Why Your Back Pain Keeps Coming Back (And What Actually Fixes It)
- Dr. Lucas Marchand
- a few seconds ago
- 4 min read
A patient called me last month convinced something was finally, seriously wrong with her spine. She'd thrown her back out reaching into the dishwasher — not lifting a couch, not falling off a ladder, just reaching into the dishwasher — and she wanted to know what was structurally broken inside her.
Nothing was. That's almost always the answer, and it's almost never the answer people want.
I've been driving a mobile chiropractic clinic around Sioux Falls since 2016, which means I've had this conversation a few thousand times. The pattern repeats with remarkable consistency: someone's back gives out doing something ordinary, they assume the ordinary thing caused it, and they miss the actual cause sitting underneath — months or years of a spine that was never given a reason to stay resilient.
The Dishwasher Isn't the Problem
Here's what nobody tells people about back injuries: the moment of pain is rarely the moment of damage. The damage was already there, accumulating quietly, and the dishwasher just happened to be the final straw.
Most of the back injuries I see in this city don't happen in a gym. They happen in kitchens, in driveways, in the back seat buckling a car seat. The body wasn't braced because it had no reason to expect a demand. A spine that's used to being asked for effort handles a surprise just fine. A spine that's spent a decade avoiding effort treats a dishwasher like a deadlift.
This is why I tell people strength training isn't optional maintenance — it's the actual prevention. Not because lifting weights is virtuous, but because a back that's regularly under load learns what load feels like. It stops treating ordinary reaching and bending as a threat.
Where Most People Go Looking for Answers
When back pain becomes a pattern instead of a one-off, the usual next stop is some combination of imaging, medication, or a series of injections. I understand the appeal — pain wants a fast, specific answer, and a needle feels more serious than a stretching routine.
But the research on this is fairly blunt: for chronic, non-specific back pain, passive interventions consistently underperform compared to approaches that get the body moving again. Relief from an injection, when it comes, tends to be partial and temporary, because an injection treats inflammation — not the years of disuse that let the inflammation take hold in the first place.
Chiropractic care works differently because it isn't trying to mask the signal. The goal of an adjustment isn't to make a joint feel different for an afternoon — it's to restore motion to a joint that's stopped moving the way it should, so the surrounding tissue can stop compensating for it.
What an Actual Visit Looks Like
I don't go straight to the adjustment, and there's a reason for that. Every visit follows a specific sequence — soft tissue work first to reduce muscle tone, targeted stretching second to restore range of motion the nervous system has been protecting, and the adjustment last, once the tissue around the joint is actually ready to let it move.
Skip the first two steps and the adjustment has to work harder for a result that holds for less time. In that order, every time, the joint gets a better shot at staying mobile between visits — which is the entire point.
The Two Things That Actually Move the Needle
Strip away the marketing around back pain and you're left with two things that consistently work:
Movement, applied correctly. Not stretching in the way most people stretch — holding a position and waiting, which triggers a protective reflex and has your nervous system fighting you the entire time. Contract-relax techniques like PIR work with the nervous system instead of against it, which is why they unlock range of motion that passive holding never reaches.
Strength, built consistently. The muscles around the spine — core, glutes, hips — are what keep a joint from being asked to do more than its job. Most of the back pain I treat isn't a structural problem. It's a support problem. Build the support, and the structure stops getting blamed for it.
Everything else — the injections, the imaging, the supplements — has a place, occasionally. But none of it replaces these two things, and most of it is sold as though it does.
What This Looks Like for You
If you're in Sioux Falls and you're tired of a back that flares up doing something unremarkable, the fix usually isn't more rest and more caution. It's the opposite — controlled, consistent loading, paired with care that restores the motion you've lost rather than just numbing the spot where you feel its absence.
That's what a visit with me looks like. I bring the table, the equipment, and ten years of doing exactly this to your home, office, or driveway — no waiting room, no referral, no insurance paperwork to chase down.
Book a visit and let's find out what your back actually needs.
Dr. Lucas Marchand
