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Dr. Brian Abelson

Low Back Pain: Breaking Free!


Low Back Pain Graphic

Low back pain is a common condition that can significantly disrupt daily life, causing frustration and concern for those affected.


The pain, often linked to musculoskeletal strains, can be both physically and emotionally draining, especially when its exact cause remains unclear. Known as Simple, Nonspecific, Mechanical, or Functional Low Back Pain, this condition impacts how you move and function, often leading to worries about pain relief, mobility, and the ability to work.

Early intervention eases the pain and helps you regain control, reducing the long-term impact on your life and finances.


Our Success Rate is Over 90%

Our comprehensive approach to treating Low Back Pain consistently achieves a 90% success rate in reducing pain and restoring function.


Article Index:

 

Construction Worker Holding Bent Over Holding His Low Back

Signs and Symptoms


Simple low back pain (SLBP) can show up differently for different people, making it crucial to recognize the signs for proper diagnosis and treatment. Common symptoms include:


  • Pain: The most common sign, ranging from a dull ache to sharp, intense discomfort, is often influenced by posture, movement, or activity.

  • Stiffness: Many experience lower back stiffness, especially after sitting or being inactive for long periods, making it hard to move freely.

  • Muscle Spasms: Involuntary muscle contractions in the lower back can be painful, usually caused by muscle strain or nerve irritation.

  • Limited Mobility: SLBP can reduce your ability to bend, stretch, or twist, affecting everyday activities like picking up objects or putting on shoes.

  • Referred Pain: Sometimes, the pain extends to the hips, buttocks, or legs, often felt as a deep, aching sensation.

  • Weakness or Numbness: Nerve involvement may lead to feelings of weakness or numbness in the lower back or legs.

  • Postural Changes: To relieve discomfort, people might unknowingly adopt new postures, creating muscle imbalances and worsening the issue.


The intensity and duration of these symptoms can vary widely, from mild and short-lived to severe and long-lasting, highlighting the importance of timely medical consultation and intervention.


 

Anatomy Image in Cobra Pose

Anatomy and Biomechanics


Understanding the anatomy and biomechanics behind Nonspecific Low Back Pain (NSLBP) is essential for effective management. The lumbar spine’s complex structures provide support and mobility, but identifying the exact source of pain can be challenging. Critical contributors to low back pain include:


  • Intervertebral Discs: These cushions between vertebrae absorb shock and allow flexibility. Degeneration or damage, like a bulging disc, can press on nerves, causing pain.

  • Facet Joints: These joints between vertebrae enable movement and stability. Inflammation or dysfunction here can lead to localized pain and restricted motion.

  • Muscles: Supporting muscles like the erector spinae and multifidus can become strained from overuse or weakness, leading to pain when they’re forced to compensate.

  • Ligaments: Ligaments connect bones and provide spinal stability. Injuries or overstretching can cause pain and inflammation in these tissues.

  • Nerves: The lumbar and sacral plexuses control motor and sensory functions. Nerve irritation or compression, often from disc issues or inflammation, can lead to low back pain and other symptoms.


Grasping how these structures interact helps pinpoint the cause of SLBP, leading to more targeted and effective treatments.



 


Doctor Holding a Spine

Examination and Diagnosis


A thorough clinical examination is crucial for diagnosing and managing SLBP, helping pinpoint the pain source and rule out severe conditions. Key assessments include:


  • Orthopedic Assessment: Tests for range of motion, joint mobility, and palpation to identify specific structures causing pain.

  • Neurological Assessment: Focuses on nerve function, reflexes, and muscle strength to detect any nerve involvement.

  • Vascular Assessment: Ensures proper blood flow to the lower extremities, as circulatory issues can sometimes present as low back pain.


Below are demonstration videos showing how we perform orthopedic, neurological, and vascular tests for Low Back Pain patients.


Low Back Examination

This educational YouTube video is an excellent resource for healthcare practitioners, students, and anyone seeking to deepen their understanding of the common causes of low back pain and how to diagnose them using orthopedic examination procedures.


Lower Limb Neuro Examination

The lower limb neurological examination is part of the overall neurological examination process and assesses the motor and sensory neurons that supply the lower limbs. This assessment helps detect any nervous system impairment and is used both as a screening and investigative tool.


Peripheral Vascular Examination - Key Points

A peripheral vascular examination is valuable for ruling out signs of vascular-related pathology. The detection and subsequent treatment of PVD can potentially mitigate cardiovascular and cerebrovascular complications. This video reviews some standard procedures we perform in daily clinical practice.



