Chronic back pain is back pain that has lasted beyond about twelve weeks, or keeps coming back, and treating it means establishing what is sustaining it, not just where it hurts. At Richter Family Chiropractic in Corona, that starts with an examination of the joints, discs, muscles and nerves involved, for anyone whose back pain has persisted or never fully left. Most back pain is mechanical, and most mechanical back pain has options that do not begin with medication or surgery.
Back pain is one of the most common reasons anybody sees a doctor of any kind — and one of the most commonly treated without anyone establishing what is actually causing it.
There are broadly two approaches people try first. One is to wait it out with rest and anti-inflammatories, which is reasonable for a recent, mild strain and does resolve some episodes. The other is to manage the symptom with medication or injections, which can make daily life workable while you work out what is wrong.
Neither of those establishes the cause. That is the gap this practice is built to close: examine the spine, work out which structures are actually involved, and treat those. If your back pain has come back repeatedly, or never fully left, the cause is the part that has not been addressed yet.
Chronic back pain is not simply acute back pain that lasted longer. Once pain has been present beyond about twelve weeks, it is usually being sustained by more than whatever started it. The original strain or disc irritation may well have settled, while the things that grew up around it have not: guarded movement patterns that were protective at first, loss of strength and mobility in the muscles that support the segment, a daily postural load that never changed, and an area that has been producing pain signals for months. A treatment aimed only at the original tissue often disappoints in a long-standing case, and that is usually why.
It does not mean the cause is unfindable. Long-standing back pain generally has several contributors at once — a mechanical restriction, an irritated disc or facet joint, deconditioned supporting muscle, inflammation, and a daily load that keeps provoking all of them. A single therapy aimed at one of those can produce partial, temporary relief and get written off as a failure, when the more accurate reading is that it addressed one contributor out of four. Establishing the whole set is what a proper examination is for, and it is the step most often skipped in a back that has already been looked at several times.
Chronic describes how long the pain has been present. It is not a verdict on what can be done about it. What it does mean is that the plan has to be broader than a single modality, and has to include the part that happens outside this office — the strength, mobility and postural work that holds any change in place. What is realistic for your particular back is something you should be told after an examination of it, not before one.
Most back pain traces to one or more of the following — and most patients have several contributing at once, which is why single-mode treatment so often falls short.
Restricted joints, alignment problems and muscle imbalance built up from posture and habit. The most common category, and the one adjustment is aimed at.
About chiropractic care →A herniated, bulging or degenerating disc causing direct pressure on a nerve or altering the mechanics of the segment.
About disc problems →Strained muscle, sprained ligament, or scar tissue left behind by an old injury that never fully rehabilitated.
About physiotherapy →Low-grade inflammation that amplifies every other source of pain present. Often the reason a minor mechanical problem hurts disproportionately.
About laser therapy →Desk work, phone posture, sleep mechanics and repetitive movement at work. Frequently the reason an episode keeps recurring after treatment ends.
Where back pain travels into the buttock or leg, a nerve is usually involved — which changes both the diagnosis and the plan.
About sciatica →Back pain is usually described by where it sits and how long it has been there. Both matter, because they change what treatment is appropriate.
Most back pain is not urgent. These symptoms are, and they need immediate medical evaluation rather than an appointment here:
These can indicate spinal infection, fracture or cauda equina syndrome — all of which need emergency assessment. Go to the emergency room.
The first visit is a full evaluation — history, postural examination, range-of-motion and neurological testing, and imaging where it is clinically indicated. You should leave it understanding what is causing your back pain. What follows is built from that, not applied to everybody.
You will be given an expectation of how your case should progress, and re-evaluated against it. If it is not tracking, the plan changes — or you get referred. We are not interested in keeping anybody on a plan that is not working.
Dr. Matthew Richter, DC has been in practice since 1997, with certification in Class IV laser and spinal decompression.
Adjustment, decompression, laser, ShockWave, EMTT and physiotherapy are all available here and coordinated into a single plan.
The examination is aimed at establishing what is driving your back pain, because that is what determines whether it stays gone.
Where a conservative approach is appropriate for your case, that is where we start.
Not every back is a chiropractic case. Where another specialty is the better fit, we will say so and refer.
Whether your back pain is recent or has been with you for years, it starts with a real evaluation — what is causing it, and what the realistic options are.
Book My New Patient Exam →Because it describes what you feel, not what is wrong. Back pain is one of the most common reasons anybody sees a doctor of any kind, and one of the most commonly treated without anyone establishing what is actually causing it. Resting with anti-inflammatories is reasonable for a recent, mild strain. Medication or injections can make daily life workable. Neither establishes the cause, and the cause is the part that determines whether the pain stays gone.
Most back pain traces to one or more of the following: mechanical dysfunction from restricted joints, alignment problems and muscle imbalance; disc injury; soft-tissue injury such as a strained muscle, sprained ligament or scar tissue from an old injury that never fully rehabilitated; low-grade inflammation that amplifies every other source of pain present; posture and daily load from desk work, phone posture, sleep mechanics and repetitive movement; and nerve involvement where the pain travels into the buttock or leg. Most patients have several contributing at once, which is why single-mode treatment so often falls short.
