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Letters

Low-back pain

C. Chan Gunn
CMAJ March 05, 2013 185 (4) 325; DOI: https://doi.org/10.1503/cmaj.113-2104
C. Chan Gunn
University of British Columbia, Vancouver, BC; and President, Institute for the Study and Treatment of Pain, Vancouver, BC
Roles: Honorary Professor, Family Practice
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Buchbinder and Underwood are to be commended for providing useful information regarding back pain.1 However, they may not have had problems in understanding heterogeneity between studies outlined in a related CMAJ article2 had the studies taken physical examinations into account.

Chronic back pain may be due to either an ongoing nociception or neuropathy affecting spinal nerves, both of which have different causes and therefore present with completely dissimilar physical findings.3 A correct diagnosis and proper treatment would lead to a quicker resolution. Without a correct diagnosis, treatment would be empirical and haphazard.

References

  1. ↵
    1. Buchbinder R,
    2. Underwood M
    . Prognosis in people with back pain. CMAJ 2012;184:1229–30.
    OpenUrlFREE Full Text
  2. ↵
    1. Costa D,
    2. Maher C,
    3. Hancock M,
    4. et al
    . The prognosis of acute and persistent low back pain: a meta-analysis. CMAJ 2012;184:E613–24.
    OpenUrlAbstract/FREE Full Text
  3. ↵
    1. Chan Gunn C
    . Neuropathic pain: a new theory for chronic pain of intrinsic origin. Ann R Coll Physicians Surg Can 1989;5:327–30.
    OpenUrl
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Canadian Medical Association Journal: 185 (4)
CMAJ
Vol. 185, Issue 4
5 Mar 2013
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Low-back pain
C. Chan Gunn
CMAJ Mar 2013, 185 (4) 325; DOI: 10.1503/cmaj.113-2104

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Low-back pain
C. Chan Gunn
CMAJ Mar 2013, 185 (4) 325; DOI: 10.1503/cmaj.113-2104
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