Dear Dr Siff,
I enjoyed your PP back pain as you say every anatomical 'abnormality' has
been done to death no one really has a clue about ongoing back pain other
than the occassional textbook 'orthopaedic' case...
Those that have success with manual based fix it techniques are doing great
work but unfortunately the same technique on a similar case may have
entirely different results so what is wrong or how does it work....??
some interesting (short readable) papers you may find worth looking at!
Magnetic Resonance Imaging of the Lumbar Spine - Useful Test or Tar Baby ?
New England J of Medicine July 14 1994 p115-116
Pain the Tissues and the Nervous System - A conceptual model Gifford L
Physiotherapy Jan 1998 vol 84 no1 p27 -35
The Mechanisms of fibromyalgia : a critical essay Wall P, Progress in
Fibromyalgia and myofascial pain Elsevier Science Publishers 1993 p53-61
(excellent challenging and humerous a rare combination)
The Placebo effect by Brown W Scientific American Jan 1998 p68-73 ....worth
another of your discussions a look at enhancing placebo or conditions that
benefit from it ....most things that much of modern medicine sees ????
Why does acute back pain become chronic - Chronic back pain is not the same
as acute back pain lasting longer Jayson M BMJ 7 June 1997 p1639-1640
sums up the complexities with up to date references in a page.....'extensive
epidemilogical studies have demonstrated little or no correlation between
back problems and inhereted factors , height weight deformity ( unless
gross) spinal movements muscle strength or radiological signs of disc
degeneration. Much more important are cardiorespiratory disease,
smoking,psychological morbidity poor work conditions social class education
and income ' etc etc how often do these things really enter into the
equation ????
Ian Stevens Glasgow UK
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