You deserve more than a temporary fix. At Breakthrough Performance Physical Therapy, our Doctors of Physical Therapy deliver one-on-one care designed to find the root cause of your back pain — and get you back to the mountain lifestyle you love. No referral needed. Most patients experience significant relief in 6 visits or less. Serving active adults, athletes, and desk workers throughout Asheville and Buncombe County.

The Pain Keeps Coming Back 

You rest, you stretch, maybe you try some ibuprofen — and it helps for a day or two. But the pain returns, often worse than before. Without addressing the root cause, the cycle never ends.

Everyday Life Gets Harder 

Getting out of bed, putting on shoes, reaching for something on a shelf — tasks you never used to think about become exhausting negotiations with your own body. Back pain doesn’t stay in your back.

At Breakthrough Performance Physical Therapy, every appointment is spent one-on-one with your licensed Doctor of Physical Therapy — never passed off to an aide. We use our proven 4-Phase Recovery Program to move you from pain relief to full strength and lasting injury prevention. Whether you’re a runner, an athlete, or someone who just wants to move without wincing, we build a plan around your goals and your life.

• One-on-one care with a Doctor of Physical Therapy — every visit, every time
• No referral needed — North Carolina is a direct access state
• Proven 4-Phase Recovery Program with most patients seeing significant pain reduction in 6 visits or less

Step 1: Get a Full Assessment 

Your first visit is a thorough one-on-one evaluation with your Doctor of Physical Therapy. We dig into your history, movement patterns, and lifestyle to uncover the true root cause of your back pain — not just where it hurts, but why.

Step 2: Follow Your Personalized Plan

We build a clear, phase-by-phase recovery program around your goals — combining hands-on manual therapy, dry needling, therapeutic exercise, and strength work to move you from pain relief to full function at your pace.

Back pain rarely exists in isolation. Our Doctors of Physical Therapy treat a wide range of musculoskeletal and orthopedic conditions that contribute to — or coexist with — back pain. If you’ve been searching for back pain relief near me, you’ve found the right team. We treat the whole person, not just the diagnosis.

• Low back pain, herniated discs, and sciatica
• Hip and sacroiliac (SI) joint pain, post-surgical rehab (ACL, meniscus, hip replacement)
• Pelvic floor dysfunction, prenatal and postpartum back pain, and core instability

Dan at Breakthrough Performance is an exceptional resource for all your PT needs. Immediately upon our initial assessment he identified some old 20+ years of patterns that addressed the cause in areas I was not aware of. After several weeks, the daily workout performance videos and App helps you stay focused, and on track. His gym is well loved, and his education and background help patients reach their fitness and performance goals! Definitely a valuable resource.

–Zachery A. 

I worked with Rachel Pascko on a couple issues over several months and I’ve seen dramatic improvement. She has a sophisticated understanding of biology and fitness training, she’s a fantastic teacher, and she’s just a lovely and pleasant person. I have referred family to this practice and would refer anyone else who could use a PT.

–Holly S. 

Dan Carmack, PT, DPT, OCS, CSCS 

Owner and Orthopedic Certified Specialist with extensive experience helping patients reach their fitness and performance goals. Known for his exceptional diagnostic abilities, identifying patterns and root causes that other practitioners miss. Specializes in orthopedic PT, sports injuries, dry needling, golf performance, and back pain.

Rachael Paszko, DPT, OCS 

Pelvic Floor Specialist and Orthopedic Certified Specialist who completed an orthopedic residency in 2020. She has found her passion for treating individuals experiencing pelvic floor dysfunction, with extensive training through Herman and Wallace Pelvic Rehabilitation Institute. Specializes in working with distance runners, triathletes, CrossFit athletes, and pregnancy/postpartum care.

Emma Gasinski, PT, DPT, Cert. DN, RYT 

Specializes in helping older adults reduce fall risk and improve overall fitness, as well as treating vestibular disorders including BPPV and vestibular hypofunction. Certified in dry needling with additional training as a registered yoga teacher and CrossFit Level 1 coach. Passionate about chronic pain management and functional movement.