Lower Back Pain

What is acute low back pain?

Acute low back pain (LBP) is defined as low back pain present for up to six weeks. It may be experienced as aching, burning, stabbing, sharp or dull, well-defined, or vague. The intensity may range from mild to severe and may fluctuate. The pain may radiate into one or both buttocks or even into the thigh/hip area. Low back pain may begin following a strenuous activity or jarring trauma, but often is seemingly unrelated to a specific activity. The pain may begin suddenly or develop gradually.

What causes low back pain?

The exact source of acute LBP is often difficult to identify. In fact, there are numerous possible pain producers including muscles, soft connective tissue, ligaments, joint capsules and cartilage, and blood vessels. These tissues may be pulled, strained, stretched or sprained. Additionally, annular tears (small tears that occur in the outer layer of the intervertebral disc) can initiate severe pain. Even if the actual tissue damage is minor, and likely to repair quickly, the pain experienced may be quite severe.

No matter which tissue is initially irritated, a cascade of events occurs which contributes to the pain experience. Numerous chemical substances are released in response to tissue irritation. These substances “stimulate” the surrounding pain sensitive nerve fibers, resulting in the sensation of pain. Some of these chemicals trigger the process of inflammation, or swelling, which also contributes to pain. The chemicals associated with this inflammatory process feed back more signals which perpetuate the process of swelling. The inflammation attributable to this cycle of events may persist for days to weeks.

Muscular tension (spasm) in the surrounding tissues may occur resulting in a “trunk shift” (the body tilts to one side more than the other) due to muscular imbalance. Additionally, a relative inhibition or lack of the usual blood supply to the affected area may occur so that nutrients and oxygen are not optimally delivered and removal of irritating byproducts of inflammation is impaired.

How long will an episode of low back pain last?

The good news is that even if the exact source of pain is not determined, usually the acute pain subsides spontaneously over time. The originally irritated tissue heals. Fifty percent of episodes nearly completely resolve within two weeks, and 80% by six weeks.

Unfortunately, the duration and severity of a single episode cannot be predicted based on the onset, location of pain, or even the initial severity. Excruciating initial pain may resolve within several days, while moderate or mild symptom may persist for weeks. However, up to 30% of individuals will experience recurrent pain or develop persistent pain in the future.

How should acute LBP be managed?

Some of the best advice for treatment for acute LBP is to continue to remain active “as tolerated”. Continuing to perform everyday activities may seem counterintuitive, and the natural inclination may be to stay in bed or “freeze”, to guard and avoid activity. Yet, activity keeps blood and nutrients flowing to the affected area, inhibiting inflammation and reducing muscular tension. Many individuals with LBP find that they can perform their usual, but more controlled cardiovascular activities, such as walking, in spite of the pain and often feel better after the activity. More vigorous or uncontrolled activities such as weight lifting or competitive or contact sports are inadvisable while pain is severe.
Local application of heat or ice can temporarily reduce pain and heat may facilitate stretching, but does not necessarily speed long term recovery.

The multi-disciplinary Health Team at In Motion is ideally suited to help you manage your low back pain. The chiropractors at In Motion will perform a detailed history and physical examination to determine the specific pain generator in your condition. As specialists in manual therapy, Doctors of Chiropractic will provide you with a plan to get you out of pain, and stay that way. When appropriate you will be referred to the other members of the Health Team, providing you with an unmatched array of professional services under one roof. We will get you back in motion, and help you stay that way.

Chronic Low Back Pain

Low back pain is considered to be chronic if it has been present for greater than three months. Chronic low back pain may originate from an injury, disease or stresses on different structures of the body. The type of pain may vary greatly and may be felt as bone pain, nerve pain or muscle pain. The sensation of pain may also vary. For instance, pain may be achy, burning, stabbing or tingling, sharp or dull, and well-defined or vague. The intensity may range from mild to severe.

Many times, the source of the pain is not known or cannot be specifically identified. In fact, in many instances, the condition or injury that triggered the pain may be completely healed and undetectable, but the pain may still continue to bother the patient. Nevertheless, even if the original cause of the pain is healed or unclear, the pain felt by the patient is real and the treating physician knows this.

Chronic low back pain may be the result by many different conditions. It may start from diseases, injuries or stresses to a number of different anatomic structures including bones, muscles, ligaments, joints, nerves or the spinal cord. The affected structure sends a signal through nerve endings, up the spinal cord and into the brain where it registers as pain.

