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L4 L5 S1 low back pain treatment and the psoas muscle

L4 L5 S1 low back pain treatment involves stretching a tightened psoas muscle. Lengthening the psoas muscle is essential for repairing the L4 L5 S1 region. The best method of opening the psoas muscle is not through massage therapy. The best way to open the psoas is through Active Isolated Stretching  The relationship between L4 L5 S1 region low back pain and psoas muscle restriction is poorly understood by the medical community. Techniques on how to unlock a tight psoas muscle are also poorly understood.

L4 L5 S1 issues are resolved by advanced stretching techniques

Low back pain treatment involves more than one muscle being tight. A series of tight muscles are involved. Correcting the psoas muscle is an essential element of  low back pain treatment. Chiropractic adjustments, epidural injections, and acupuncture do not lengthen a tight psoas muscle. Massage is unable to reach all the attachments of the psoas muscle. Active Isolated Stretching (AIS) has the best method for opening the psoas muscle. The therapist assisted psoas stretch in AIS involves the client laying face down on a table and a strong therapist pulling the leg upward – separating the space between the junction of the upper thigh and the pelvis (see picture below: back exercises psoas). The target psoas muscle lies towards the front of the pelvis but it attaches to the lumbar vertabrae  (L3, L4, L5, S1). A tightened psoas muscle will pull down on the L4, L5, and S1 discs, the pressure of this action causes low back pain.

After the client has received AIS assisted stretching for the psoas, the client will be taught the self-applied psoas stretch, but psoas lengthening initially requires the help of a trained therapist. The self-applied stretch will maintain an open psoas but not open it initially. In the early stages of recovery, the client may have to do the self-applied psoas stretch two or three times a day to keep it open.

L4 L5 S1 massage will not work. AIS will work.

L4 L5 S1 issues involve a tightened psoas muscle. For L4 L5 S1 massage to be corrective, massage must be able to fully repair the psoas. However, the psoas cannot be opened through deep tissue massage. Some massage therapists have techniques for trying to open the psoas, but it is a muscle that needs to be stretched. Massage techniques are ineffective because the psoas has so many attachments to the vertebrae that it is impossible to massage each attachment. Furthermore, the psoas lies deep inside the stomach. It is too deep  to affect with massage.

L4,L5,S1 Low Back Pain Treatment

Herniated disc, bulging disc, degenerative disc in the low back

Back pain that originates in L4, L5, and S1 is commonly diagnosed. But psoas stretching through the AIS method is not fully understood by other back pain specialists. Unfortunately, too many  diagnosed with L4 L5 S1 pain are opting for surgery. Surgery does not elogate the psoas. Which is why the pain surrounding the L4 L5 S1 region frequently returns after back surgery. Back surgery will shave off or fuse the discs in between L4, L5, and S1. Often times a tightened psoas results in bulging disc, herniated disc, or degenerative disc. Why is the disc bulging, herniating, or degenerating? The cause is a tightened psoas. That’s what needs to be adjusted, not a microdiscectomy or spinal fusion.

Back surgery or AIS therapy?

The back surgery approach theorizes that if the disc around L4. L5,or S1 is fused or shaved then the pain will diminish because the disc protrusion is irritating the nerve. Unfortunately, this theory does not address why the disc is protruding. The AIS approach claims that a tightened psoas is principal cause of L4 L5 S1 low back pain.  If the psoas is lengthened to normal position,  the disc will be encouraged to slide back inside the vertebral column.

This article can also be helpful to you :

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  2. Flat Back Syndrome & Chronic Low Back Pain
  3. Hip Pain From Running
  4. Neuropathy pain – remove muscular inflammation to resolve nerve pain.
  5. Sciatica nerve pain – affecting the deep six muscles, the hip rotators.

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33 Responses to L4 L5 S1 low back pain treatment and the psoas muscle

  1. Hi Staci,
    I hope that my instructional videos will help you with your L4, L5 bulging disc issues.
    Remember to not exert too much force during the stretches. The range of motion increases during the repetitions.
    The ideal number of repetitions is eight.

  2. Hi Rakesh S.
    No, there are no AIS therapists that I know of in India. I have two videos for purchase on my website, but your internet speed has to be fast enough to allow for the video to be processed.
    Sent by,
    Anthony Ohm

  3. I have a L4, L5 bulging disc causes back pain for me everyday. Thank you for the video.

  4. From MRI

    1. Degenerative disc disease at the L4-5 and L5-S1 levels as above. At L5-S1, there is a broad-based right paracentral/medial foraminal disc protrusion which slightly narrows the right lateral recess and causes mild posterior displacement of the right
    descending S1 nerve root. There is no significant central spinal canal narrowing in the lumbar spine.
    2. No acute osseous abnormality of the lumbar spine is demonstrated.

