Case Study: Chiropractic Treatment of the Mid Back for Low Back Pain and Hip Flexion Dysfunction

Getting Back to Pain-Free Movement

We’ve all been there—one moment, you’re moving just fine, and the next, a sharp, nagging pain makes even simple movements unbearable. That’s exactly what happened to one of our patients, who came in with mysterious low back pain that made bending, lying down, and even lifting a knee a challenge. Luckily, with a little chiropractic detective work and the right adjustments, Dr. Harrell helped them get back to pain-free movement. Let me share with you their story.

Patient Overview

A patient came to Bear Paw Chiropractic with unexplained low back pain that worsened with:

• Bending forward
• Lying flat on their back
• Lifting their right knee

The pain had been persistent for one day before they sought chiropractic care.

Pinpointing the Problem: Assessment & Care Plan

Once the patient arrived at Bear Paw Chiropractic, it was time to play detective. What exactly was causing this sudden, disruptive pain? After a thorough assessment of movement and restrictions, Dr. Harrell found three major pain triggers:

• Bending forward: The simple act of reaching down worsened discomfort.
• Sleeping flat on their back: Resting should bring relief, not pain.
• Lifting the right knee: Even small movements became a struggle.

What Dr. Harrell Discovered:

Upon further evaluation, Dr. Harrell identified two key problem areas:

Sacrum (base of the spine) – Restrictions here can lead to low back pain and movement limitations.

Left hip extension – A lack of mobility in the left hip may have been overloading the lower back.

The Game Plan for Recovery

With these findings, Dr. Harrell designed a customized treatment approach to relieve pain and restore mobility:

• Spinal traction with Back on Trac: A gentle, non-invasive way to decompress the spine and reduce tension.
• Targeted chiropractic adjustments: Focusing on the sacrum and improving left hip extension mobility.
• Arthrostim adjustments for the lumbar spine: A precise, instrument-assisted technique to enhance alignment without side posture manipulation.

By addressing these restrictions directly, the goal was to restore proper movement and alleviate pain as quickly as possible. The next step? Fine-tuning the adjustments for even better results.

Fine-Tuning the Treatment: Visit 5 Insights & Adjustments

By the fifth visit, it was time to take a deeper dive into hip mobility and spinal alignment to pinpoint what was still holding this patient back from full relief.

Assessing Hip Extension: Finding the Root of the Problem

With the patient lying face down on the table, Dr. Harrell assessed hip extension—one leg at a time.

Right Leg: Moved freely with no pain
Left Leg: Tight, restricted, and painful

This imbalance hinted at a deeper issue. Something higher up the spine was likely contributing to the dysfunction.

Pinpointing the Key Problem Area

Through careful movement testing, Dr. Harrell identified a crucial factor:

• The T9/T10 vertebral segment on the right side was the provocative segment—meaning, when gentle mobilization was applied to that area, the patient’s pain disappeared.

This discovery meant that restricted motion in the mid-back (thoracic spine) was creating a chain reaction, ultimately limiting hip extension and causing low back pain.

Customized Mobilization & Real-Time Adjustments

Using the Arthrostim with a ball attachment, Dr. Harrell applied precise spinal mobilization to improve movement while the patient actively lifted their right leg into extension.

• The patient was asked after every adjustment whether the pain was:
  Better, Worse or the Same

Dr. Harrell continued fine-tuning the mobilization until the patient could extend the leg pain-free.

The Breakthrough Moment: Immediate Relief

After three targeted repetitions of left hip extension while holding the mobilization, the patient experienced a major shift.

• Pain-free movement during hip extension
• Increased flexibility
• Marked improvement in mobility

This visit was a game-changer. With one key adjustment, Dr. Harrell unlocked significant pain relief and restored mobility. The next step? Reinforcing these results through continued care and movement retraining.

Tracking Progress: Follow-Up Care & Long-Term Results

With the breakthrough moment achieved on Visit 5, the focus shifted to reinforcing the improvements and ensuring long-term mobility.

Building on Success: Ongoing Treatment Plan

To maintain and expand the patient’s progress, we continued a structured approach based on assessment, mobilization, and re-evaluation using the Mulligan Concept, a proven method that combines hands-on mobilization with active movement.
Key Treatment Components:

• Spinal Mobilization using the Arthrostim gun across the lumbar, thoracic, and cervical spine
• Progressive adjustments to reinforce pain-free movement
• Reassessment at every visit to ensure lasting improvements

Test & Retest: The Power of Measurable Progress

Each visit included movement testing to confirm continued relief. By tracking the left hip extension over time, we saw steady, measurable progress.
Final Outcome After 20 Days & 8 Total Treatments:

• 0/10 pain with full right hip flexion
• Full range of motion restored
• No restrictions in movement

This case highlights the effectiveness of targeted chiropractic care in addressing low back pain, hip mobility issues, and spinal dysfunction. With a combination of precision adjustments, movement-based treatment, and real-time feedback, we were able to eliminate pain and restore function—without invasive procedures or medications.

Final Outcome & Lasting Results

After just three additional visits focused on mobilization and movement, the patient achieved:

• Complete resolution of hip flexion pain
• Full range of motion restored (0/10 pain with right hip flexion)
• Significantly reduced lower back pain and improved mobility

This wasn’t just about pain relief—it was about getting the patient back to a fully functional, active lifestyle without discomfort or restrictions.

Key Takeaways: Why Dr. Harrell’s Approach Worked

Targeted Mobilization: Using the Arthrostim gun with a ball attachment, we precisely targeted restricted spinal segments, relieving hip extension dysfunction.

Active Movement + Mobilization (Mulligan Concept): This dynamic approach paired manual spinal mobilization with patient-driven movement, accelerating recovery.

Patient-Centered Care: By testing and reassessing progress at every visit, we ensured that treatment was continuously adjusted to the patient’s response, leading to a successful outcome.

What This Case Proves

This case study demonstrates the power of chiropractic care—not just for temporary relief but for long-term healing through precise spinal adjustments, soft tissue mobilization, and active movement strategies.

By identifying the root cause of dysfunction and using a non-invasive, hands-on approach, chiropractic care helped this patient move beyond pain and regain full mobility—without surgery or medication.

Dr. Harrell’s Closing Thoughts

"Helping patients move beyond pain and regain full function is why I love what I do. Every case is unique, and my approach is always to find the root cause rather than just treating symptoms. In this case, a precise combination of targeted mobilization, active movement, and chiropractic care provided long-lasting relief. If you’re struggling with lower back pain or hip dysfunction, know that you don’t have to settle for discomfort. Let’s work together to find the best path forward for your health and mobility."

- Dr. Dawn Harrell, Bear Paw Chiropractic