 2023 — Back pain is the world's leading cause of years lived with disability; around 90% of cases are non-specific and therefore treatable conservatively.
How we treat back pain at American Chiropractic Haus:
Phase 1 — Acute phase: out of pain
First the thorough examination: case history (trigger, course, accompanying symptoms, previous treatments), orthopaedic tests, neurological tests to exclude nerve involvement, assessment of the mobility of the lumbar spine, pelvis/SIJ and overall posture. Most back pain can be diagnosed directly in the practice this way — without imaging.
What we do in this phase:
Chiropractic adjustments. Targeted correction of restricted vertebral and SIJ joints restores normal mobility and breaks the pain-tension cycle. Adjustment is performed, depending on findings and patient, by hand or with the Activator instrument — a gentle, controlled technique (PMID 12975628) particularly suited to sensitive or anxious patients.
Soft tissue therapy. Releasing the tense and overloaded musculature around the spine and pelvis — myofascial techniques and trigger point treatment.
Treating the whole chain. Back pain rarely arises at an isolated point. We treat the functional connections — pelvis, thoracic spine, hip — not just the painful spot.
In the acute phase the patient is largely passive. The body is treated, the pain reduced.
Honestly stated: many patients feel significantly better after just one or two treatments. But: in the first weeks, a relapse is common — the body needs time to consolidate the new movement pattern. This is why we recommend a treatment plan of around 4–6 sessions for acute back pain, rather than stopping after the first improvement.
Phase 2 — Rehabilitation: making the back resilient again
When the acute pain subsides, the rebuilding begins.
Targeted core stabilisation exercises. The deep trunk and back musculature stabilises the spine. In back pain patients it is often weakened or poorly coordinated. We specifically train the neuromuscular control — including with DNS-based exercises.
Restoring full mobility. Pain-free movement in all directions is the goal — not just freedom from pain at rest.
Correcting loading patterns. We analyse which movements and postures in daily life overload the back, and correct them specifically.
Phase 3 — Prevention: so the pain does not return
Given the high recurrence rate, prevention is not an optional extra but part of the treatment.
An individual home exercise programme — tailored to your specific weak points and daily life.
Ergonomic advice — workplace, sitting posture, lifting technique, sleeping position.
Maintenance treatment in chronic cases. Patients with chronic back pain often need regular check-up appointments — monthly or bi-monthly — to maintain the restored mobility. How often depends on lifestyle, age and fitness. The goal is not dependence on treatment, but a stable, resilient back with as few appointments as necessary.
Chiropractor, orthopaedist, physiotherapist — what's the difference?
One of the most common questions. In short:
The orthopaedist is a medical specialist, makes medical diagnoses, can order imaging, prescribe medication and perform surgery. For suspected serious structural causes, this is the right address.
The physiotherapist usually treats on medical referral and works mainly with active exercises, strengthening and accompanying manual therapy.
The chiropractor specialises in the function of the spine and joints. The focus is on the manual restoration of joint mobility (adjustment), supplemented by soft tissue therapy and rehabilitation. You do not need a referral.
The three are not mutually exclusive — on the contrary. When needed, we work together with orthopaedists and physiotherapists.
When to see a chiropractor for back pain?
Come in if:
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you have acute back pain (lumbago, "put your back out")
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your back pain has lasted for weeks or keeps recurring
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the pain is movement-dependent (better/worse depending on posture)
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you feel tension and restricted movement in the lower back
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the pain radiates into the buttock or leg (after exclusion of serious nerve involvement)
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you get symptoms after prolonged sitting or one-sided loading
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you have had repeated bouts of lumbago and want to clarify the cause
When to see a doctor first
For the red flags above: hard neurological deficits, bladder/bowel dysfunction, unintended weight loss, night pain, trauma, fever, cancer or rheumatic history. In these cases we clarify, where necessary, together with your doctor before beginning treatment.
FAQ — Common Questions About Acute Back Pain
What does a chiropractor do for back pain?
First a thorough examination to find the cause — orthopaedic and neurological tests, assessment of spine and pelvis. Then targeted treatment: chiropractic adjustment of restricted joints, soft tissue therapy of the tense musculature and, in the second phase, rehabilitation exercises. The goal is not just pain relief, but the restoration of normal function and the prevention of relapses.
Is a chiropractor good for back pain?
For mechanical and non-specific back pain — around 90% of all cases — yes. A systematic review in the BMJ (Rubinstein et al., 2019) showed that chiropractic spinal manipulation is as effective for chronic back pain as the standard therapies recommended in guidelines. The prior assessment is important: with red flags or suspicion of a serious cause, medical diagnosis comes first.
How long does it take for chiropractic to work?
Many patients feel a marked improvement after just one or two treatments. But this can be deceptive: in the first weeks a relapse is common, because the body must first consolidate the new movement pattern. This is why we recommend a plan of 4–6 sessions for acute complaints. With chronic back pain it is more about long-term maintenance with regular check-up appointments.
What is the difference between an orthopaedist and a chiropractor?
The orthopaedist is a medical specialist — they diagnose, order imaging, prescribe medication and perform surgery. The chiropractor specialises in the function and mobility of the spine and joints and treats manually, without medication or surgery. For serious structural causes the orthopaedist is responsible; for mechanical dysfunction the chiropractor. The two often complement each other.
Which is better — a physiotherapist or a chiropractor?
It is not an either-or question. The physiotherapist usually works on referral and focuses on active exercises and strengthening. The chiropractor focuses on the manual restoration of joint mobility through adjustment, supplemented by rehabilitation. For acute, movement-dependent restrictions the chiropractic adjustment often works quickly; for long-term rebuilding, active training is decisive. Often the combination is ideal.
Can a chiropractor release a blockage?
Yes — releasing restricted joints is a core competency of chiropractic. An important clarification: a recent network meta-analysis (Gevers-Montoro et al., JOSPT, 2025) shows that the effect does not depend on hitting one single, very specific vertebra. The idea of the one "slipped" vertebra that must be reset is simplistic — the effect of the adjustment arises through the nervous system and the restoration of mobility, not through a single mechanical point.
When should you not go to a chiropractor?
With acute red flags: hard neurological deficits (paralysis, strength loss in the leg), bladder or bowel dysfunction, unintended weight loss, severe night pain, fresh trauma, fever, or a known cancer or inflammatory disease. In these cases, medical assessment comes first. With osteoporosis or increased fracture risk we do not refuse treatment outright, but adapt our methods to the reduced bone density — gentle techniques instead of forceful manipulation.
Can you go to a chiropractor with osteoporosis?
Yes, with adapted caution. Forceful manipulation techniques are not suitable with reduced bone density, but gentle, controlled methods — such as the Activator technique and soft tissue work — can be sensible and safe for osteoporosis patients. The prerequisite is that we know the diagnosis. With known or suspected osteoporosis we coordinate with your doctor before beginning treatment.
Can back pain affect blood pressure?
Pain and tension can temporarily raise blood pressure — this is a normal stress response of the body and applies to any severe pain, not just the back. However, an idea circulating online is misleading: there is no single "vertebra responsible for blood pressure" whose treatment permanently regulates it. For high blood pressure, internal medical assessment and management is the right address. What chiropractic can do is treat the pain and tension cause — which indirectly contributes to relaxation.
Discover which therapist fits you best:
Also relevant: [Acute Back Pain →] | [Disc Herniation →] | [Hip Pain →]