Lower back pain is the #1 reason people miss work and avoid the activities they love. At Solas Physical Therapy, we treat the root cause — not just the symptoms — with one-on-one hands-on care by a doctoral-level therapist.
Lower back pain presents differently for everyone. These are the most common patterns we treat at Solas Physical Therapy in El Paso.
Pain that ranges from a dull ache to sharp stabbing sensations, especially with bending, lifting, or prolonged sitting.
Shooting pain, tingling, or numbness that travels from the lower back into the buttocks, thigh, or below the knee — often a sign of nerve involvement.
Waking up stiff and needing 20–30 minutes to "loosen up" is common with mechanical low back pain and certain inflammatory conditions.
Back pain that worsens during exercise, lifting, CrossFit, or sports — limiting performance and preventing you from training the way you want.
Increased pain after long periods of sitting, driving, or desk work — a hallmark of disc-related or postural lower back pain.
Back pain that keeps coming back every few months despite rest, chiropractic care, or medication — a sign the underlying cause has never been fully addressed.
Dr. Cisneros uses a comprehensive, movement-based approach that combines hands-on manual therapy with exercise prescription tailored to your specific diagnosis and goals.
Every evaluation starts by examining your full kinetic chain — not just your back. Hip mobility, core control, movement patterns, and neurological screening all factor into your diagnosis. This is how we find the real cause, not just the pain site.
Hands-on techniques including spinal joint mobilization, soft tissue work, and neural mobilization to restore normal movement, reduce pain, and reset how your nervous system processes the injured area.
Trigger point dry needling targets the deep paraspinal muscles and gluteal muscles that are often chronically guarded in low back pain. This reduces muscle tension and opens a window for strength work. For pain that has lasted months, electrical dry needling adds a low current through the needles.
Specific exercises designed for your diagnosis — whether that's lumbar stabilization, hip hinge mechanics, or deadlift technique. Dr. Cisneros's strength and conditioning background means your rehab bridges directly into real performance.
Also read: Lower Back Pain Treatment — What a Real Exam Finds →
“I initially reached out to him due to lower back pain that showed an L5/S1 disc bulge with imaging. He’s helped me through my recovery and on-loading progression. I’m a physically active individual and I like the fact that he’s approached my plan of care with that in mind. I like the one on one service as well, as the ‘insurance model’ doesn’t work for me. The fact that I work with him and only him makes my moneys worth. None of this stretching with a timer then seeing a PTA then a PT for 10 minutes. I feel better now than when I did when I first started and will continue to use his services.”
A disc bulge on imaging is not a reason to stop loading — it is a reason to load correctly. Book an evaluation →
Electrical dry needling for chronic low back pain places thin, solid needles into the deep back and hip muscles that stay guarded and sore, then passes a low, comfortable current through them for 10 to 15 minutes. The needle releases the trigger point. The current adds rhythmic contractions in the muscle and calms pain signaling in the spinal cord, which is why it tends to help pain that has lasted for months more than a needle alone. At Solas PT it is included at no extra charge when it is indicated, and it is always paired with the strength work that keeps the back from flaring again.
The multifidus and erector spinae alongside the spine, the quadratus lumborum between the pelvis and the lowest rib, and the gluteus medius and minimus. The piriformis is added when pain reaches the buttock or leg (dry needling for sciatica).
Back pain that has lasted longer than about three months, flare-ups that keep coming back, pain that feels widespread or sensitized, and backs that respond only briefly to needling alone. A fresh strain often needs just the needle, or no needling at all.
Needling turns the pain down so the loading can go up: hinges, carries, split squats and, when it fits, deadlifts. Relief without strength is a short break before the next flare, so every session ends with the exercise that makes it last.
Current delivered through needles is not new for back pain. In a randomized trial in JAMA (Ghoname and colleagues, 1999), percutaneous electrical nerve stimulation reduced chronic low back pain and improved activity and sleep more than surface TENS or exercise alone over a three-week course. Dry needling for low back pain works best combined with exercise rather than on its own, which is how it is used here.
