Customers are entitled to access some special supplements and downloads. These documents are just as much a part of the tutorial as the included chapters, but they are separated so that they can serve as common resources for other tutorials as well, such as the neck cricks or trigger points books.

• SUPPLEMENT Does Spinal Manipulative Therapy (SMT) Work? — Adjustment, manipulation, and popping of the spinal joints and the subluxation theory of disease, back pain and neck pain
• SUPPLEMENT Do Nerve Blocks Work for Neck Pain and Low Back Pain? — Analysis of the science of stopping the pain of facet joint syndrome with nerve blocks, joint injections, and nerve ablation
• QRG Trigger Point QRG — Quick Reference Guide to Trigger Point Diagnosis and Self-Treatment

This document and all of SaveYourself.ca was, for many years, created in my so-called “spare time” and with a lot of assistance from family and friends. Undying thanks to my wife, Kimberly, for countless indulgences large and small, and for being my “editor girlfriend”; to my parents for (possibly blind) faith in me, and much copyediting; and to Mike Gobbi, buddy and digital mentor, for many of the nifty features of this document (hidden and obvious). And thanks to all of the above, and many others, for many (many) answers to “what do you think of this?” emails.

Thanks finally to every reader, client, customer, and big tipper for your curiosity, your faith, and your feedback and suggestions and stores. Without you, all of this would be pointless.

And a few thanks to some health professionals who have been particularly inspiring to me: Dr. Steven Novella, Sam Homola, DC, Dr. Harriet Hall, Simon Singh, and Dr. Stephen Barrett.

• Mind Over Back Pain: A radically new approach to the diagnosis and treatment of back pain, a book by John Sarno (book review). Essential reading for anyone with back pain or neck pain, and for all physicians and physical therapists.
• The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, a book by Clair Davies and Amber Davies (book review). amazon.com This is an important book: offering hope and practical, effective self-treatment tips to countless people suffering needlessly from pain that doctors have failed to diagnose. Unfortunately, Davies also makes it sound like trigger point therapy can cure anything. That doesn’t work, of course. But considering the importance of trigger points to virtually all low back pain, this book is a worthwhile investment.
• “The Pain Perplex,” a chapter in the book Complications, by Atul Gawande. Gawande’s entire book is worth reading, but his chapter on pain physiology is certainly the best summary of the subject I have ever read, and a terrific reminder that good writing for a general audience can be just as illuminating for professionals. Anyone struggling with a pain problem should buy the book for this chapter alone, though you are likely to enjoy the whole thing. Much of the chapter focuses on one of the most interesting stories of low back pain I’ve read, and it is a responsible and rational account — although Gawande, like most doctors, seems to be unaware of the clinical significance, or even existence, of myofascial trigger points.
• “Marketing, Money, and Medical Decisions,” a chapter in the book How Doctors Think, by Jerome Groopman MD. Groopman, writing from personal experience with chronic back pain and a spinal fusion surgery, discusses back pain as intelligently as any medical expert I’ve come across, but he does so in a way that will fascinate patients. In this chapter, his discussion of back pain is placed in the context of how medical thinking is influenced by marketing and money, giving us a somewhat chilling insiders’ view of the surgical treatment of back pain. And despite the quality of Groopman’s writing and thinking, he is yet another doctor who seems to be uninformed about myofascial trigger points.

Here is what some readers have said about the low back pain tutorial over the years. Feedback is always welcome. I focus on the positive in this section, but I want to acknowledge that I certainly do receive some criticisms as well. In many cases I respond by making improvements to the tutorial. However, the vast majority of feedback is enthusiastic. Thanks, everyone!

I purchased the low back tutorial recently and got the free trigger points one also. Many thanks. They are great! I had already accessed the perfect spot series and have been working on my trigger points. It is very pleasing to have the full discussion on the chemistry and physiology, and I now have a much better idea about the whole ghastly business.

— Leah Brannen, Saskatoon, Canada

I have been suffering from lower back pain for the last 5 weeks and found your page to be very informative and interesting. I really can’t thank you enough actually because for the first time I’m really starting to feel like I’m on the right track here.

— Glenn Hill, Canterbury, Australia

Thanks to your website, I pretty much got rid of my back problems almost overnight. It’s also fun and thought provoking to read!

