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Legacy update log for the low back pain tutorial

This is a listing of older updates made to the low back pain tutorial. They are provided for historical interest only, a “paper trail” demonstrating how the document has been maintained. Newer updates are listed in the tutorial itself.

2016Upgrade: Greatly improved information about opioids (and linking to much more information). [Section: Prescription medications: opioids, sedatives, and anticonvulsants.]

2016Upgrade: Added much more information. [Section: Over-the-counter pain medications might be slightly useful (and maybe even alcohol).]

2016Correction: Removed overconfident statements about the clinical significance of the effects of psychoactive drugs, plus related minor updates. [Section: A trigger point checklist: does this sound like you?]

2016Minor update: Some editing and new caveats. [Section: Diagnostic numbing of facet joints.]

2016Science update: Some fresh citations that strongly reinforce the main point of the section, and a few entertaining new examples of weird placebo effects. [Section: The back surgery placebo problem, and how it limits our knowledge of the effectiveness of back surgeries.]

2016Safety update: Updated opioid summary for consistency with new CDC guidelines. [Section: Prescription medications: opioids, sedatives, and anticonvulsants.]

2016Update: Added new intro to section about distorted body image. [Section: Is there such a thing as a “subluxation”? Can your back be “out”?]

2016Minor update: Clarification of the significance of some previously cited science, Ferreira et al. [Section: Core strengthening has failed to live up to the hopes and dreams of therapists and patients.]

2016Science updated: New citations and more information about spontaneously resolving herniations. [Section: Low Back Pain Diagnosis: Your low back is not fragile! Most of what is supposedly “wrong” with spines is nonsense.]

2016Science update: Beefed up the evidence that vertebroplasty is an ineffective surgical fix for an allegedly structural problem. [Section: Low Back Pain Diagnosis: Your low back is not fragile! Most of what is supposedly “wrong” with spines is nonsense.]

2016Minor science update: Added a note about the odds of back pain having a serious cause. [Section: “What if there’s something seriously wrong in there?”.]

2016Science update: Added some general explanation of cognititive-behavioural therapy, with a key reference. [Section: The confidence cure.]

2015Science update: Added discussion of a popular acupuncture-for-back-pain paper, Cherkin 2009. Which is not fit to line a birdcage, in my opinion. [Section: The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.]

2015Edited: Modernization of trigger point summary, more science, and more acknowledgement of controversies. [Section: There is nothing “just” about muscle.]

2015Edited: Modernization of trigger point summary, more science, acknowledgement of controversies. [Section: So then what? The missing muscle piece.]

2015Science update: Added surprisingly good news about methylene blue injections. [Section: Facet joint and intradiscal steroid injections are not recommended for most patients.]

2015Science update: There’s been more study of the role of bacteria in back pain. And still not enough! [Section: Antibiotics for back pain: a debacle.]

2015Science update: Added information and references about transitional vertebrae and Bertolotti’s syndrome. [Section: The role of true nerve problems in low back pain.]

2015Science update: Added 3 good references and a diagram about how much “wiggle” room nerve roots have. [Section: Could you have a “pinched” nerve? The nerve pinch myth.]

2014Minor update: Added a reference for reassuring data about recovery rates. [Section: The case for hope: some “incurable” chronic low back pain can still be cured.]

2014Major update: The first complete professional editing of this book has now been completed. Although the difference will not be obvious to most readers, several hundred improvements and corrections were made, and it is definitely a smoother read.

2014Minor update: Added Digital Motion X-ray. [Section: A few more snack-sized reality checks: brief comments on other treatments to avoid.]

2014Minor update: Plugged a good quality microbreaking reminder app [Section: Sitting, chairs, and ergonomics.]

2014Minor Update: Some relevant humour: added a pretty funny video about a core strengthening product. [Section: Is it core weakness?]

2014New section: A minor topic, but one of the most overdue sections I’ve ever added to the book: I’ve been asked about these devices a lot over the years. [Section: Back bracing and stabilization contraptions (especially inflatable ones).]

2014Rewritten: Cleaned up and modernized, more information, especially a more useful and evidence-based self-treatment tip. [Section: Morning pain and sleep posture.]

2014New section: No notes. Just a new section. [Section: 3 Lessons From an Acute Back Trauma: Joint popping, muscle dominance, and the mind game.]

