Back Pain Relief
in Bethesda, MD

Lower back pain has several common sources, and the right treatment depends on identifying which one is driving yours. The most frequent cause is muscle strain: an overstretched or torn muscle from a sudden movement, heavy lift, or poor posture held too long. Lumbar disc issues occur when the cushioning discs between vertebrae bulge or herniate and press on a nearby nerve root. Sacroiliac joint dysfunction affects the joint where the lower spine meets the pelvis, a common and often overlooked cause of one-sided low back pain. Facet joint irritation involves the small joints at the back of each vertebra, which can become inflamed or restricted. Dr. Helms evaluates all of these structures at your first visit rather than treating your back pain as a single category.

Upper back pain usually starts in one of three places: the thoracic spine, the rib joints, or the large muscles between the shoulder blades. The thoracic spine connects to the ribs and can become restricted with surprisingly little provocation. The shoulder blade muscles, including the rhomboids and trapezius, often carry tension from hours of sitting, screen time, or a workstation that isn't quite set up right. Stress and shallow breathing add to the load. Dr. Helms evaluates which structures are involved, whether the issue is joint-based, muscle-based, or both, and addresses them accordingly.

Yes. Spinal manipulation, also called a chiropractic adjustment, is one of the most well-studied treatments for both acute and chronic back pain. It restores movement in restricted vertebrae, reduces local inflammation, and can provide meaningful relief, often within a few sessions. At Helms Performance, chiropractic care is paired with physical therapy, which means Dr. Helms addresses the joint restriction and the muscle weakness or movement problem that caused it together, rather than one or the other. That combination is what tends to produce more lasting results than either discipline alone.

Several factors affect women specifically. The sacroiliac joint, where the lower spine meets the pelvis, is wider in women and more mobile, making it more prone to dysfunction and pain. Hormonal changes during the menstrual cycle can increase ligament laxity and contribute to low back aching. Pregnancy and postpartum recovery place significant strain on the lumbar spine and pelvis, often leaving the deep stabilizing muscles in a weakened state that persists long after delivery. Other causes, including disc issues, muscle strain, and facet joint irritation, affect men and women equally. Dr. Helms takes a full history to identify which factors are most relevant to each patient's situation.

It depends on how long the pain has been present and what is driving it. Acute back pain from a recent strain often responds quickly, with meaningful improvement in 4 to 6 sessions. Chronic pain that has been present for months or years typically takes longer, as there are often layers of muscle compensation and habitual movement patterns that need to be addressed alongside the original injury. After your first visit, Dr. Helms will give you a realistic timeline, not an open-ended treatment plan that keeps you coming back without a clear goal.

Treatment starts with finding the specific source of your back pain, not just the location of it. Depending on your assessment, this may include spinal adjustments (a hands-on technique that restores movement in restricted vertebrae and reduces nerve irritation), Active Release Technique (a massage and movement-based technique that treats problems with muscles, tendons, ligaments, fascia, and nerves), dry needling (targeting trigger points and overactive muscle tissue), and physical therapy exercises to rebuild stability and address the movement habits that contributed to the pain. Dr. Helms works one-on-one with every patient and adjusts the plan as you progress.