The electrical part is not used with a pacemaker or other implanted electrical device, a seizure history, or metal hardware in the area being treated. Needling near the lowest ribs is done at controlled angles and depths, because the base of the lungs and the kidneys lie close to that area, and every needling patient signs a written consent. Back pain with new bowel or bladder changes, numbness in the groin or inner thighs, or worsening leg weakness needs emergency care, not needling.
Cost: included in the $150 evaluation or a $120 treatment visit when it is indicated. If you only want the needling, a 30-minute Focused Dry Needling Consultation ($100) treats one area. How electrical dry needling compares with TENS →
When the gluteus medius cannot hold the pelvis level on each step, the low back makes up the difference. Glute med strength and control are tested and trained with every low back patient at Solas PT.
How the glute med connects to back pain →It depends on how long you've had the pain and the underlying cause. Acute lower back pain often responds in 4–6 sessions. Chronic or complex cases may take 8–12. Dr. Cisneros will give you a realistic timeline at your first evaluation.
No. Texas allows direct access to physical therapy, meaning you can book an evaluation without a physician referral. This saves you time and an extra office visit.
Insurance-based clinics often limit you to 15-minute appointments shared with an aide. At Solas, every session is 45–60 minutes one-on-one with Dr. Cisneros. Most patients see faster results and need fewer total sessions — which often makes it more cost-effective overall.
Yes. Chronic low back pain responds very well to manual therapy combined with specific exercise. Many patients who have struggled for years see significant improvement because their previous treatment never addressed movement patterns and muscle imbalances.
Not necessarily. Most lower back pain does not require imaging to begin PT effectively. If Dr. Cisneros identifies something during your evaluation that warrants imaging, he will refer you appropriately.
Yes — physical therapy is one of the most evidence-supported treatments for back pain and is recommended as a first-line intervention before injections or surgery. A physical therapist identifies the specific cause of your back pain (disc, muscle, joint, nerve) and builds a targeted plan. At Solas PT in El Paso, Dr. Cisneros performs a full evaluation to determine the root cause and create a treatment plan specific to your condition — no referral required.
There's no single 'best' exercise — the best treatment starts with an accurate diagnosis and your goals, delivered as a comprehensive plan. At Solas PT in El Paso every session is a full 60 minutes one-on-one with Dr. Cisneros, who adjusts the plan as you respond. That is the gap with cookie-cutter clinics. You often see the actual therapist once, then get handed to a technician. Under Texas law, physical therapist assistants cannot change your plan of care. For chronic low back pain, Dr. Cisneros leads with graded exposure: exercise that improves tissue health through the spine, paired with pain education. That reduces the fear and anxiety that keep people from moving. Manual therapy and dry needling support that foundation.
Acute back pain typically responds in 4–6 sessions over 3–4 weeks. Chronic back pain that has persisted for months or years may require 8–12 sessions. Most patients notice meaningful improvement within the first 2–3 visits. Dr. Cisneros will give you a realistic timeline after your first evaluation — not a vague package commitment.
Physical therapy can resolve the underlying cause of back pain — not just manage symptoms — which is why results often last. The key is identifying and correcting the movement patterns, muscle imbalances, and habits that created the problem. Patients who finish a full course of PT and keep up their home exercises have far lower rates of recurring back pain than those who rely on rest or medication alone.
Yes — this is one of the most common patterns we treat. Prolonged sitting creates hip flexor tightness, glute inhibition, and disc compression that overloads the lower back. Treatment focuses on releasing the tissues under load, reactivating inhibited muscles, and retraining movement patterns so the back isn't compensating for weak or tight hips. Most desk workers see significant improvement within 3–4 sessions.
Acute lower back pain often responds in 4–6 sessions. Chronic or complex cases may take 8–12. Dr. Cisneros will give you a realistic timeline at your first evaluation — there are no preset packages or pressure to commit upfront.