2013Minor update: Added some great backup from a terrific surgeon blogger — who advocates for the necessity of testing placebo surgeries, exactly as I have in this section for many years. [Section: The back surgery placebo problem, and how it limits our knowledge of the effectiveness of back surgeries.]

2013Minor update: Added a (fascinating) footnote about the myth of anaesthetic paralysis. [Section: Prescription medications: opioids, sedatives, and anticonvulsants.]

2013Expanded: Added subsection on electroacupuncture. [Section: The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.]

2013Science update: Reporting on the greatest hits of back pain science (Machado 2009, a source of several important points here and in other sections). [Section: So what’s the plan?]

2013Science update: Some science showing that the effect of hamstring tightness on back function/pain isn’t exactly potent. [Section: What about stretching?]

2013Science update: Interpretation of a little junky new science about Pilates. [Section: Core strengthening has failed to live up to the hopes and dreams of therapists and patients.]

2013Comedy update: Added an amusing, extended example from the TV show, The IT Crowd. [Section: Pain and fear, together at last: an even simpler vicious cycle.]

2013Minor update: Added a quote that beautifully expresses the reason for treating chronic pain with … maturity. [Section: Another %[email protected]&*!! personal growth opportunity.]

2013New section: An overdue upgrade! This way pain and fear power each other is now explained much more clearly and thoroughly than before. It’s noteworthy that, with this update, Dr. Lorimer Moseley’s valuable perspective on back pain is now fairly well-represented in this book. [Section: Pain and fear, together at last: an even simpler vicious cycle.]

2013New section: Important new chapter about a hype-hot news item. [Section: Antibiotics for back pain: a debacle.]

2013New evidence: Rare good news: the first good quality scientific test of “the confidence cure” had promising results — which is just about the best thing that could have happened to this chapter. [Section: The confidence cure.]

2013Minor update: Interesting, useful new reference. [Section: Low Back Pain Diagnosis: Your low back is not fragile! Most of what is supposedly “wrong” with spines is nonsense.]

2013Minor update: Upgraded risk and safety information about Voltaren Gel. [Section: Over-the-counter pain medications might be slightly useful (and maybe even alcohol).]

2013Major update: All major professional treatment options now summarized. [Section: Getting professional help: A consumer’s guide to buying therapy and medical care for low back pain.]

2013New section: New standard section I’m introducing to most of the tutorials to “manage expectations.” Too many readers assume there’s going to be a specific miracle treatment plan. [Section: So what’s the plan?]

2013Major update: All major self-treatment options now summarized. [Section: Self-treatment options: How to save yourself from low back pain, or at least avoid getting hurt or ripped off trying.]

2013Edited: Nothing in particular has changed, but it’s definitely a better chapter now. [Section: The confidence cure.]

2012Science update: Added (more) evidence showing the role of smoking in chronic back pain. [Section: Now what?: An action-oriented summary of recommendations.]

2012Science update: New reference strongly supporting a key, controversial point. [Section: The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.]

2012Minor update: Added an intriguing quote about evolution and the lack of back pain in hunter gatherers. [Section: Are you crooked? The alignment theories: short legs, pelvic tilts, and spinal curves.]

2012Science update: Put “foot fear” in context with some reassuring high heels science. [Section: Is it all in your feet? Foot-o-centric low back pain theories.]

2012Science update: Added evidence that the stakes are high with chronic pain: it may even shorten lives. [Section: A tragic low back pain myth.]

2012Minor update: Added a new suggestion for safe, pleasant self-tractioning. [Section: Traction: low back pain on the rack!]

2012New section: No notes. Just a new section. [Section: Back pain and sneezing.]

2012Science update: Interesting evidence that massage therapists cannot reliably find the side of pain by feel. [Section: Structural problems in the low back are hard to diagnose accurately.]

2012Minor update: Added a fine example of taking yoga very, very seriously as an option. See first footnote in section. [Section: Stress relief and the tyranny of meditation and yoga.]

2012Update: Editing, and several new paragraphs about safety issues. [Section: Yoga and meditation are still an option, of course.]

2012Minor update: Some simple revision for clarity and quality, and a bit more content. [Section: Stress relief and the tyranny of meditation and yoga.]

