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Lower Back Pain
Treatment in Overland Park, KS · Dr. Ladd Carlston
What it feels like
Ache across the lower back or SI joint area. Stiffness after sitting that eases once you move. Sharp pain when bending forward or picking things up. Pain that gets worse as the day goes on. Tightness that stretching only helps temporarily. Feeling like your back "locks up" after long drives.
What’s actually causing it
Here's what I see in my office every single day: someone comes in pointing at their "lower back" and what they're actually pointing at is their SI joint. The muscles across that area are working overtime — not because they're weak, but because the glutes aren't doing their job. And the glutes aren't doing their job because the hip flexors — specifically the psoas and iliacus — are locked tight. Think of it like static on a radio signal. Tight hip flexors create interference that prevents the glutes from firing properly. So the low back has to do the heavy lifting — literally. Every time you walk, stand up, or push forward, your back is doing the extension work that your glutes should be handling. I used to give people stretches for this. Didn't help. What actually works is deep myofascial release of the psoas, iliacus, and QL. Once those hip flexors release, the "static" clears, the glutes wake up, and the low back can finally stop overworking.
How I treat it
I test the muscles around the affected area individually, find which ones aren’t firing, and reset the connection using gentle techniques. No cracking, no popping.
How long it takes
Most patients feel a difference after one session. Chronic cases typically resolve in 4–6 sessions.
Why Stretching Your Back Doesn't Fix It
You stretch, it feels better for an hour, and then you're right back where you started. That's because your back isn't the problem — it's the victim. The psoas muscle runs from your lumbar spine through your pelvis to your femur. When it's chronically tight, it creates axial compression — it literally squeezes your spine and SI joint together. Your back muscles tighten in response, trying to stabilize against that compression. Stretching the back loosens the symptom but doesn't touch the cause.
The Hip Flexor–Glute Connection Nobody Checks
Here's the thing nobody checks: your glutes. Not whether they're strong — whether they're actually firing when they need to. A tight psoas inhibits glute activation. It's not a strength problem, it's a communication problem. Your brain sends the signal to fire, but the tight hip flexor creates enough interference that the glute doesn't respond properly. So your body finds a workaround — your low back extensors take over the job of driving your body forward. They weren't designed for that. They fatigue, they tighten, they hurt. And the cycle continues.
What I Actually Do
I start by testing your glutes and hip flexors individually with manual muscle testing. Almost every low back patient I see has inhibited glutes and locked-down psoas and iliacus. From there, it's deep myofascial release — hands-on work into the psoas, iliacus, and QL to break up the chronic tension. This isn't a massage. It can be uncomfortable because these muscles are deep and they've been tight for a long time. But once they release, the change is immediate. Your glutes start firing again, the compression on your spine decreases, and your back muscles can finally relax.
What to Expect
Most patients feel a significant difference after the first visit — the relief from releasing the psoas is often dramatic. Full resolution depends on how long the pattern has been running. If you've been sitting at a desk for 10 years, those hip flexors are deeply entrenched. Expect 4–6 visits for meaningful, lasting change. I'll also show you how to maintain the release at home — not stretches (those didn't work, remember?) but specific positions and movements that keep the psoas from locking back down.
“I had been suffering for years and was unsuccessfully treated by others. In one visit, Dr. Ladd was able to find and address the real issue.”
Patient review · Lower Back Pain patient
Techniques I use for lower back pain
Common questions
Is it actually my SI joint and not my lower back?
Probably. Most people point at their SI joint when they say "lower back." The muscles across that area are overworking because of hip flexor tightness and glute inhibition. I'll tell you exactly what's happening on your first visit.
Why didn't stretching help?
Because the problem isn't tightness in your back — it's tightness in your hip flexors. Your back is just compensating. Deep myofascial release of the psoas and iliacus is what actually changes things.
How long until I feel better?
Most people feel a noticeable difference after the first visit. Lasting change takes 4–6 visits as the hip flexors learn to stay released and the glutes retrain.
Will you crack my back?
No. My approach is deep soft tissue work — releasing the psoas, iliacus, and QL — combined with muscle testing to make sure the glutes are firing. No popping, no cracking.
Does sitting cause this?
It's a major contributor. Sitting keeps your hip flexors shortened for hours. Over years, they lock down and stop releasing fully. That's why this is so common in desk workers.
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