A number of different theories have developed to try to explain chronic pain but the exact mechanism is not completely understood. In general, it is believed that the nerve pathways that carry the pain signals from the nerve endings through the spinal cord and to the brain may become sensitized. Sensitization of these pathways may increase the frequency or intensity with which pain is perceived. A stimulus that is usually not painful, such as light touch, can be amplified or changed by these sensitized pathways and experienced as pain. Sometimes, even after the original injury or disease process has healed, sensitized pathways continue to send signals to the brain. These signals feel just as real and sometimes worse than the pain caused by the original injury or disease process.

What treatments are available?

Treatments for chronic back pain can vary greatly depending on the type and source of the pain. If a treatable source of the pain is found, then the underlying process can be addressed. When the underlying cause is either not specifically identifiable or not amenable to treatment, then the symptoms are treated. The goals of the treatment are to reduce pain, improve quality of life and increase function.

There are several different general categories of treatment that are usually recommended for chronic back pain. These categories include chiropractic, physical therapy, medications, coping skills and acupuncture. In Motion will tailor a program involving a combination of these options to address your needs.

How is chronic low back pain diagnosed?

As mentioned earlier, chronic low back pain is defined as back pain that lasts greater than three months. During the evaluation of chronic back pain, the goal is to rule out any injuries or disease processes that place the patient at risk of further injury if not treated or addressed. In addition, a specialist will consider diagnoses that can be treated in order to reduce the pain. A good patient history and a thorough physical examination by a member of the In Motion Health Team are the most important aspects of the evaluation. Serious injuries and illnesses can often be diagnosed or ruled out based on the history and physical exam alone. Lack of a definite diagnosis does not necessarily mean more testing is needed. Needless tests do not add anything to what the doctor has already discovered in his or her physical examination and review of previously performed studies and treatments. In fact, unnecessary testing is not only expensive to the patient, but can expose the patient to unnecessary risks or radiation.

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Dr. Brendan Carney Kilian

Chiropractor | Clinic Director

Dr. Brendan Carney Kilian graduated from the University of Waterloo with an Honours Bachelor of Science (Kinesiology – Pre-health Professions Option) in 2002 and from the Canadian Memorial Chiropractic College in June 2006, Magna Cum Laude with Clinic Honours. Dr. Carney Kilian has completed certification training in the area of strength and conditioning with the NSCA and has over twenty years experience in the fitness industry. He has special interests in musculoskeletal injury rehabilitation, weight management, and individualized program design. Dr. Carney Kilian has taken additional training as a Certified Golf Performance Therapist, a Spine certified Active Release Techniques® (ART) Provider and has completed the Contemporary Medical Acupuncture Course through McMaster University.. From his small town roots, Dr. Carney Kilian emphasizes a patient-centered approach that stresses patient education and long-term successes.

Dr. Carney Kilian opened In Motion: Health – Wellness – Fitness to provide an innovative Pain Management, Rehabilitation and Injury Prevention solutions for the residents of Sarnia-Lambton.

Dr. Jane Pilkey

Chiropractor

Dr. Jane received her Honours Bachelor of Kinesiology from McMaster University and went on to graduate from the Canadian Memorial Chiropractic College in 2011. She furthered her education by becoming a Contemporary Medical Acupuncture Provider in 2013. Dr. Jane takes special interest in prenatal and pediatric care and is working towards obtaining a residency in pediatrics through the ICPA.

Dr. Jane is an evidence based practitioner that focuses on a patient-centered approach to care; she emphasizes patient education and promotes an active lifestyle to help keep patients both pain free and fully functional. She maintains professional affiliations with the Canadian Chiropractic Association and the Ontario Chiropractic Association in addition to being a registered service provider for the Department of Veterans Affairs, RCMP, and WSIB.

Originally from Sarnia, Jane was born into an active family and grew up a competitive figure skater, swimmer, soccer player, and golfer. Her love of sport and volunteer work as a coach and athletic trainer with various teams has resulted in immense experience dealing with athletic injuries. She looks forward to her future with In Motion and helping her clients to remain active.

Dr. Joel Simpson

Chiropractor

Dr. Joel Simpson was born and raised in Corunna. He attended Western University where he received an Honours Specialization Bachelor of Arts (Kinesiology) in 2010. From there he graduated from the Canadian Memorial Chiropractic College in 2016.