2012Science: More science, and a few substantial new footnotes fielding common concerns and questions. [Section: Core strengthening has failed to live up to the hopes and dreams of therapists and patients.]

2012Science update: Clarified information about pelvic tilt, and beefed it up with some more science. [Section: Are you crooked? The alignment theories: short legs, pelvic tilts, and spinal curves.]

2012Minor update: Important new, skeptical footnote about the dangers of the powerful narcotic drugs. [Section: Prescription medications: opioids, sedatives, and anticonvulsants.]

2011Science update: More evidence of the exercise effects are limited and non-specific. See the paragraph starting “Does spinal function improve … ” [Section: Core strengthening has failed to live up to the hopes and dreams of therapists and patients.]

2011New section: No notes. Just a new section. [Section: What is the difference between a ‘confidence cure’ and a mere placebo?]

2011Updated: Added scientific cases studies, examples, pictures and video of true dislocation and abnormal anatomy to help drive home the point that even significant spinal joint dysfunction can be surprisingly harmless … never mind subtle joint problems. [Section: Spinal manipulative therapy (SMT): Adjustment, manipulation, and cracking of the spinal joints.]

2011Minor update: Minor, but fun — a great quote about models of slipped discs, and a good new image to help it along. [Section: Those scary spine models.]

2011Rewritten: Improved and expanded. In particular, intramuscular stimulation (IMS) was “demoted.” I am disillusioned with it and no longer want to promote it without strong caveats. [Section: “Medical” treatment option for trigger points: dry needling (IMS), stretch and spray, and trigger point injections.]

2011Major science update: Detailed reporting on some new yoga science. Significant re-writing of the section ensued. Sometimes new science does not back up my preconceptions: I’ve changed my tune here somewhat. [Section: Yoga and meditation are still an option, of course.]

2011Minor update: Added a couple great points/quotes from doctors about overuse of MRI, as reported by Gina Kolata for the New York Times. [Section: Low Back Pain Diagnosis: Your low back is not fragile! Most of what is supposedly “wrong” with spines is nonsense.]

2011New science: I stumbled across a fantastic scientific paper about the prevalence of nerve pinches (hint: it’s low). Excellent perspective. [Section: Could you have a “pinched” nerve? The nerve pinch myth.]

2011New section: A key concept covered in the trigger points tutorial long ago, but so relevant to low back pain that I decided it needed to be here as well. [Section: Could it be a vicious cycle of pain-spasm-pain?]

2011New section: This section is a summary of an important concept that’s been available in a free article since late 2008, but it really needed to be emphasized here. [Section: From the frying pan of injury pain to the fire of trigger point pain.]

2011Minor update: A few new paragraphs summarizing an important new study of massage for low back pain with disappointing results. [Section: The evidence for massaging back pain.]

2011Minor update: Added a reference about the poor overall quality of online information about common injuries. See Starman et al. [Section: Introduction.]

2011New section: More information about an important characteristic of muscle-dominated back pain. [Section: “Out of nowhere”: seemingly random episodes of low back pain.]

2011Major update: Totally renovated section: re-written, reformatted, expanded, upgraded. A few new checklist items were added, most were expanded, and all were clarified. A separate and handier “quick” checklist was added to the existing “slow” checklist. [Section: A trigger point checklist: does this sound like you?]

2011Major update: Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really been cleaned up in general, making it significantly easier for me to update the tutorial — which will translate into more good content for readers. Care for more detail? Really? Here’s the full announcement.

2011Minor Update: Added evidence that spinal fusion surgeries are not just ineffective but often harmful (Nguyen). [Section: The back surgery placebo problem, and how it limits our knowledge of the effectiveness of back surgeries.]

2011Minor update: Added a fascinating science item about the effect of anti-inflammatory gels on back pain (Huang). [Section: Over-the-counter pain medications might be slightly useful (and maybe even alcohol).]

2011Minor Update: Long overdue, I finally added some science to this section, showing that the connection between low back pain and obesity is weaker than it seems (Wright). [Section: Do you really need to lose some weight?]

2011Minor Update: Added some interesting references about sensation (Luomajoki) and the relationship between back pain and a disrupted “body schema” (Bray). [Section: Is it core weakness?]

2011Upgraded: New artwork from PainScience.com artist Gary Lyons, plus some important new references. [Section: Spinal manipulative therapy (SMT): Adjustment, manipulation, and cracking of the spinal joints.]

