In Reply: Drs Runhaar and van der Wouden raise interesting points about patient population generalizability in our clinical trial. In our view, patients included in our study were representative of patients seen in general clinical practice. Recruitment was 16.4% by general practitioners, 52.0% from chiropractors, 12.0% from physiotherapists, and 19.6% from the newspaper advertisement. In Norway, persons with chronic LBP with or without an acute flare often see different types of health care personnel according to their own preferences. Medical doctors, chiropractors, and physiotherapists specializing in manual therapy are licensed to prescribe sick leave; order x-ray tests, computed tomography, and MRIs; and refer to medical specialists.
Wilkens P, Scheel IB, Storheim K. Effect of Oral Glucosamine on Pain-Related Disability in Patients With Chronic Low Back Pain—Reply. JAMA. 2010;304(15):1673. doi:10.1001/jama.2010.1467