There is a category of patient that every manual therapist encounters: the person who has tried everything. Physiotherapy, osteopathy, chiropractic, acupuncture, cortisone injections, prescribed medication. They have had scans that show nothing definitive. They have followed every recommendation. And the pain persists.
This is not an unusual situation. It is, in fact, one of the more common presentations in chronic pain practice, and its existence points to something important about the limits of how back pain is conventionally understood and treated.
What Conventional Approaches Address
The standard model of back pain assessment looks for structural causes: disc herniation, facet joint arthrosis, spinal stenosis, sacroiliac dysfunction, muscle strain, ligamentous laxity. Where these are found, treatment is directed at them. Where imaging is unremarkable, the absence of a structural finding tends to produce either a psychosomatic hypothesis or a management rather than resolution approach.
Conventional manual therapy, whether osteopathy, physiotherapy or chiropractic, works primarily at the structural and mechanical level: mobilising restricted joints, releasing tight soft tissue, correcting postural imbalances. These are effective interventions for the majority of back pain presentations and should be the starting point.
The problem arises when the structural layer has been addressed and the pain persists. This indicates that the structural layer was not the whole story, or was not, in fact, where the primary problem resided.
The Neurological Holding Pattern
Body stress release offers a different framework for understanding this situation. From the BSR perspective, chronic back pain that persists despite structural treatment often involves tension that has been locked into the neuromuscular system at a level that conventional manual therapy does not access.
This tension is not a mechanical restriction. It is a neurologically maintained holding pattern: the nervous system actively sustaining a state of muscular contraction in response to a stressor, or series of stressors, that exceeded the body’s adaptive capacity. The original stressor may have been physical, an injury, a sustained postural load, a period of extreme physical demand. It may have been emotional or psychological, held in the body as chronic sympathetic activation. Often it was both.
Because the holding pattern is maintained by the nervous system rather than residing in the structural tissue, approaches that work at the structural level release the surface manifestation of the pattern without addressing its source. The structure changes under treatment, and returns to its previous state because the neurological instruction to hold has not been changed.
What BSR Does Differently
BSR works at the level of the neurological holding pattern rather than the structural tissue. Light, precise pressure applied to monitor sites along the spine communicates with the nervous system and creates the conditions for the holding pattern to be released from within, rather than being overridden from without.
For patients who have experienced the frustrating cycle of temporary relief followed by return to the same pattern, BSR often provides the first genuinely different response they have encountered. The release is different in character from the release produced by conventional treatment: it tends to be more progressive across a course of sessions, less immediately dramatic, and more durable.
Peter van Minnen’s experience is particularly valuable here. He spent 15 years managing a back problem with conventional approaches before a course of BSR resolved it. He has now spent 27 years applying the same principles to patients, many of whom arrive having already exhausted the options that did not hold.
If your back pain has not responded adequately to conventional treatment, book a session with Peter at Hever Health and find out whether BSR can reach what other approaches have not.