    Will stretching and exercise fix this issue or is surgery needed? Waiting to be scheduled to see the Back doctor.

    Horrible pain while sitting and bending, something’s waking.

  5. Hi, I had surgery on L4,L5 a few years ago but the pain has never really gone away. I am now also suffering with S1. I would like to know more about this treatment and the costs please.

  6. severe sciatica, left leg. piriformis, pedundal pain. sleeping, sitting only short times. vicodin, torodol shot somewhat helpful. Can ais help? Please reply. NYC

  7. Santosh,
    The exercises in my pay-to-view videos are more effective in treating L4, L5 pain than what you’ve learned in conventional therapy.
    Member’s that have purchased the videos, can send me their MRI report and I will give specific suggestions on how to best utilize the video instruction. For the most part, the videos already state which exercises are contra-indicative for which conditions. If you have further questions, I will give you additional advise.
    Sent by,
    Anthony Ohm

  8. I’m having a l4-l5 diffused posture. I have only recovered 60% through physio-therapy. What exercises should I continue to do to normalize my body?

  9. Hi Mike C.

    The epidural injection into the L4, L4, S1 region is only one approach. In many cases, it feels great the first time, not as good the second time, and the third time it feels like the doctor missed the spot.
    After you tell the physician about the third time experience, the doctor begins the conversation about considering back surgery.
    I’m glad that you found me early in your pain cycle. Improving core strength is a very important part of recovering from low back pain. But the AIS stretching must come before the strengthening. Right now your muscles are compressed and inflamed. That’s what is causing the pain. If you try to strengthen muscles that are inflamed the pain isn’t going to go away. This important step is under valued by physical therapists.
    I’m releasing two videos that can be streamed from my website. The upper body video should be available in three days. The lower body video might take two weeks (hopefully less) to be available. I recommend that you start practicing both videos because the upper body affects the low back too.
    Kind regards,
    Anthony Ohm

  10. Hi James B.
    I am about to release my instructional video. There are two parts. The upper body and the lower body. Low back pain, what you are suffering from, is the midpoint of the body. The upper body muscles and the lower body muscles both contribute to this problem. So I recommend that you purchase both videos. The upper body video should be available on my website within a few days (maybe three?). And the lower body video will take about two weeks to be ready (hopefully less than that).
    The goal of doing the exercises is to decrease the muscular tension surrounding your L4-L5 disc protrusion. The best outcome is the decreased pressure allows the disc to go back inside the space, instead of protruding. The tear at S1 is a little less predictable. In some tear cases doing the exercises will provide great benefit. But in some cases, you may experience pain around the afflicted area. The outcome varies from case to case. If you repeatedly experience pain after doing the lower body exercises, then you may have to wait until the tear has healed.
    You can write back and tell me how things are going once the video is out and you are doing the exercises.
    Kind regards,
    Anthony Ohm

  11. That seemed really cool. I’m a 42 yr ol construction worker that played all kind of sports as a kid up to high school. I have a bad s1 l4, and l5. I’ve recently had my 2nd epidural shot and I’m going to really work on strengthing my core so I’m looking for a good routine and some good stretches to keep this awful pain away. I recently saw on the web that icing the area every hour for 15 minutes is good to do.

  12. Do you have a video I could buy. I have L4 L5 protruding and a s1 tear. I would love to buy a video to try these stretches before I go for surgery. I do not go for about a year. Major pain in my groin buttocks big toe and lower back. In very rough shape. Have gained 20 lbs because I can not do anything anymore. I can barely stand to sit at my office job for my whole shift. Hope you can offer some advice. Thanks.

  13. I am releasing an instructional video that will help you with your L4, L5 low back pain problem. It will also help you with the nerve root compression, and the pain/tingling you are feeling in your legs.
    Please check my website within the next two weeks. The video series will be available for purchase. There will be two videos. One on the upper body and one on the lower body. Both will cost twenty dollars individually. I recommend that you purchase both the upper and lower body exercises.
    Kind regards,

    Anthony Ohm

  14. Hi,

    I have L4, L5 disc pain and nerve root compression. Due to this, both my legs are getting pain and tingling. I am unable to walk or stand for a few minutes. How do I get relief? What can i do?