Dr. Joel has completed his certification as a strength and conditioning professional with the NSCA, Functional Movement Systems and Selective Functional Movement Analysis. Dr. Joel focuses on patient centred care utilizing short term and long term goals. This is done through a variety of treatment techniques in order to keep patients pain free but also maintain an active lifestyle in the future.

Amanda Sargent

Registered Massage Therapist

A local girl, Amanda Sargent was born and raised in Sarnia and attended Lambton College. Prior to becoming a Registered Massage Therapist in 2003, Amanda spent time in the healthcare setting as a nursing student and a personal support worker. Amanda has gained experience working as part of a multi-disciplinary healthcare team, at Canada’s leading facility for comprehensive healthcare assessments, and in a small family chiropractic office. Amanda has additional training in fascial release, advanced lumbar spine techniques, and Neuromuscular Integration and Structural Alignment (NISA). Amanda has special interests in pregnancy and deep tissue massage. She is excited to be back home to serve her local community as a member of In Motion’s Health Team.

Jenn Van Horne

Registered Massage Therapist

Born in Sarnia, Jenn was raised and currently resides in Corunna. She graduated from SCITS high school and then from the 3 year massage therapy program at Lambton College in 2007. During that time she took special interest in treating those with chronic pain. Jenn has taken courses in soft tissue release and deep tissue massage. She is experienced in treating MVA injuries, clients in severe, chronic pain, pregnant and elderly clients as well as repetitive strain and sports injuries. She incorporates the use of hydrotherapy into treatments whenever indicated to aide in fully releasing the tissue.

Shelley Dixon

Registered Massage Therapist

I am a new resident of Sarnia as of August 2023. I grew up in Ingersoll, then made London my home in the early 90's. The youngest of 6 children, my parents were always encouraging us to be active and live healthy lives. I attended Fanshawe College after high school for Fitness & Health Promotion and worked at the YMCA for many years teaching Aerobic Classes and Personal Training. In my mid 20's I ran two marathons and competed in several Triathlons. Nowadays, I enjoy Yoga, walking, cycling and lifting weights.

It wasn't until I was in my 30's that I decided to go back to school for Massage Therapy at D'Arcy Lane. During my 18 plus years as an RMT, I've had the opportunity to expand my knowledge by taking such courses as: Acupressure, Ultrasound Therapy, Deep Tissue Manipulation and Thai Massage.

I have a daughter and son, and a granddaughter. My partner has two daughters and a son. Family is very important to us. I never visited Sarnia until I met my partner who was born and raised here. Over the years, and our many trips to Sarnia for family functions and outings with friends, I came to love the area. Being so close to the water is truly a perk. Now, I find myself saying "I can't believe I actually live here".

As soon as I stepped through the doors of In Motion, I knew I found my new work home. Such a comfortable environment, and a group of talented individuals who truly love what they do was evident. As part of the In Motion Team I am excited to be working alongside other like-minded Healthcare Professionals. I am eager to learn some new skills and help my clients attain their optimal health goals. I also look forward to meeting you soon.

Vanessa Macedo

Registered Massage Therapist | Physiotherapist Assistant

Vanessa Macedo was born and raised in Sarnia. She attended and graduated from the two-year Massage Therapy program at Lambton College in 2023. Prior to becoming a Registered Massage Therapist, Vanessa attended and graduated from the two-year Occupational Therapist Assistant and Physiotherapist Assistant program at Lambton College in 2021.

As an Occupational Therapist Assistant and Physiotherapist Assistant student, Vanessa has gained knowledge in human movement and therapeutic exercise. As a Registered Massage Therapist, Vanessa has experience in the treatment of traumatic brain injuries, motor vehicle accidents, individuals with developmental and physical disabilities, and a variety of soft tissue dysfunctions. Vanessa utilizes General Swedish and Non-Swedish techniques, specialized massage techniques, hydrotherapy, and therapeutic exercise in the treatment of a variety of conditions and ailments when indicated.

Vanessa is registered with the College of Massage Therapists of Ontario (CMTO) and the Registered Massage Therapists Association of Ontario (RMTAO). Vanessa is excited to be starting her career and helping our local community as a member of the In Motion health team.

