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July 19, 1985

Medical Management of the Regional Musculoskeletal Diseases: Backache, Neck Pain, Disorders of the Upper and Lower Extremities

JAMA. 1985;254(3):429-430. doi:10.1001/jama.1985.03360030123039

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The subtitle of this book explains its compass. Arthritis is not excluded, as the section on the hand and wrist obviously has to pay attention to osteoarthritic lesions and rheumatoid arthritis. Arthritis is not the focus of the book, however; soft-tissue lesions are.

The ubiquitous backache naturally leads the way. A major public health problem, it will afflict at least seven of every ten of our population. It has a multiplicity of causes and has been treated with standard measures and some that are either suspect or controversial, including many that have never been subjected to controlled study. Manipulation is discussed intelligently, as are chemonucleolysis and many other procedures, culminating in the way the author approaches backache.

As Dr Hadler rightly indicts, "low back pain stands as a reproach to clinical investigation." It is the "leading cause of absenteeism from industry... responsible for an extraordinary percentage of compensable injuries and