  15. Please help me, I have been in agony and it sounds like you may have the answer! Where can I find help?

    Many thanks

  16. Anthony Ohm wrote:

    Hello Dean M.

    I am confident that your father will find AIS therapy to be highly beneficial. Muscles can become hardened for senior citizens. This is why elderly people so commonly experience physical pain issues throughout the body.
    Many people that come to Active Isolated Stretching treatment have first tried the conventional treatments that you mentioned.
    AIS therapy is the best treatment for musculoskeletal pain because it lengthens the muscles better than any other form of physicalrehabilitation.
    I hope to see you in Hawaii in August when I return.

  17. Mr. Ohm,

    Hello. My dad (89 years old) has degenerative back issues. He has gone thru physical therapy, chiropractor, acupuncturist, cortisone shots (past three years) — have not really helped his back.

    Do you think the AIS therapy could help him?

    I am in Honolulu and would like my dad to see you in August if you think the therapy would help him.


    Dean Morihara

  18. Hello A. muarleetharan,

    I get similar emails as yours quite frequently. Unfortunately there is a shortage of AIS practitioners throughout the world.
    Very few people practice AIS outside the United States. If no one is available for you. Then you’ve got to try what’s available in your region. If you want to come to me, I am in Honolulu, Hawaii.

    Best regards,
    Anthony Ohm

  19. Hi Jennylyn,

    I’ll be in Honolulu, Hawaii during February, March, and part of April 2012 if you would like to see me for treatment.
    Hope you improve,
    Anthony Ohm

  20. Hello Mr. Ohm. My name is Jennylyn, I am 34 years old and I have been suffering from posterior disc bulge,L4-L5,with minimal ventral thecal sac indentation for about 2 years now. I feel as if my body is losing the battle it faces everyday with severe backpain and I fear the worst is yet to come. I saw your video of the stretches you did to that man on the bench and though I know they seem to cling right to the desired location for healing the disc, it seems physically impossible for me to raise my leg like the way you raised that mans. I wish to see you though I am not sure how…

  21. Hi Pradeep,
    I practice a method called Active Isolated Stretching and Strengthening (AIS) which is a highly effective form of treatment for lower back pain in the L4, L5, S1 region. Unfortunately, there are no practitioners of this method in your country. So unless you can travel (a long distance) to an AIS practitioner, then you have to try the methods that are closer to your region. These other methods are not as good as AIS, but that doesn’t mean that they will not help you. Try the techniques that are available in your region. There is a long tradition of Ayurvedic medicine that has their own approach towards lengthening muscles. Look for people that can help you to stretch and seek out massage from skilled practitioners.
    Do you do a lot of bicycle riding? And you are relatively young? And you sit at a desk for long periods of time? If these conditions are true then you need to have someone help you lengthen muscles in your body that may have become shortened through your activities. Some of the muscles that you need to focus on are: hamstrings, thigh (quadricep) muscles, iliotibial band, calves, and psoas muscles.
    When you are trying out different techniques ask them and ask yourself if these techniques are lengthening the muscles in your body that are causing pressure in your low back.
    Don’t rush to get surgery on your back. Low back pain is usually caused by a series of muscles being overly tight. Athletes are prone to low back pain because of the stress that they place on their muscles. And office workers are susceptible to low back pain from sitting for long periods of time. If all methods fail, then you’ll have to use your marketing skills to organize a group of students that want to bring me over to teach Active Isolated Stretching and Strengthening. I would be very happy to bring AIS to your country. If there were a group of thirty students that were serious about learning, I could conduct a teaching seminar in your country.

  22. Hello Mr. Ohm. My name is Konstantine, I am 23 years old and I have been suffering from L5-S1 herniation for about 3 years now. I feel as if my body is losing the battle it faces everyday with this herniation and I fear the worst is yet to come. I saw your video of the stretches you did to that man on the bench and though I know they seem to cling right to the desired location for healing the disc, it seems physically impossible for me to raise my leg like the way you raised that mans. I wish to see you though I am not sure how…

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Anthony Ohm is a pain specialist and a sports therapist. The technique is called Active Isolated Stretching and Strengthening(AIS). Treatment is available in Honolulu, Hawaii and Los Angeles, California The AIS method is highly beneficial for: disc issues, chronic physical pain, pain related to aging, arthritis, bursitis, sciatica, neuropathy, Parkinson's disease, and much much more... However you are presenting, whether you are crippled or a professional athlete, AIS treatment will put you in better physical condition than your current state.