 


Doctor Holding a Stethoscope

Differential Diagnosis


To effectively manage low back pain, a thorough examination, patient history review, and diagnostic tests are essential to rule out other potential causes. Common conditions that can mimic Simple Low Back Pain (SLBP) include:


  • Lumbar Disc Herniation: Occurs when the inner core of a disc protrudes through its outer layer, potentially compressing nerves and causing symptoms similar to SLBP, such as localized pain, muscle spasms, and pain radiating to the legs.

  • Lumbar Spinal Stenosis: Involves narrowing of the spinal canal, which can compress the spinal cord or nerve roots, leading to low back pain, leg pain, and neurogenic claudication (pain, numbness, or weakness in the legs that worsens with walking).

  • Spondylolisthesis: The forward slippage of one vertebra over another can cause low back pain, muscle tightness, and nerve compression symptoms similar to SLBP.

  • Sacroiliac Joint Dysfunction: Inflammation or dysfunction in the sacroiliac joint can mimic SLBP, causing pain in the lower back, buttocks, and potentially radiating to the thigh or groin.

  • Hip Issues: Conditions like hip osteoarthritis, labral tears, or bursitis can present with pain that may be mistaken for SLBP, affecting the hip and radiating to the lower back or thigh.

  • Systemic Diseases: Conditions like ankylosing spondylitis, rheumatoid arthritis, or malignancy can cause low back pain resembling SLBP, often accompanied by systemic symptoms like fever, fatigue, or unexplained weight loss.


Accurate differential diagnosis is key to identifying the true cause of low back pain and guiding appropriate treatment.



 


Practitioner Performing Manual Therapy

Manual Therapy


Manual therapy is valuable to SLBP treatment, as it provides pain relief and enhances mobility. When integrated into a comprehensive treatment plan, it can significantly improve patient outcomes. Key techniques include:


  • Spinal Manipulation: This high-velocity, low-amplitude (HVLA) thrust technique helps restore joint mobility and alleviate pain by addressing joint restrictions and improving nervous system function. It’s particularly effective in relieving pain from restricted spinal joints or muscle tension.

  • Spinal Mobilization: A gentle, low-velocity, high-amplitude (LVHA) technique that moves the spinal joints within their normal range of motion, reducing stiffness, increasing mobility, and promoting overall spinal health.

  • Soft Tissue Manipulation: Techniques such as deep tissue massage, trigger point therapy, and myofascial release target muscles, ligaments, and fascia to alleviate pain and discomfort by addressing soft tissue restrictions contributing to SLBP.

  • Motion Specific Release (MSR): MSR combines multiple techniques tailored to the individual’s needs, effectively addressing joint restrictions, muscle imbalances, and other lumbar spine issues through a personalized approach.


Below are treatments that might be used for SLBP, depending on the specific case. These are just a few of the possible procedures available.

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Chiropractic Adjustments

Decreased Pain, Better Posture, Improved Function - Spinal manipulation is an essential aspect of musculoskeletal therapy, with a notable impact on force distribution and shock absorption.





SI Joint Pain - Unravelling the Mystery

The sacroiliac (SI) joint, a pivotal anatomical juncture that unites the spine and pelvis, is indispensable in load distribution and spinal stability.






Fascial Expansion: MSR Low Back Pain Protocol

Utilizing fascial expansions in Low Back pain management presents an effective strategy that merges contemporary insights in fascia, kinetic chain relationships, and core acupuncture or traditional Chinese medicine principles. In this video, Dr. Abelson, the Motion Specific Release (MSR) developer, demonstrates using fascial expansions to treat Low Back Pain.



 

Treatment Frequency for Low Back Pain (LBP)


Tailored Approach: Frequency is customized based on pain levels, functional abilities, and treatment response. Depending on their schedule, patients can choose between two 15-minute sessions per week or one 30-minute session.


  • Acute LBP (2 to 4 weeks):

    • 2-3 sessions per week.

    • Focus on symptom relief, reducing inflammation, and preventing chronicity.

    • In very acute cases, collaboration with a family practitioner may be necessary to prescribe medications or injections, helping patients tolerate therapy, perform exercises, and get adequate rest.


  • Sub-Acute LBP (4 to 8 weeks):

    • 1 session per week or bi-weekly.

    • Aims to promote healing, restore function, and prevent chronic pain.


  • Chronic LBP (12 weeks or more):

    • 1 session every 2-4 weeks or as needed.

    • Focus on maintenance, managing symptoms, and enhancing self-management.


Important Note: Combining manual therapy with a functional exercise program is significantly more effective than using either approach alone. Sole reliance on medications or injections offers minimal long-term benefits and should be considered the least effective strategy.



