Treat the Patient, Not the CT Scan

Great article from a professor at the Stanford School of Medicine. I have had many patients who while in severe pain were told by some doctor that nothing was wrong with them because their x-ray or MRI was negative! I know they were taught about functional disorders in school as these types of disorders occur in most of the body systems. This is similar to telling someone with symptoms from a heart arrythmia that nothing is wrong with them because the heart echocardiogram does not show any abnormalities of the heart structures.

Here is a link to the article: Treat the Patient, Not the CT Scan

Family practitioners and orthopedist very deficient in knowledge of evidence based guidelines for managing low back disorders

This study shows that family practitioners and orthopedist are very deficient in their knowledge of research based guidelines for the management of back disorders. The family practitioners scored poorly at 70% and the orthopedists did even much worse at 44%! Unfortunately many people hold up orthopedists as the experts for all back problems.

Orthopaedists' and family practitioners' knowledge of simple low back pain management:

Spinal manipulation as good as surgery for most patients with sciatica due to disc herniation

There surprisingly have been very few studies of any treatments for sciatica secondary to disc herniation, including surgery. Here is a new study comparing manipulation to surgery on patients with sciatica secondary to disc herniation. All the patients in the study had failed at least 3 months of management including treatment with analgesics, lifestyle modification, PT, massage therapy, and/or acupuncture. 60% of this population that had failed other medical management benefited from manipulation to the same degree as the surgical group!

Manipulation or Microdiskectomy for Sciatica? A Prospective Randomized Clinical Study