A full evaluation — history, postural examination, range-of-motion and neurological testing, and imaging where it is clinically indicated. You should leave it understanding what is causing your back pain. The new patient examination fee covers that visit and a second one, where your doctor reviews the findings and lays out what is recommended. Treatment begins at the second visit, and only if you agree to the plan.
Yes, because it changes what treatment is appropriate. Under six weeks is acute — a recent injury from lifting, sleeping awkwardly or a fall. Six to twelve weeks is sub-acute, an injury that has not fully resolved, and the point at which it is worth acting. Beyond twelve weeks is chronic, meaning persistent or recurring pain that usually needs a broader approach than a single therapy.
One who will examine what is sustaining it, because chronic back pain — beyond about twelve weeks — usually has several contributors at once: a restricted joint, a disc, weakened supporting muscle, inflammation and daily postural load. A Doctor of Chiropractic is one conservative, drug-free option for that kind of mechanical pain. Not every back is a chiropractic case, and where another specialty is the better fit, we will say so and refer.
For mechanical back pain — the kind caused by joint irritation, disc problems, or muscle strain — a Doctor of Chiropractic (DC) is a good first option because care is hands-on and drug-free. If back pain comes with fever, follows a trauma, or is accompanied by loss of bladder or bowel control, go to an emergency room first. At Richter Family Chiropractic in Corona, Dr. Richter is a DC; depending on your exam findings, care may include spinal adjustments, decompression, Class IV laser, Storz shockwave (radial or focused), or EMTT therapy.
For most lower back pain, a conservative, non-drug approach is the recommended place to start — the American College of Physicians' 2017 low back pain guideline lists spinal manipulation among the first non-drug options. A Doctor of Chiropractic provides that, along with examination of the lumbar joints, discs and nerves. Here it can be combined with spinal decompression where a disc is involved, Class IV laser and rehabilitation. Where your findings point elsewhere, you are referred.
What goes into your plan is built from your examination rather than applied to everybody. Chiropractic adjustment is the starting point for most mechanical back pain. Spinal decompression is used where a disc is involved. Class IV laser therapy is directed at the inflammatory and soft-tissue component, particularly where pain is out of proportion to the mechanical findings. ShockWave, which is Storz Medical acoustic wave therapy, is used for long-standing soft-tissue problems and stubborn trigger points. EMTT, a contact-free pulsed electromagnetic field therapy, is used alongside those rather than in place of them. Physiotherapy and postural correction are the parts aimed at recurrence.
Pain that has been present beyond about twelve weeks. Under six weeks is described as acute, six to twelve as sub-acute, and past twelve as chronic. The distinction is not bureaucratic — it changes what is likely to be driving the pain, and therefore what treatment is appropriate. A lifting strain from last week and a five-year ache in the same spot are not the same problem, even when they hurt in the same place.
Usually more than one thing at once, which is the part that makes it stubborn. The original mechanical problem — a restricted joint, an irritated disc or facet, a strained muscle — may still be present, or may have settled while what grew up around it did not: guarded movement patterns, loss of strength and mobility in the muscles that support the segment, low-grade inflammation, and a daily postural load that never changed. That is why treatment aimed at a single contributor can give partial relief and then stall. Establishing which of them apply to you is what the examination is for.
This page will not promise you an outcome, and an office that does so before examining you is guessing. What can be said is that chronic describes how long the pain has been present rather than what can be done about it, and that a long-standing case is rarely resolved by one therapy applied on its own. How it is approached here: establish which contributors are actually present, treat those rather than the label, and build in the strength, mobility and postural work that holds a change in place. You are given an expectation of how your case should progress and re-evaluated against it. If it is not tracking, the plan changes, or you get referred.
Not automatically. Imaging is decided case by case rather than ordered by default, and the first visit is a history, postural examination, and range-of-motion and neurological testing, with imaging where it is clinically indicated. If you have already had an MRI, bring the written radiology report — your doctor reviews it alongside the examination findings and gives you a plain-language explanation of what it says, since those reports are written for clinicians. One thing worth knowing about scans in long-standing back pain: an image shows structure, not pain, and findings turn up on scans in people with no symptoms at all. That is why the examination matters as much as the picture.
Often because the daily load that produced it has not changed. Desk setup, lifting mechanics, phone posture and sleep position are what most commonly bring an episode back after it settles. Correcting that is part of the plan rather than an afterthought, and the home exercise program is what carries it between visits.
Most back pain is not urgent. These symptoms are, and they need immediate medical evaluation rather than an appointment here: loss of bladder or bowel control, numbness through the saddle area of the inner thighs and groin, progressive weakness in a leg, severe pain immediately following a fall or other trauma, back pain accompanied by fever, or sudden severe pain unlike anything you have experienced before. These can indicate spinal infection, fracture or cauda equina syndrome.
You are given an expectation of how your case should progress, and re-evaluated against it. If it is not tracking, the plan changes, or you get referred. Not every back is a chiropractic case, and where another specialty is the better fit, we will say so.
