Mr R was presented with bilateral low back pain aggravated by sudden twisting and turning of his back during reaching. Disc bulge was shown on imaging and on examination repeated lower back extension resulted in centralization and reduce back pain. Shockwave, soft tissue release and McKenzie exercises were provided to promote recovery. Shockwave was utilized to increase vascularization around the injured soft tissues to promote healing. McKenzie exercises such as prone elbow extension was prescribed to target at the posterior disc bulge. The patient had shown significant reduction in pain and increased in lumbar flexion after several sessions.