 

Woman Exercising on a Yoga Matt

Exercise for Low Back Pain


Exercise is critical for managing Simple Low Back Pain (SLBP), improving function, reducing pain, and preventing future episodes. A well-rounded program should focus on mobility, strength, flexibility, balance, and proprioception, all tailored to the patient's needs. Here’s how each component helps:


  • Mobility & Flexibility: Exercises like cat-cow stretches, lumbar rotations, and hamstring stretches relieve pain and stiffness by improving the range of motion in the spine and surrounding muscles.

  • Strengthening: Core, back, and hip strengthening exercises such as pelvic tilts, bridges, and bird dogs enhance spinal stability, reducing the risk of recurrent pain.

  • Balance & Proprioception: Activities like single-leg stands, tandem walking, and side planks boost body awareness, helping to prevent falls and injuries that can contribute to SLBP.

  • Functional Exercises: Movements like squats, lifts, and bends mimic daily activities, helping patients return to regular tasks pain-free by developing proper movement patterns.


Tailoring the exercise program to each patient’s pain level, functional limitations, and health conditions ensures its safety and effectiveness. Regular monitoring and adjustments help patients progress toward optimal results.


Below are exercise routines that could be prescribed and customized to meet individual patient needs.


Stop Back Pain Fast

This routine is designed to get you out of pain ASAP. This instructional video features Miki Burton, a registered massage therapist, demonstrating an acute low back pain routine. Acute lower back pain is a debilitating condition that significantly impacts individuals' quality of life.


5 Minute Low Back Pain Relief

If you're experiencing discomfort in your lower back after prolonged sitting in front of your computer, it's essential to address it promptly. Prolonged sitting puts excessive strain on the lumbar spine and can result in lower back pain.



The 6-Minute Plank Routine

Intermediate Level" is a great way to progress from the beginner-level plank routine. We recommend practicing the routine for several weeks before attempting the advanced plank routine.




Advanced Balance Exercise Demonstration Video

Improve Your Balance - Advanced Exercises

Balance exercises can benefit people of any age. They improve your ability to control and stabilize your body's position, reducing injury risk, rehabilitating current injuries, and increasing your sports performance. Before attempting this series of exercises, you should be comfortable with the beginner exercises.



 

Why Choose Our Approach for Low Back Pain Treatment


Our comprehensive approach to treating Low Back Pain consistently achieves a 90% success rate in reducing pain and restoring function. Here's why our method stands out:


  • Proven Expertise: Developed by Dr. Brian Abelson, our methodology is backed by over 30 years of clinical experience and the successful treatment of more than 25,000 patients, ensuring you receive top-quality care.

  • Thorough Assessments: We conduct detailed evaluations to identify all contributing factors, including potential nerve compressions or muscle imbalances, to address the root causes of your pain.

  • Advanced MSR Procedures: Our Motion-Specific Release (MSR) methodology precisely targets myofascial restrictions, joint dysfunctions, and nerve entrapments, providing effective and lasting relief.

  • Customized Exercise Programs: We create individualized exercise plans that improve mobility, strengthen the core and back muscles, and restore function, accelerating your recovery.

  • Logical, Evidence-Based Approach: Our treatment protocols integrate manual therapy, exercises, and supportive strategies, ensuring a comprehensive and lasting solution.


Choose our proven, patient-centred approach for effective, long-term relief from Low Back Pain. Take the first step toward your recovery with confidence.



 

References


  1. Maher, C., Underwood, M., & Buchbinder, R. (2017). Non-specific low back pain. The Lancet, 389(10070), 736-747.

  2. Balagué, F., Mannion, A. F., Pellisé, F., & Cedraschi, C. (2012). Non-specific low back pain. The Lancet, 379(9814), 482-491.

  3. Chou, R., & Shekelle, P. (2010). Will this patient develop persistent disabling low back pain?. JAMA, 303(13), 1295-1302.

  4. Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., ... & Koes, B. W. (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356-2367.

  5. van Tulder, M., Becker, A., Bekkering, T., B Real, A., Hutchinson, A., ... & Koes, B. (2006). Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. European spine journal, 15(Suppl 2), S169-S191.

  6. Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G., Shekelle, P., ... & Godges, J. J. (2012). Low back pain. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1-A57.

  7. Hayden, J. A., Van Tulder, M. W., Malmivaara, A. V., & Koes, B. W. (2005). Meta-analysis: exercise therapy for nonspecific low back pain. Annals of internal medicine, 142(9), 765-775.

