Sometimes its difficult to go in and work on an area with cases of very bad pain. And I do agree, get a bit of reduction in the pain/irritability first. Cold (acute) or heat, IFT, or a gentle massage. That should allow you to get in and be more effective in your assessment and later treatment. The patient may benefit from a thoracolumbar support also (though I am not a fan for their continued use for too long-once they are over the initial bad pain curve I feel they should use it but rather develop good core stability)

all the best