2011Minor Update: Added a fun and informative quote from the TV show House. [Section: Low Back Pain Diagnosis: Your low back is not fragile! Most of what is supposedly “wrong” with spines is nonsense.]

2011Updated: Added some new evidence about back pain and aging, and a nice new graph. [Section: Maybe you’re just getting older? Actually, no ….]

2011Minor update: Just added a link, but a really great link! The CBC show Marketplace did an amazing job last year reporting on spinal decompression machines. Well worth a look — the show and their show page is probably now the single best source of information on this topic. [Section: Spinal decompression therapy: worth the money and risks?]

2011Minor update: Some editorial cleanup on core strengthening, and I a link to a good summary of recent research. [Section: Is it core weakness?]

2010Like new: Re-written and significantly expanded. [Section: Act normal! Rest minimally and strategically, while maintaining as much normal activity as you can.]

2010New section: No notes. Just a new section. [Section: Could low back pain be an overuse injury?]

2010Major Update: Rewriting and expansion of the Special Supplement on spinal manipulative therapy. [Section: Is there such a thing as a “subluxation”? Can your back be “out”?]

2010Updated: Added a much more detailed description of the Hancock et al study, and in fact turned it into the main substance of this section. [Section: Structural problems in the low back are hard to diagnose accurately.]

2010Updated: Added a very beefy footnote about some new research showing that muscle imbalance does not result in higher rates of injury. This almost should have been a new section, but I decided to just make it a ginormous footnote — footnotes are there for delving if you want to, that’s the idea! You can read a summary of the research in the bibliography (see Hides et al), but the relevance to back pain is spelled out in detail here. And it’s interesting. [Section: Low Back Pain Diagnosis: Your low back is not fragile! Most of what is supposedly “wrong” with spines is nonsense.]

2010Upgraded: Section now includes discussion of that bizarre and already infamous paper in the New England Journal of Medicine (see Berman). I also make an important new point: exactly why acupuncture placebos are such a problem for low back pain patients in particular. [Section: The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.]

2010Like new: Rewritten. I’ve lost track and can’t be bothered to go back into the archives to figure it out for sure, but I think that this section was brand new (but never announced) late in 2009, and then this past week I gave it a substantial upgrade: it is now one of the best-referenced chapters in the book, and it says as much as probably needs to be said on the subject — or more! [Section: Core strengthening has failed to live up to the hopes and dreams of therapists and patients.]

2010New cover: At last! E-book finally has a “cover.”

2010Minor update: Updated with a summary of a bizarre experiment with muscle relaxants that had quite surprising results. [Section: Prescription medications: opioids, sedatives, and anticonvulsants.]

2010Minor update: Added a scientific thumbs down for transcutaneous electric nerve stimulation (TENS). [Section: A few more snack-sized reality checks: brief comments on other treatments to avoid.]

2010New section: A surprising scientific thumbs up for comfrey ointment was worth a whole new small section. [Section: Comfrey makes backs comfy, study claims.]

2010Minor update: Added clear evidence that family doctors don’t do a good job caring for patients with low back pain, and that a myth-busting ebook like this is still important. [Section: A tragic low back pain myth.]

2010Major upgrade: Rewritten and significantly expanded information about medications. [Section: Prescription medications: opioids, sedatives, and anticonvulsants.]

2010New section: No notes. Just a new section. [Section: Less than a cure, but better than nothing: short term symptom relief options for low back pain.]

2010New section: An important update: a major new section that goes a long way to substantiating one of the most important points of this tutorial. [Section: The evidence for massaging back pain.]

2010Major upgrade: Rewritten and significantly expanded information about medications. [Section: Over-the-counter pain medications might be slightly useful (and maybe even alcohol).]

2010New section: Having debunked expensive spinal traction using expensive decompression machines, here are some ideas for cheaper and safer methods of tractioning. [Section: Traction: low back pain on the rack!]

2010New section: No notes. Just a new section. [Section: Spinal decompression therapy: worth the money and risks?]

2009New section: Today I found a way to say some simple things about the power of self-treatment that have been “on the tip of my tongue” for years now. It all evolved from writing about an important bit of research, showing that manual therapists cannot (reliably) diagnose trigger points. [Section: Limitations of trigger point therapy, and how to take advantage of them.]

