Another method of locating subluxations is the use of x-ray, where segments classified by the Houston Conference Classification are identified and treated with manipulation. Some chiropractors utilize a device that detects the temperature of the skin in the paraspinal region to identify spinal areas with a significant temperature variance that requires manipulation. Many chiropractors utilize a wholistic, biomechanical concept of treating the bipedal structure in its entirety, in an attempt to balance the structure from the feet upward. Identifying weak links in the kinetic chain, sometimes quite distant from the area of complaint, are treated. Combinations of any of these treatment approaches along with exercises that strengthen the weak, underactive muscles of the trunk and pelvis and stretch the tight, overactive muscles usually results in a more beneficial, long term result.
Goal setting is driven by the patient's pain and disability issues and activity intolerance.
Patient education is important to reduce anxiety levels that often accompany intense low back pain. Consistent among all guidelines of low back pain treatment is the prevention of chronicity.