Kristi Kleinsmith

Personal Trainer | Physiotherapist Assistant

In 2000 Kristi earned herself a full tennis scholarship to Northern Illinois University where she spent four years playing tennis for the Huskies and earning her Bachelor's of Science Degree, with Honours, in Preventative and Rehabilitative Exercise Science. A minor in Exercise Gerontology was also achieved. She continued her education for two years on graduate assistantship and received her Master's of Science in Education focusing on Exercise Physiology and Fitness Leadership. Kristi has also obtained an American College of Sports Medicine certification (Certified Health and Fitness Specialist).

Kristi has experience working with people of all ages and fitness levels. She has experience working in different fitness industries such as corporate fitness, commercial fitness, and exercise gerontology. Kristi was a university professor at Northern Illinois University and Lambton College where she taught health and fitness, weight training and conditioning, tennis, volleyball, and badminton classes.

In 2018, Kristi became a Functional Patterns, Human Foundation Practitioner. This new system of personal training develops the human body as a whole organism. Learn how to correct your dysfunctions by assessing your current posture and gait cycle. Correct your biomechanics and bring the body into a state homeostasis and have it remain there for a lifetime.

Her interests include spending time with her family outdoors, whether it is hiking, biking, swimming, kayaking, or skating. Her family likes to visit the local fruit, vegetable, and animal farms in the area. Discovering the Pinery Park and other parks in the area create new adventures and experiences. She is constantly learning more about how to be a healthy human for a lifetime and wants to share this knowledge with her family, friends, and clients.

Get ready to be motivated, encouraged, and challenged to your full potential. Let her ambitious and uplifting attitude guide you through various workouts and classes.

Adam Gray

Chiropodist

Adam was born and raised in Sarnia. He attended the University of Waterloo for his 4 year B.A, and after completing his studies, completed a 3½ year Podiatric Medicine program, at the Michener Institute of Applied Health Sciences/ University of Toronto Campus. In addition, he has completed 3 years of internship in the Greater Toronto Area in various hospitals and private clinics.

As a registered Chiropodist, his specialization includes, but is not limited to: lower limb, foot, and ankle injuries (sports medicine); dermatological and nail care; soft-tissue surgeries; nail surgeries; arch pain; biomechanical assessments, footwear, and orthotics; diabetic consultation/treatment; prescriptions for NSAID’s, antibiotics, and/or antifungals; pharmacological care and injections; compression stockings; and treatment using therapeutic modalities (TENS, ultrasound. Etc.)

Erika Vasconcelos

Registered Physiotherapist

Erika earned her Bachelor’s Degree in Physical Therapy in Brazil in 2008 and completed her Bridging Program at the University of Toronto in 2016. During her journey to become a registered Physiotherapist in Canada, she had the opportunity to shadow an expert in the Myofascial Release Approach by John Barnes, which sparked her passion for this technique.

In 2017, Erika began taking specialized courses in Myofascial Release, which she now uses as her primary treatment strategy, along with Neurodevelopmental Therapy (NDT), orthopedic injury management, and manual therapy. This integrated approach allows her to address a wide range of issues, drawing on her diverse training to provide comprehensive care for her patients. With experience in both acute care and rehabilitation settings, Erika has witnessed significant improvements in her patients’ chronic pain, posture, movement patterns, muscle activation, and overall functionality.

Erika takes a holistic view of her patients, believing that understanding the whole person is key to effective treatment. Her goal is to empower individuals to transform their lives and guide them on their healing journeys. She begins with a thorough assessment to identify the root causes of symptoms related to the fascial system, which are unique to each individual. From there, she employs targeted hands-on techniques to address these issues and teaches self-care strategies for managing symptoms between visits. She also introduces specific exercises to enhance strength and mobility, helping patients regain movement and overcome limitations. Finally, Erika provides personalized education to help patients learn how to use their bodies correctly, reducing pain and enabling them to participate fully in their activities.

In her free time, Erika enjoys spending time with her family, exploring the outdoors, and staying active. She has a strong interest in neuroscience and emotional intelligence, fascinated by how the brain functions and its impact on the body’s interpretation to signals, judgement, behavior, movement, and overall well-being. Additionally, Erika is passionate about women's health and is eager to explore this area further in her career.