2009Funny, but today I found a way to say some simple things about the power of self-treatment that have been “on the tip of my tongue” for years now. So here’s a nice new section: And it all evolved from writing about an important bit of research, showing that manual therapists cannot reliably diagnose trigger points.

2009A little extra scientific evidence to make the point “” This new study from the Lancet puts the nail in the coffin of the MRI myth: it’s now just about as busted as a myth can get.

2009New section, “,” based on interesting new scientific evidence. The research is explained in a short free article, but I discuss it in quite a bit more detail here.

2009Overhauled all the diagnosis sections — — reorganizing and editing here there and everywhere. Three sections were added or almost completely re-written. In particular, information about nerve blocks was added, and disc herniations are discussed in more detail than before.

2009Polished and expanded the section, “.”

2009Added a reference to some really fascinating new research about vertebroplasty — yet more evidence that structural “instability” isn’t actually the main problem in back pain, because “stabilizing” doesn’t actually help.

2009The sections on and have been condensed into finely tuned summaries, and link to external articles covering these topics in much greater detail.

2009Small but good new section “.” Hat tip to Dr. Tarzwell for suggesting this one: I had previously neglected the (obvious) importance of this particular medical speciality for back pain patients.

2009Important safety update. The section “” has been upgraded, based on a much more careful and thorough translation of the best and most recent medical guidelines, and links out to a new free article with considerably more detail for patients who are concerned about an ominous cause of their low back pain. I’m really happy with this update: for some time now I’ve known that I needed to “cover my butt” with better information about more serious causes of low back pain — they are rare, but they do exist. I was inspired to do so by a case study from a physician I know, who encountered a patient with back pain that was actually caused by a cancer. That story convinced me that it was time to make sure my readers know when to worry about low back pain, and when not to.

2009Minor update. Started a new section, “.”

2009Minor update. Added a solid new reference concerning the overuse of X-ray and MRI.

2009Another new section this morning — a long overdue debunking of prolotherapy, a particularly classic example of a therapy that has failed to prove efficacy after 50 years and numerous fair scientific tests. I recommend the section not just for the useful information, but because it’s quite an interesting topic. See “.”

2009Small new section, based on some persuasive scientific reviews recently published in the journal Spine: “.”

2009Substantive new section, “,” summarizing some common causes of low back pain, such as facet joint dysfunction and injury. Such topics were missing from the tutorial before because they are so hard to diagnose accurately, because professionals and patients alike to over-react to the very idea of them, and because they are almost invariably complicated by muscle pain that becomes more prominent than the original problem. Nevertheless, these problems have a place in the tutorial.

2009The visual design of the site was upgraded over the past several days. Although this is not an update to the content of this tutorial, it is nevertheless a significant upgrade for all of them — like publishing new editions of books with better typesetting and layout. The new design is even cleaner and reader-friendly; it now looks that good in most web browsers; and pages load as much as 50% faster. Many under-the-hood improvements will make it much easier for me to improve tutorial content. The tutorials are now well-oiled machines of digital publishing goodness, vastly superior to the low-production values of most eBooks. More information about the upgrade is published on the front page.

2009Two completely new and large sections about scoliosis — one section about dubious diagnosis of scoliosis and the exaggeration of the importance of it in low back pain, and another section about how scoliosis is more or less impossible to therapize. Both sections include interesting case studies and lots of great examples of nonsense in low back pain management — this is the most substantial addition to the tutorial in several months. The new sections are: “” and “.”

2009Minor update: added/clarified a good reference to the scientific literature regarding acupuncture for low back pain.

2009Added a new appendix to the tutorial today, just something interesting that I couldn’t find a good place for in the main body of the tutorial: “.”

2009Some small but important updates to the section, “.” This section still suggested that optimism about acupuncture was justified. Recent scientific evidence has continued to hammer away at acupuncture, and optimism can no longer be justified. You can read about the most recent acupuncture evidence in, Does Acupuncture Work for Pain?.

2009New section about sleeping factors, “

2008Physical Therapy just published a new review of a form of therapeutic exercise for the low back (“motor control” training, which is a form of the better known concept of core strengthening), and I’ve integrated it into the tutorial. See the section “.”