  8. Koes, B. W., Van Tulder, M., Lin, C. W., Macedo, L. G., McAuley, J., & Maher, C. (2010). An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. European spine journal, 19(12), 2075-2094.

  9. Deyo, R. A., Mirza, S. K., & Martin, B. I. (2006). Back pain prevalence and visit rates: estimates from US national surveys, 2002. Spine, 31(23), 2724-2727.

  10. Airaksinen, O., Brox, J. I., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., ... & Zanoli, G. (2006). Chapter 4. European guidelines for the management of chronic nonspecific low back pain. European spine journal, 15(Suppl 2), S192-S300.

  11. Maher, C., Underwood, M., & Buchbinder, R. (2017). Non-specific low back pain. The Lancet, 389(10070), 736-747.

  12. Chou, R., Qaseem, A., Snow, V., Casey, D., Cross Jr, J. T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of internal medicine, 147(7), 478-491.

  13. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1789-1858.

  14. Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., ... & Buchbinder, R. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, 73(6), 968-974.

  15. Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., ... & Turner, J. A. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet, 391(10137), 2368-2383.

  16. Oliveira, C. B., Maher, C. G., Pinto, R. Z., Traeger, A. C., Lin, C. W., Chenot, J. F., ... & Koes, B. W. (2020). Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. European Spine Journal, 29(11), 2791-2803.

  17. Rubinstein, S. M., de Zoete, A., van Middelkoop, M., Assendelft, W. J., de Boer, M. R., & van Tulder, M. W. (2019). Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. bmj, 364.

  18. Searle, A., Spink, M., Ho, A., & Chuter, V. (2015). Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials. Clinical Rehabilitation, 29(12), 1155-1167.

  19. Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of internal medicine, 166(7), 514-530.

  20. Deyo, R. A., Dworkin, S. F., Amtmann, D., Andersson, G., Borenstein, D., Carragee, E., ... & Weiner, D. K. (2014). Report of the NIH Task Force on research standards for chronic low back pain. Physical therapy, 94(8), 1138-1149.


 

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The content on the MSR website, including articles and embedded videos, serves educational and informational purposes only. It is not a substitute for professional medical advice; only certified MSR practitioners should practice these techniques. By accessing this content, you assume full responsibility for your use of the information, acknowledging that the authors and contributors are not liable for any damages or claims that may arise.


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By using the MSR website, you agree to indemnify and hold the authors and contributors harmless from any claims, including legal fees, arising from your use of the site or violating these terms. This disclaimer constitutes part of the understanding between you and the website's authors regarding the use of the MSR website. For more information, read the full disclaimer and policies in this website.


 

DR. BRIAN ABELSON, DC. - The Author


Photo of Dr. Brian Abelson

With over 30 years of clinical practice and experience in treating over 25,000 patients with a success rate of over 90%, Dr. Abelson created the powerful and effective Motion Specific Release (MSR) Treatment Systems.


As an internationally best-selling author, he aims to educate and share techniques to benefit the broader healthcare community.


A perpetual student himself, Dr. Abelson continually integrates leading-edge techniques into the MSR programs, with a strong emphasis on multidisciplinary care. His work constantly emphasizes patient-centred care and advancing treatment methods. His practice, Kinetic Health, is located in Calgary, Alberta, Canada.


 


MSR Instructor Mike Burton Smiling

Join Us at Motion Specific Release


Enroll in our courses to master innovative soft-tissue and osseous techniques that seamlessly fit into your current clinical practice, providing your patients with substantial relief from pain and a renewed sense of functionality. Our curriculum masterfully integrates rigorous medical science with creative therapeutic paradigms, comprehensively understanding musculoskeletal diagnosis and treatment protocols.


Join MSR Pro and start tapping into the power of Motion Specific Release. Have access to:

  • Protocols: Over 250 clinical procedures with detailed video productions.

  • Examination Procedures: Over 70 orthopedic and neurological assessment videos and downloadable PDF examination forms for use in your clinical practice are coming soon.

  • Exercises: You can prescribe hundreds of Functional Exercises Videos to your patients through our downloadable prescription pads.

  • Article Library: Our Article Index Library has over 45+ of the most common MSK conditions we see in clinical practice. This is a great opportunity to educate your patients on our processes. Each article covers basic condition information, diagnostic procedures, treatment methodologies, timelines, and exercise recommendations in an easy-to-prescribe PDF format you can directly send to your patients.

  • Discounts: MSR Pro yearly memberships entitle you to a significant discount on our online and live courses.


Integrating MSR into your practice can significantly enhance your clinical practice. The benefits we mentioned are only a few reasons for joining our MSR team.



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