Conventional medicine
Triage to exclude serious pathology, manage with NSAIDs and PT, escalate to imaging and pain specialist if persistent past 6 weeks.
Movement-first / holistic
Treat the spine as a load-bearing structure that needs capacity, not protection. Build stiffness on demand, train the hinge, and accumulate daily walking volume.
History, neuro exam, red-flag screen (cauda equina, fracture, infection, malignancy). Straight-leg raise.
Identify pattern: flexion-intolerant (sitting/bending worse) or extension-intolerant (standing/walking worse). Screen red flags first.
McKenzie extension or flexion-bias program, core stabilization, manual therapy, lumbar traction. NSAIDs PRN.
Curl-up, side plank, bird dog. Built for spine endurance, not flexibility. Daily 10–15 min.
X-ray for fracture / spondy; MRI if radicular symptoms, persistent pain, or pre-procedural planning.
Glute bridges, hip hinge drills, kettlebell deadlifts, RDLs. 8–12k daily steps. Breath work (90-90, crocodile breathing).
Epidural steroid injection (ESI) for radicular pain; facet blocks or RFA for facet-mediated pain. Medication management.
Kettlebell swings (Simple & Sinister), farmer carries, get-ups. Functional Range Conditioning (Spina) for spine CARs.
Microdiscectomy (radicular pain w/ herniation), laminectomy (stenosis), fusion (instability / spondy). Last resort.
McGill Big 3 daily. Swings or deadlifts 2–3x / week. 8–12k steps. Stand more, sit less.
Every step has a price.
Here’s what we found.
We called clinics across Austin and pulled cash-pay quotes. Click any tile for the full provider list, phone numbers, and last-verified dates.
Who built
track B.
Consolidated from what these coaches, PTs, and researchers publish, with edits where peer-reviewed work disagrees.
"The Big 3 build spine endurance, not flexibility. Stop stretching a sore back."
"The swing is the closest thing to a magic pill for the back." Simple & Sinister program.
Hip hinge mechanics, lumbar bracing, deadlift form for backs. Practical PT for lifters.
Controlled articular rotations (CARs) for spine. Joint-by-joint mobility owned through active range.
- ACP Clinical Practice Guideline · LBPSpecialty body
- JAMA · Imaging for LBPMeta-analysis
- Cochrane · ESI for radiculopathySystematic review
- Stuart McGill · backfitpro.comPhD spine biomechanics
- Pavel Tsatsouline · StrongFirstStrength coach
- Squat University (Horschig)PT · 4.2M
- Andreo Spina · FRCSports chiro / mobility