Overview
Back pain is the single most common reason patients walk into our office in Belleville. Some have woken up stiff and sore after a weekend project. Others have been managing chronic pain for years and want an alternative to pain medication, injections, or surgery. Either way, the starting point is the same: find out what is actually causing it.
At Philiatros Healthcare, Dr. Charles Portwood — board certified in musculoskeletal ultrasound (RMSK) and in practice for over 30 years — combines a focused orthopedic and neurological exam with imaging review (and in-office ultrasound when appropriate) to identify the source of your pain. Treatment is then tailored to the diagnosis: an acute lumbar sprain, a herniated disc, and facet joint pain look similar to the patient but require very different care.
Conditions treated
- Acute low back pain and lumbar sprain/strain
- Chronic low back pain
- Herniated and bulging discs
- Sciatica and lumbar radiculopathy
- Spinal stenosis
- Degenerative disc disease
- Facet joint syndrome
- Sacroiliac (SI) joint dysfunction
- Postural and work-related back pain
- Pregnancy-related low back pain
- Failed back surgery syndrome (post-laminectomy)
What to expect
Bring what you have
If you have a recent X-ray, MRI, or CT, bring it on disc, paper, or a phone photo. Prior imaging often shortens the path to the right treatment.
Examination & diagnosis
A focused exam identifies whether your pain is mechanical (joint/muscle), neurogenic (nerve root), or a combination. When indicated, we use in-office musculoskeletal ultrasound to confirm soft-tissue findings.
Matched treatment plan
Mechanical pain often responds quickly to chiropractic adjustments and soft-tissue work. Disc-related pain typically needs Cox Flexion Distraction spinal decompression. Most plans combine techniques.
Reassessment & honest scope
We recheck progress at regular intervals. If you are not improving, we change the plan or refer to the appropriate specialist — orthopedic, pain management, or neurosurgical — without delay.
How we decide which treatment fits your back pain
“Back pain” is a symptom, not a diagnosis. Two patients with identical complaints can need very different care. Here is the rough decision tree we use once the exam is complete:
- Joint and muscle pain (mechanical, no leg symptoms) — most often responds to chiropractic adjustments and soft-tissue care over 3–6 visits.
- Disc-related pain with leg symptoms (sciatica, numbness, tingling) — typically benefits from Cox Flexion Distraction spinal decompression, often combined with adjustments and rehab.
- Chronic pain with overlapping causes — multimodal plan: adjustments, decompression, and acupuncture or dry needling for stubborn muscular components.
- Red flags or non-responsive cases — we refer. Some back pain is not a chiropractic problem, and we will tell you when that is the case.
Frequently Asked Questions
When should I see a chiropractor for back pain?
Sooner is usually better. Most acute back pain that is not improving after 3–7 days of rest is appropriate for evaluation. You do not need a referral, and you do not need to wait for it to become chronic. Severe pain with new weakness, loss of bowel or bladder control, or trauma is a medical emergency — go to the ER first.
Do I need an MRI before being seen?
No. Most patients do not need imaging to begin care. If you already have an MRI or X-ray, bring it. If imaging is clinically indicated based on the exam, we will order it or coordinate referral.
Can chiropractic care help if I have a herniated disc?
Often, yes. For many patients with disc herniation, sciatica, or radiculopathy, Cox Flexion Distraction spinal decompression is an evidence-supported, non-surgical option. Your specific findings on imaging and exam determine whether decompression is appropriate for you.
How is your approach different from other chiropractors?
Two things: diagnosis and scope. We use exam findings, your imaging, and in-office musculoskeletal ultrasound (RMSK) to identify the actual source of pain before recommending care. And we have an honest scope — if your back pain is not a chiropractic problem, we will tell you and refer you to who can help.
Will my insurance cover treatment?
Most major medical insurance plans, Medicare, and Tricare cover chiropractic care for medically necessary back pain. We will help verify your benefits and explain any out-of-pocket cost before treatment begins.
Do you treat patients from Scott AFB and the surrounding area?
Yes. We see patients from Belleville, Shiloh, O'Fallon, Fairview Heights, Swansea, Mascoutah, and Scott Air Force Base.