No. Texas is a direct access state — you can see a licensed physical therapist for back pain without a physician's referral. At Solas PT in El Paso, there is no referral requirement, no prior authorization, and no insurance involvement. You can call or book online and start treatment this week at (915) 318-7381.
Yes, as part of a plan. At Solas PT in El Paso, Dr. Cisneros uses dry needling for back pain driven by trigger points in the multifidus, erector spinae, quadratus lumborum, glutes and piriformis, and adds a low electrical current through the needles (electrical dry needling) when the pain has lasted for months or keeps flaring. Needling reduces pain and muscle guarding in the short term; it is always combined with manual therapy and progressive strength work, because that combination is what keeps the back from flaring again.
Electrical dry needling places thin, solid needles into the deep back and hip muscles and passes a low, comfortable current through them for 10 to 15 minutes. The current produces rhythmic contractions in the muscle and calms pain signaling in the spinal cord. It is used for back pain that has lasted longer than about three months or keeps returning, and at Solas PT it is included at no extra charge when indicated.
Yes, when it is done by a trained clinician with screening. Needling near the lowest ribs is done at controlled angles and depths because the base of the lungs and the kidneys lie close to that area, and every patient signs a written consent. The electrical part is not used with a pacemaker or implanted device, a seizure history, or metal hardware in the treated area. Mild soreness for a day or two is the most common side effect.
Seek immediate care if back pain is accompanied by loss of bladder or bowel control, numbness in the groin or inner thighs, severe leg weakness, or follows a significant trauma. These may indicate a medical emergency. For all other back pain — even severe — a physical therapy evaluation is appropriate as a first step. Dr. Cisneros will identify any red flags during your assessment and refer you for imaging or specialist care if needed.
Yes — and surgery should be a last resort for most back pain. Non-surgical options include physical therapy (manual therapy, dry needling, therapeutic exercise), which has strong evidence for disc herniations, nerve pain, and chronic mechanical back pain. At Solas PT in El Paso, Dr. Cisneros has helped patients avoid recommended surgery by addressing the root cause through one-on-one hands-on care. Most back pain — including disc herniations and sciatica — resolves with conservative treatment when addressed properly.
The right home program is specific to you — if someone hands you a generic exercise sheet without an in-depth assessment, question it. For radicular or sciatic symptoms, Dr. Cisneros prescribes specific repeated lumbar movements plus nerve glides dosed to your neural excursion. If the exam shows core or hip weakness, that's addressed; if it shows spinal or hip mobility deficits, mobility work leads. For chronic low back pain, the home plan targets your key impairments and adds progressive resistance training plus aerobic exercise for overall tissue and general health. The common thread: it's matched to what your evaluation actually found — which is why a proper assessment comes first.
Solas Physical Therapy in El Paso offers one-on-one back pain treatment with Dr. Andrew Cisneros, PT, DPT, MS — a doctoral-level physical therapist with advanced training in manual therapy and dry needling. Located at 300 N Resler Dr, Ste F, El Paso, TX 79912. No referral needed. Same-week appointments available. Call (915) 318-7381 or book online at solaspt.com.
The best physical therapist for lower back pain is one who finds your directional preference and the mechanism behind the pain before loading anything, and progresses you back to lifting and daily life on criteria. Solas Physical Therapy in west El Paso holds a 5.0-star rating across 47 Google reviews. Chronic low back pain responds very well to manual therapy combined with specific exercise, and that combination is the foundation of Dr. Cisneros's plan. Dry needling is layered in where muscle guarding is driving the symptoms. Every session is one-on-one with Dr. Andrew Cisneros, PT, DPT, MS for the full 60 minutes — no aides, no double-booking. Solas PT is cash-based and direct-access at 300 N Resler Dr, Ste F, and can usually see new patients the same week with no referral required.
Book a one-on-one evaluation with Dr. Cisneros today. Same-week appointments available. No referral needed.
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