Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study

Dear Editor,

Henschke et al (1) do not appear to be aware of the modern approach to
acute back pain (especially work related)as published by McGurk B, Bogduk
N,(2)and also presented to the World Pain Congress in 2005. McGuirk B
Bogduk N (3)have now published an article covering the simple exercises
with explanations, used originally by Indahl A et al(4) and also promoted
by McKenzie R (5)for all back pain management.

I have used these in my primary care/physiotherapy and
musculoskeletal practice very successfully for many years and our
musculoskeletal group has reviewed the basic anatomy of the lumbar spine
and recognised the importance of the Psoas/Erector-Multifidus muscles
around the lumbar spine as the true core spinal muscles, (which are
directly moderated by the mentioned exercises) and the activated sacro-
coccygeal entheses. For moderate to chronic back pain we also use our
modification of Blomberg's injection of localised entheses under
paravertebral dorsal nerve root anaesthesia(6)

When will primary care and others catch up with and use the proven
successful methods of managing acute back pain,(and now moderate to
chronic back pain), instead of rehashing older, but less useful methods
for research?

References:

1. Henschke et al, "Prognosis in patients with recent onset low back pain
in Australian primary care: inception cohort study" BMJ 2008; 337: a171

2. McGuirk B, Bogduk N," Evidence-based care for low back pain in
workers eligible for compensation." Occup Med (Lond). 2007 Jan;57(1):36-
42.)

3. McGuirk B, Bogduk N, "The "Indahl" exercises for low back pain"
Australasian Musculoskeletal Medicine Journal13;1:8-14 May 2008

4. Indahl A, Velund L, Reikeraas "Good prognosis for low back pain when
left untampered. a randomised clinical trial" Spine. 1995 Feb 15;20(4):473
-7)

5. McKenzie R "Treat your own back" 5th Edition Lower Hutt Spinal
Publications 1997 pp42-52)B

6. McKay B, 'Cheese and Chalk? Missing the real anatomy 'Letters to the
Editor Pain 137 (2008) 229-231.

Competing interests:
None declared