2008I published a major upgrade today (by far the largest ever I think). The tutorial gained about 10,000 new words and many miscellaneous improvements. Most of the new content is in the second half of the tutorial. In particular, there are now much more detailed treatment recommendations. Previously, the tutorial leaned too heavily on the idea of the “confidence cure” for low back pain. Even though I do not believe that low back pain is an all-in-your-head problem, some readers may have been left with the impression that the solution is all in your head — which I regret. As important as the confidence cure is, it’s just as important for low back pain patients to have concrete, evidence-based treatment and self-treatment options to pursue (especially treatment options for resolving muscular trigger points in the low back). I’m happy to say that those options are now thoroughly explored. A great deal of content was moved from the trigger points tutorial and adapted specifically for low back pain, and I also spent a lot of time adding miscellaneous practical tips and tricks and re-organizing the entire tutorial. It’s a different e-book! It has the same spirit as before … but with dramatically more practical advice.

2008Some major upgrades today! This is really where the power of a “web text” really shines, because this new information is based on bleeding edge, just-published science. I finally launched a new major chapter about surgery, “” kicking it off with a brand new section about “” And a large section, “” formerly an appendix, was updated and added to the new surgery section. Other sections about different types of surgery are planned for the relatively near future.

2008Integrated new information (in several places in the tutorial) related to the recent Journal of the American Medical Association study showing that increased spending on spinal pain (i.e. expensive surgical procedures especially) has not generally been helping people. See Back Pain Spending Surge Shows No Benefit in the New York Times.

2008Added valuable new section, “.”

2008Introduced special offer: all low back pain tutorial customers now receive a second, companion tutorial at no charge, Trigger Points & Myofascial Pain Syndrome This is a really great deal, and a valuable extension to this tutorial. If you missed this bargain and want to be included, just drop me a line and I will happily grandfather you into the deal.

2008Edited and expanded a few footnotes for clarity and to add a little more scientific evidence to the pile.

2007Today I took some existing content and reorganized it into several new “reality check” sections to help readers make sense of the many questionable theories out there about the cause of low back pain. There were many changes throughout, but most of the new content is in two of those sections, “” and “.”

2007Added a table to the section “,” illustrating the differences between nerve pain and trigger point pain. You can also find the same table in the free article Nerve Pain Is Overdiagnosed.

2007Added a good case study example in “”, and added a long overdue new section about self-treatment of trigger points, “.” It’s rudimentary for now, but will soon be expanded, and of course it links to more complete articles elsewhere on PainScience.com.

2007Added new section “” based on interesting new evidence from Archives of Internal Medicine.

2007Added a new section based on terrific new science from Archives of Physical Medicine & Rehabilitation. See “.”

2007Confused about whether or not to ice or heat the low back? I just added a new section, “.” The section is short, but it links to another (free) article that just got a bunch of major upgrading, so the details are available to anyone. And I upgraded the along with it.

2007A new study of back surgery published in New England Journal of Medicine inspired a major expansion and upgrade to the section, “.”

2007Added the substantial “” section, which discusses competitive back pain cure products, and critically reviews a prominent back pain program called “Lose the Back Pain.” Also spent a couple hours starting to seriously upgrade the treatment recommendations. Historically, this article relied too heavily on the idea that simply understanding back pain was significantly therapeutic in itself — that is true, but it’s not the whole story. The process of beefing up other self-treatment advice began today.

2007Added the “” and “” sections to bulk up this important subject matter.

2007Added the “” section to make it more certain that no reader with truly ominous back pain symptoms is inappropriately reassured by this article. Most back pain is not as serious as people think — but some back pain really is serious!

2007“Modernized” 122 footnotes. When I first published this article, it was the first heavily footnoted document I’d published on the internet, and my methods were clumsy, labour-intense, and error-prone. I’ve installed a much more reliable and user-friendly bibliography system on PainScience.com since then, but only just now got around to converting the messy old footnotes into the shiny new kind of footnotes. Hope you like ‘em!

2007Thoroughly revised all the sections discussing yoga (), and added the section. This was in response to some feedback from a client who wisely pointed out that I was too critical of yoga and meditation as a back pain treatment. In my eagerness to make it clear to readers that they don’t have to do yoga and meditate, I neglected to mention that it actually is a good option for people who want to practice yoga and meditation. Good point! Thanks, Sandra.