Jodi Rawcliffe

Office Manager

I was born in Michigan, raised in Corunna, ON. I have more than 20 years of client relation experience and more than 10 years of managerial experience working for NCO. In 2012 when NCO closed I was lucky enough to have the opportunity to go back to school. I enrolled in the Medical Office Administration Program at Lambton College and graduated in 2014 at the top of my class. While attending Lambton College I was the Campus Program Coordinator for the Ministry of Health campaign - Leave the Pack Behind, which focuses on Smoking Cessation for students. I also gained experience working in a medical office environment as a work study and co-op student in the Lambton College Wellness Centre.I am married to my husband, Steve and we have 2 children – Alexis and Jaxon. Alexis is currently attending the University of Ottawa and hopes to become a dentist. Jaxon is an avid lacrosse and football player. I also have 2 furbabies – Chihuahuas, Martini and Skye.We love travelling, playing with our dogs, and watching Jaxon play lacrosse and football.

Erica Verberne

Client Relations

I was born and raised half in London, and the other half on a farm in Strathroy. I have worked in the administrative/customer service industry for 15+ years. In recent years, I have enjoyed the financial/accounting side to administration, but overall enjoy meeting new people and building on my customer service expertise.

Among COVID downtime, I decided to become a First Aid/CPR instructor, and enjoy teaching to help build a safer community.

I love travelling, and have spent a year backpacking through New Zealand, as well as numerous trips to Key West. I have visited 16 countries so far and hope to continue exploring with my spouse, Adam, and my 3 children.

Alexis Rosandich

Client Relations

I was born in Sarnia, raised in Corunna. After graduating from SCITS highschool in 2013, I enrolled at the University of Ottawa. There, I received my Bachelor of Health Sciences and graduated in 2017.
I have two children, Scarlett, 3, and Sebastian, 2, who I have stayed home with since they were born.
In my free time I enjoy cooking and baking, especially experimenting with new recipes. I also love to read and I aim to read at least one book a week for the entire year!

Stefanie Senior

Registered Dietitian & Sports Nutritionist

Stefanie Senior is one of the leading registered dietitians and sports nutritionists in Toronto. She specializes in weight management, eating for exercise and athletic performance, and corporate wellness.Stefanie Senior, RD offers registered dietitian and sports nutrition services in the GTA and runs a private practice at Athletic Edge Sports Medicine and online via Skype for In Motion. Stefanie offers nutrition counselling, weight management programs and support groups and creates customized meal plans based on food preferences, lifestyle and goals. Stefanie is also a professor in food and nutrition at the Centre for Hospitality and Culinary Arts at George Brown College and the in-house dietitian and spokesperson for the CBC Live Right Now campaign.Stefanie is a professional speaker who uses dynamic and interactive seminars to teach simple, powerful and sustainable strategies for achieving optimal health, energy and wellbeing. The energetic nutrition guru has appeared on CP24, CTV, Rogers Live, CBC television and radio, Canada AM and has interviewed for articles published in the Toronto Star, Canadian Living, Best Health Magazine, Chatelaine, the Huffington Post, and the Toronto Observer. Stefanie studied dietetics at the University of British Columbia and completed a post-graduate dietetic internship program at Mount Sinai Hospital in Toronto. Previous to entering the field of dietetics, she did a Bachelor of Science degree, with a major in Psychology at the University of Guelph and worked as a Personal Trainer in Vancouver, British Columbia.Stefanie has a unique approach to her practice and provides advice that is realistic, easy to follow and emphasizes stepwise change, balance and flexibility. She is a firm believer that small, gradual changes to an individual’s eating and exercising regimen coupled with patience, commitment and a positive attitude can lead to permanent lifestyle change and a happier, healthier and more fulfilling life.In her spare time, Stefanie enjoys being active, cooking, travelling and experiencing the newest restaurants and food trends in Toronto and across the globe. Stefanie is excited to join the In Motion Team to offer high quality nutrition and weight loss couseling via Skype.

Akhy Bhushan

Registered Physiotherapist

Akhy completed his undergraduate degree in Health Sciences at UOttawa and went on to complete his masters degree in physiotherapy at McMaster University. He has taken further education and is certified in concussion management and is currently developing his skills further in the McMaster contemporary Neurofunctional Acupuncture course.

Akhy has a background in playing many competitive sports, namely soccer and martial arts. Akhy has a huge passion in helping others heal as his own injuries through life have motivated him to be a physical therapist. Akhy prioritizes finding a diagnosis and using his knowledge of anatomy and physiology to develop evidence based exercise care plans to help patients overcome obstacles to mobility. By understanding that everyone is a unique individual, with unique anatomical abilities and levels, Akhy works with each patient to ensure a plan is best suited for you. Akhy is an virtual practitioner at this location and only provides sessions via zoom online.