— Amsterdam Jeroen Strompf, MFA, Screenwriting, Chapman University

First, THANK YOU for this information. You’ve done all the heavy lifting: reading the literature, the studies, et cetera. And you’ve presented all the information in a concise, useful and entertaining format. I have learned a lot from reading these two tutorials, including the miscellaneous articles you have referenced along the way.

— Jan Nelson, pharmacist and power yoga practitioner

I bought two of your eBooks last week, and I’m enjoying going through them. Your presentation is excellent. It’s far too early too say, of course, but I think I’ve already begun to benefit from your approach. One of the things I like most about your approach is your respect for “science,” as opposed to “merchandising.” You've put so much into those two eBooks, it's going to take time to do them the justice they deserve.

— David Calderisi, Toronto, Ontario

David diligently followed up a month later with the following comment: “By now I’m convinced your research and recommendations are right on the money. Thanks. I’ve recommended you to a few people who, like myself, have had back problems on and off for years. Thanks for having provided such a useful tool.” — Paul

I was just about to buy some “magic cure” book and pay for it when I came across your review of it and decided against it. Then I took the bold step to buy yours instead, although I feared your review was just a ploy to grab business from your competition. But thank God I did! That is the best £10 I have ever spent. In fact, pound for pound, I’ve never purchased anything which has had a greater impact on my physical well being. It was such a relief that you were able to really understand and define exactly what my symptoms were in such detail. Also to be able to visualize the problem and understand what’s going on and why the therapies work is really satisfying. Thank you very much. Your literature is very informative, easy to read and digest. Moreover, it bloody well works. Well done and keep the good work.

— Osman Hassan, London

Your low back pain tutorial is refreshing. I’d gotten tired of hearing the same old explanations for my back pain, which are obviously wrong simply because the back pain was around before the things that supposedly caused it! It was nice to read something clear and logical that is actually consistent with my experience.

— Jean Gallagher, low back pain sufferer, California

Read 15 more comments

One more special comment. In the Spring of 2009, I received an incredible endorsement from Jonathon Tomlinson, a GP in Hackney, East London, praising the whole website and every tutorial:

I'm writing to congratulate and thank you for your impressive ongoing review of musculoskeletal research. I teach a course, Medicine in Society, at St. Leonards Hospital in Hoxton. I originally stumbled across your website whilst looking for information about pain for my medical students, and have recommended your tutorials to them. Your work deserves special mention for its transparency, evidence base, clear presentation, educational content, regular documented updates, and lack of any commercial promotional material.

— Dr. Jonathon Tomlinson, MBBS, DRCOG, MRCGP, MA, The Lawson Practice, London

High praise indeed! Thank you, Dr. Tomlinson — testimonials just don’t get much better than that.

This tutorial has been continuously, actively maintained and updated for 8 years now, staying consistent with professional guidelines and the best available science. The first edition was originally published in September of 2004, after countless hours of research and writing while I spent a month taking care of a farm (and a beautiful pair of young puppies) in the Okanagan.

A major feature of my tutorials is that I actively update them as new science and information becomes available. Unlike regular books, and even ebooks — which can be obsolete by the time they are published, and can go years between editions — this tutorial is updated at least once every three months and often much more. I also log updates, making it easy for readers to see what’s changed. This tutorial has gotten 47 major and minor updates worth logging since I started logging carefully in late 2009, and countless more minor tweaks and touch-ups.

Update (Apr 27 '12, section #3.5) — Editing, and several new paragraphs about safety issues. See section #3.5, Yoga and meditation are still an option, of course.

Minor update (Apr 27 '12, section #3.1) — Some simple revision for clarity and qualit, and a bit more content. See section #3.1, The tyranny of meditation and yoga.

Science (Apr 4 '12, section #4.14) — More science, and a few substantial new footnotes fielding common concerns and questions. See section #4.14, Core strengthening has failed to live up to the hopes and dreams of therapists and patients.

Science update (Mar 21 '12, section #2.21) — Clarified information about pelvic tilt, and beefed it up with some more science. See section #2.21, Are you crooked? The alignment theories: short legs, pelvic tilts, and spinal curves.

Minor update (Mar 7 '12, section #3.7) — Important new, skeptical footnote about the dangers of the powerful narcotic drugs. See section #3.7, Pain medications (and even alcohol) can be useful.

