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low back pain is a frequent presenting complaint to physicians affecting at least one quarter of US adults in the last three months and serving as a leading cause of disability most low back pain is categorized as nonspecific in which theres no identifiable cause or pathology acute or subacute low back pain typically improves over time and nonpharmacologic treatment is preferred including heat massage acupuncture and spinal manipulation OMT including soft tissue and articulatory techniques may be beneficial in patients with low back pain in this video we will demonstrate prone pressure with counter leverage an SI joint articulatory technique the prone pressure counter leverage soft tissue technique begins with the patient lying prone and the physician standing contralateral to the treatment side the physician can assess by palpating for hypertonic paraspinal tenderness asymmetry tissue texture changes and decreased spinal range of motion to begin the treatment the physician cephalad