Science update (Dec 16 '11, section #4.14) — More evidence of the exercise effects are limited and non-specific. See the paragraph starting “Does spinal function improve…” See section #4.14, Core strengthening has failed to live up to the hopes and dreams of therapists and patients.

New section (Dec 10 '11, section #3.3) — No notes. Just a new section. See section #3.3, What is the difference between a ‘confidence cure’ and a mere placebo?

Updated (Dec 1 '11, section #4.4) — Added scientific cases studies, examples, pictures and video of true dislocation and abnormal anatomy to help drive home the point that even significant spinal joint dysfunction can be surprisingly harmless … never mind subtle joint problems. See section #4.4, Spinal manipulative therapy (SMT): Adjustment, manipulation and cracking of the spinal joints.

Minor update (Nov 25 '11, section #2.4) — Minor, but fun — a great quote about models of slipped discs, and a good new image to help it along. See section #2.4, Those scary spine models.

Rewritten (Nov 23 '11, section #4.6) — Improved and expanded. In particular, intramuscular stimulation (IMS) was “demoted.” I am disillusioned with it and no longer want to promote it without strong caveats. See section #4.6, “Medical” treatment option for trigger points: dry needling (IMS), stretch and spray, and trigger point injections.

Major science update (Nov 3 '11, section #3.5) — Detailed reporting on some new yoga science. Significant re-writing of the section ensued. Sometimes new science does not back up my preconceptions: I’ve changed my tune here somewhat. See section #3.5, Yoga and meditation are still an option, of course.

Minor update (Nov 1 '11, section #2) — Added a couple great points/quotes from doctors about overuse of MRI, as reported by Gina Kolata for the New York Times. See section #2, Diagnosis: Your low back is not fragile!

New science (Aug 26 '11, section #2.26) — I tumbled at random across a fantastic scientific paper about the prevalence of nerve pinches (hint: it’s low). Great stuff! A most welcome addition. See section #2.26, Could you have a “pinched” nerve? The nerve pinch myth.

New section (Aug 26 '11, section #2.15) — A key concept covered in the trigger points tutorial long ago, but so relevant to low back pain that I decided it needed to be here as well. See section #2.15, Could it be a vicious cycle of pain-spasm-pain?

New section (Aug 26 '11, section #2.14) — This section is a summary of an important concept that’s been available in a free article since late 2008, but it really needed to be emphasized here. See section #2.14, From the frying pan of injury pain to the fire of trigger point pain.

Minor update (Aug 12 '11, section #3.17) — A few new paragraphs summarizing an important new study of massage for low back pain with disappointing results. See section #3.17, The evidence for massage.

Minor update (Jul 29 '11, section #1) — Added a reference about the poor overall quality of online information about common injuries. See Starman et al. See section #1, Introduction.

New section (Jul 13 '11, section #2.10) — More information about an important characteristic of muscle-dominated back pain. See section #2.10, “Out of nowhere”: seemingly random episodes of low back pain.

Major update (Jul 12 '11, section #2.9) — Totally renovated section: re-written, reformatted, expanded, upgraded. A few new checklist items were added, most were expanded, and all were clarified. A separate and handier “quick” checklist was added to the existing “slow” checklist. See section #2.9, A trigger point checklist: does this sound like you?

Major update (Jun 19 '11, section #2.9) — Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really be cleaned up in general, paving the way for efficient conversion to other formats (Kindle, Apple’s iBookstore, etc). Best of all, it is now significantly easier for me to update the tutorial — which will translate into more good content for readers. Care for more detail? Really? Here’s the full announcement. See section #2.9, A trigger point checklist: does this sound like you?

Minor Update (May 11 '11, section #4.8) — Added evidence that spinal fusion surgeries are not just ineffective but often harmful (Nguyen). See section #4.8, The back surgery placebo problem, and how it limits our knowledge of the effectiveness of back surgeries.

Minor Update (May 11 '11, section #3.7) — Added a fascinating science item about the effect of anti-inflammatory gels on back pain (Huang). See section #3.7, Pain medications (and even alcohol) can be useful.

Minor Update (May 11 '11, section #2.22) — Long overdue, I finally added some science to this section, showing that the connection between low back pain and obesity is weaker than it seems (Wright). See section #2.22, Do you really need to lose some weight?

Minor Update (May 5 '11, section #2.23) — Added some interesting references about sensation (Luomajoki) and the relationship between back pain and a disrupted “body schema” (Bray). See section #2.23, Is it core weakness?

Upgraded (Feb 17 '11, section #4.4) — New artwork from SaveYourself.ca artist Gary Lyons, plus some important new references. See section #4.4, Spinal manipulative therapy (SMT): Adjustment, manipulation and cracking of the spinal joints.

Minor Update (Feb 17 '11, section #2) — Added a fun and informative quote from the TV show House. See section #2, Diagnosis: Your low back is not fragile!

Updated (Jan 12 '11, section #2.2) — Added some new evidence about back pain and aging, and a nice new graph. See section #2.2, Maybe you’re just getting older? Actually, no ….

Minor update (Jan 7 '11, section #4.18) — Just added a link, but a really great link! The CBC show Marketplace did an amazing job last year reporting on spinal decompression machines. Well worth a look — the show and their show page is probably now the single best source of information on this topic. See section #4.18, Spinal decompression therapy: worth the money and risks?

Minor update (Jan 7 '11, section #2.23) — Some editorial cleanup on core strengthening, and I a link to a good summary of recent research. See section #2.23, Is it core weakness?

Like new (Dec 29 '10, section #3.19) — Re-written and significantly expanded. See section #3.19, Act normal! Rest minimally and strategically, while maintaining as much normal activity as you can.

New section (Dec 29 '10, section #2.16) — No notes. Just a new section. See section #2.16, Could low back pain be an overuse injury?

Major Update (Oct 1 '10, section #2.20) — Rewriting and expansion of the Special Supplement on spinal manipulative therapy. The update was inspired by new science on the (significant) risks of spinal manipulative therapy, and by Sam Homola’s excellent article at ScienceBasedMedicine.org, Chiropractic Vertebral Subluxations. See section #2.20, Is there such a thing as a “subluxation”? Can your back be “out”?

Updated (Sep 21 '10, section #2.3) — Added a much more detailed description of the Hancock et al study, and in fact turned it into the main substance of this section. See section #2.3, Structural problems in the low back are hard to diagnose accurately.

Updated (Sep 15 '10, section #2) — Added a very beefy footnote about some new research showing that muscle imbalance does not result in higher rates of injury. This almost should have been a new section, but I decided to just make it a ginormous footnote — footnotes are there for delving if you want to, that’s the idea! You can read a summary of the research in the bibliography (see Hides et al), but the relevance to back pain is spelled out in detail here. And it’s interesting. See section #2, Diagnosis: Your low back is not fragile!

Upgraded (Aug 25 '10, section #4.13) — Section now includes discussion of that bizarre and already infamous paper in the New England Journal of Medicine (see Berman). I also make an important new point: exactly why acupuncture placebos are such a problem for low back pain patients in particular. See section #4.13, The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.

Like new (Aug 7 '10, section #4.14) — Rewritten. I’ve lost track and can’t be bothered to go back into the archives to figure it out for sure, but I think that this section was brand new (but never announced) late in 2009, and then this past week I gave it a substantial upgrade: it is now one of the best-referenced chapters in the book, and it says as much as probably needs to be said on the subject — or more! See section #4.14, Core strengthening has failed to live up to the hopes and dreams of therapists and patients.

New cover (Aug 6 '10, section #4.14) — At last! This e-book finally has a “cover.” SHOW See section #4.14, Core strengthening has failed to live up to the hopes and dreams of therapists and patients.

Minor update (Jun 7 '10, section #3.7) — Updated with a summary of a bizarre experiment with muscle relaxants that had quite surprising results. See section #3.7, Pain medications (and even alcohol) can be useful.

Minor update (Jun 5 '10, section #4.19) — Added a scientific thumbs down for transcutaneous electric nerve stimulation (TENS). See section #4.19, A few more snack-sized reality checks: brief comments on other treatments to avoid.

New section (Jun 5 '10, section #3.23) — A surprising scientific thumbs up for comfrey ointment was worth a whole new small section. See section #3.23, Comfrey makes backs comfy, study claims.

Minor update (Feb 13 '10, section #1.1) — Added clear evidence that family doctors don’t do a good job caring for patients with low back pain, and that a myth-busting ebook like this is still important. See section #1.1, A tragic low back pain myth.

New section (Jan 23 '10, section #3.31) — No notes. Just a new section. See section #3.31, Less than a cure, but better than nothing: short term symptom relief options for low back pain.

New section (Jan 23 '10, section #3.17) — An important update: a major new section that goes a long way to substantiating one of the most important points of this tutorial. See section #3.17, The evidence for massage.

Major upgrade (Jan 23 '10, section #3.7) — Rewritten and significantly expanded information about medications. See section #3.7, Pain medications (and even alcohol) can be useful.

New section (Jan 22 '10, section #3.22) — Having debunked expensive spinal traction using expensive decompression machines, here are some ideas for cheaper and safer methods of tractioning. See section #3.22, Traction: low back pain on the rack.

New section (Jan 21 '10, section #4.18) — No notes. Just a new section. See section #4.18, Spinal decompression therapy: worth the money and risks?

New section (Nov 25 '09, section #3.10) — Today I found a way to say some simple things about the power of self-treatment that have been “on the tip of my tongue” for years now. It all evolved from writing about an important bit of research, showing that manual therapists cannot (reliably) diagnose trigger points. See section #3.10, Limitations of trigger point therapy, and how to take advantage of them.

1. Is “much” information really “just plain wrong”? I will establish this in the sections ahead with a steady supply of clearly explained references to the medical literature that patients can understand and professionals can respect. This extra “layer” of information in easy-to-use footnotes is available for any reader who wants to dig deeper and check my facts. For example, here’s a good start: In 2010, the Journal of Bone & Joint Surgery reported that “the quality and content of health information on the internet is highly variable for common sports medicine topics,” such as knee pain and low back pain — a bit of an understatement, really. Expert reviewers examined about 75 top-ranked commercial websites and another 30 academic sites. They gave each a quality score on a scale of 100. The average score? Barely over 50! For more detail, see Starman et al. BACK TO TEXT
2. I was an alternative health professional myself for many years — a Registered Massage Therapist, trained in Canada (unusually good training standards). Of course, some of my colleagues in alternative medicine were diligent students of medical science. However, in my experience, most were certainly not — indeed, many lack even the most basic knowledge of how medical science works or how to keep current with recent discoveries with clinical implications. BACK TO TEXT
3. 

   Don’t take my word for anything. Take this guy’s word for it. Dr. Richard Deyo has been busting myths about low back pain for longer than I’ve been alive.

   

   Or this guy’s word. Dr. Nikolai Bogduk has authored dozens of scientific papers about low back pain. He also questions and challenges many common beliefs about low back pain, and is one of the expert sources this tutorial relies upon.

   

   Or this guy’s. Dr. Siegfried Mense is the world’s foremost expert in muscle pain. He is the author of the most current and authoritative text on that subject, and one of this tutorial’s most important sources.

   BACK TO TEXT
4. There is an anxiety-producing myth that low back pain is serious and chronic if you can’t shake it after the first several weeks, when in fact many people recover just fine after that “deadline.” An entire section below is devoted to the strong scientific evidence about this. BACK TO TEXT

5. Most doctors are well aware that there are serious shortcomings in the medical management of most musculoskeletal problems, especially chronic pain cases. Dr. Jonathon Tomlinson, an instructor at St. Leonards Hospital in Hoxton, explains that “undergraduate training is focused on hospital orthopedics (broken bones and anything else that’s amenable to surgery) or rheumatology (nasty inflammatory diseases) which comprise a minority of the aches/pains/strains and injuries that people actually suffer from.”

   Medical researchers have done many studies showing that most doctors do not understand aches and pains or heed expert recommendations. A good recent example is a paper in the Archives of Internal Medicine showing that family doctors frequently ignore guidelines for the care of low back pain — see Williams et al.

   More generally, the Journal of Bone and Joint Surgery, and the Journal of the American Osteopathic Association, have both published papers recently showing that physicians simply do not have an adequate understanding of musculoskeletal medicine. In 2002, Freedman et al felt that “It is ... reasonable to conclude that medical school preparation in musculoskeletal medicine is inadequate.” Then again in 2005 in JBJS, Matzkin et al concluded that “training in musculoskeletal medicine is inadequate in both medical school and non-orthopaedic residency training programs.” Most recently, in 2006, Stockard et al wrote “82% of allopathic graduates ... failed to demonstrate basic competency in musculoskeletal medicine.”

   BACK TO TEXT
6. Once in a great while some cranky reader (always a guy) writes to tell me, “I didn’t learn anything from your book.” I’m a little skeptical about that, and it’s always tempting to start quizzing! There’s a great deal of information here, including analysis of research done last month. Sure, readers who have already done a lot of reading about back pain might already be familiar with a lot of it — but you will know that going in, of course, and you’ll find the nuggets of new information and perspective that any keen reader is always looking for. BACK TO TEXT
7. ZOOM

   

   Dr. John Sarno’s original best-seller about low back pain.

   My original inspiration for this tutorial was Dr. John Sarno’s 1984 book Mind Over Back Pain. (His more recent Healing Back Pain make too many empty promises. See my review.) However, as much as I respect Dr. Sarno’s early work, there are at least three reasons why this tutorial is better than his books: (1) I make a much more airtight case against the conventional medical myths of back pain than Dr. Sarno does; (2) I also build a much better case for the real causes of back pain, heavily referencing more credible sources than Dr. Sarno does; (3) and I offer many more practical suggestions than Dr. Sarno does, instead of focussing exclusively on the psychological factors. Although I have less experience and education than Dr. Sarno, I do have a lot more hands-on experience (and the useful perspective of a journalist). BACK TO TEXT
8. This is my translation/interpretation for patients of the somewhat more detailed information for physicians published in “Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society”. BACK TO TEXT
9. Dr. Richard Deyo, one of the great myth busters of low back pain research, believes that “low back pain is second to upper respiratory problems as a symptom-related reason for visits to a physician” — only the common cold causes more complaints. Hart et al puts low back pain in fifth place (lower because Hart oddly excludes chronic low back pain). Chronic low back pain is usually the kind that this article will examine. Andersson writes: “Although the literature is filled with information about the prevalence and incidence of back pain in general, there is less information about chronic back pain ….” Indeed, it is almost impossible to measure how much chronic low back pain there is: for every time that acute low back pain is the main reason for a visit to a physician, how many times does a patient mention low back pain as a secondary problem? Or goes to see an alternative health care professional about it instead? (Answer: pretty danged often.) So it’s actually possible that low back pain is the single most common reason that people seek help. BACK TO TEXT
10. Many researchers seem to believe that low back pain is a modern problem. For instance, Waddell writes, “Observations of natural history and epidemiology suggest that low-back pain should be a benign, self-limiting condition, that low back-disability as opposed to pain is a relatively recent Western epidemic ….” In 2008, Martin et al found that, “The estimated proportion of persons with back or neck problems who self-reported physical functioning limitations increased from 20.7%… to 24.7% … 1997 to 2005,” which certainly shows that it is a growing problem, and therefore likely to be worse now than in the past. A Spanish study (Jiménez-Sánchez et al) showed that musculoskeletal complaints (including a great deal of back pain, presumably) increased significantly from 1993 to 2001 (though remained stable in the years after that). Finally, Harkness et al did a nice job in 2005 of comparing rates of musculoskeletal pain (including low back pain) 40 years apart in the northwest of England, and found a large increase. Sarno also strongly portrays low back pain as a modern problem in his books — though he doesn’t defend it. It’s quite hard to say if back pain actually is a modern problem, or whether it just tends to be described as such. Remember that human beings have a strong tendency to sensationalize and dramatize! Harkness pointed out in their study that the appearance of an increase could be “could be partly explained by the ‘worried well’. The ‘worried well’ are those patients who are concerned about their health, and attend their GP to seek reassurance about their well-being.” This is a great example of how hard it is to really be sure of anything! BACK TO TEXT
11. Nachemson says, “Rarely are diagnoses scientifically valid ….” And Deyo: “There are wide variations in care, a fact that suggests there is professional uncertainty about the optimal approach.” Many other researchers have made this point, but Sarno states it most eloquently: “There is probably no other medical condition which is treated in so many different ways and by such a variety of practitioners as back pain. Though the conclusion may be uncomfortable, the medical community must bear the responsibility for this, for is has been distressingly narrow in its approach to the problem. It has been trapped by a diagnostic bias of ancient vintage and, most uncharacteristically, has uncritically accepted an unproven concept, that structural abnormalities are the cause of back pain” (p111). BACK TO TEXT
12. Sarno. Mind Over Back Pain, p27. BACK TO TEXT

There are 246 more footnotes in the full version of this book.
I like footnotes, and I try to have fun with them.

ZOOM

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