Detailed guides to painful problems, treatments & more

All Archived Updates for:

The Complete Guide to Low Back Pain

This page lists all 247 updates for one book on PainScience.com, The Complete Guide to Low Back Pain. See also:


showing of all-time updates

MAug 22The Complete Guide to Low Back Pain — Science update, intro to the nature of the beast — First update to this section in eight years, because the basic point has been sound the whole time. What changed? Better science, just a particularly good and relevant study that supports the gist of this introduction more strongly than anything that was available before.
MJul 29The Complete Guide to Low Back Pain — New sub-topic, backpacks and back pain.
LJul 21The Complete Guide to Low Back Pain — New chapter, all about walking for back pain.
MMay 31The Complete Guide to Low Back Pain — Minor addition, posture chapter — Added a bit of a rant, some summary perspective and colour: “Chasing posture as a cause of back pain is a dead end.”
LMay 27The Complete Guide to Low Back Pain — New chapter, risk factors — New chapter, inspired by new evidence, about how being out of shape is probably worse for your spine than biomechanical glitches, and how back pain patients eat more junk food.
MMay 22The Complete Guide to Low Back Pain — Revised, vicious cycle hypothesis — This is mostly an old chapter, but reframed, revised, with significant clarifications and caveats added. Despite being mostly the same, it’s quite different!
LMay 22The Complete Guide to Low Back Pain — New chapter, anxiety and back pain.
MMay 15The Complete Guide to Low Back Pain — More detail — More and better information about the dramatic over-prescription of anticonvulsants.
MMay 15The Complete Guide to Low Back Pain — Addition — Added an important clarification and citation about Nachemson’s famous flexion loading chart.
LApr 16The Complete Guide to Low Back Pain — New chapter.
SApr 14The Complete Guide to Low Back Pain — Added exercise advice — Oddly, the summary of all treatment recommendations chapter had nothing to say about exercise until now. Better late than never!
LApr 13The Complete Guide to Low Back Pain — Substantial re-write, exercise chapter — I added a new section about the science of back exercise, based largely on a major new review (IJzelenberg) … and then kept going and significantly improved the whole chapter.
MOct '23The Complete Guide to Low Back Pain — Revision, MDT review chapter — Just a bunch of miscellaneous revision as I prepared the chapter for publication as an excerpt.
LOct '23The Complete Guide to Low Back Pain — New section.
LSep '23The Complete Guide to Low Back Pain — Rewritten, back pain as an overuse injury — Like-new re-write. Before: simplistic and old-school by my 2023 standards. After: not very scientifically rigorous, but much more informed and wide-ranging speculation. And kinda fun.
LAug '23The Complete Guide to Low Back Pain — New chapter, treating rib subluxations.
LAug '23The Complete Guide to Low Back Pain — New chapter, rib subluxations — Not just a new chapter, but a particularly huge one, based on interesting new science, with plenty of value. (PainSci Members can also read this in a recent blog post, “Extra, extra! Extra floating ribs are way more common than anyone knew.”)
LAug '23The Complete Guide to Low Back Pain — New chapter.
SJun '23The Complete Guide to Low Back Pain — Science update, posture — Cited Schmidt on lordosis assessment reliability (there is none).
MMay '23The Complete Guide to Low Back Pain — Edited, directional preference chapter — Numerous minor corrections and improvements. Added ‘focalization’ as a clearer alternative to ‘centralization.’ Added two images. There's also now a blog post version of this chapter for PainSci members, and an audio version of the chapter embedded here.
SMay '23The Complete Guide to Low Back Pain — Small additions — Post-publication editing and polishing, most notably a couple more citations about MDT efficacy, and an interesting point about the implications of centralization’s origin story.
LMay '23The Complete Guide to Low Back Pain — New chapter, McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT)
LMay '23The Complete Guide to Low Back Pain — New chapter, centralization and directional preference.
MFeb '23The Complete Guide to Low Back Pain — Revised, specific diagnosis — After several years without much attention, this chapter has finally gotten a variety of improvements.
MDec '22The Complete Guide to Low Back Pain — Upgraded, movement snacks and general exercise — Added more about the role of general exercise in treating back pain.
MDec '22The Complete Guide to Low Back Pain — Upgraded, heat/ice chapter — Revised and expanded to include a discussion of Hydrocollators.
LNov '22The Complete Guide to Low Back Pain — Rewritten, scoliosis treatment chapter — Completely rebooted, all new everything about scoliosis treatment.
LNov '22The Complete Guide to Low Back Pain — Rewritten, scoliosis etiology chapter — Some of the original chapter remains, but mostly I just started over.
SNov '22The Complete Guide to Low Back Pain — Minor revision, ‘specific’ back pain chapter — Polished and tweaked. Nothing fancy, just good old fashioned editing.
MOct '22The Complete Guide to Low Back Pain — Additions, yoga — Restored some selected passages lost in the rewrite (and it’s now one of the longest chapters in the book, maybe the very longest, and longer than most standalone articles on the topic). Turning into a book within a book!
LOct '22The Complete Guide to Low Back Pain — Rewritten, yoga — A complete reboot of my coverage of the topic of yoga for back pain, with much more (and more recent) science.
MSep '22The Complete Guide to Low Back Pain — Science update — Added a much more detailed explanation of how the sensitivity of muscle has been demonstrated experimentally, based on Graven-Nielsen et al.
LAug '22The Complete Guide to Low Back Pain — New chapter, Pain Reprocessing Therapy — A major addition to the book, months in the making, 1000 words about the most sensational back pain science claim of 2022: that PRT works dramatically better than anything else.
LAug '22The Complete Guide to Low Back Pain — New chapter, CBT for back pain — A major addition to the book, months in the making, 1500 words and a dozen new citations, all about “the elephant in the mind-game room.”
LAug '22The Complete Guide to Low Back Pain — New chapter, overview of the psychology of back pain — An announcement and summary of key ideas on the theme of the psychology of back pain coming to the book throughout the middle of 2022.
MApr '22The Complete Guide to Low Back Pain — Improvements, hamstring stretching chapter — Just a bunch of miscellaneous clarifications and minor elaborations.
MApr '22The Complete Guide to Low Back Pain — New introduction, alignment chapter — Added a new introduction that makes this chapter officially the main posture chapter in the book. It now explains how poor posture supposedly causes back pain, which was previously missing, and is important context for other chapters (like hamstring stretching).
SMar '22The Complete Guide to Low Back Pain — Minor addition — Added “lack of personal experience” to the list of reasons professionals fail with back pain treatment.
LJan '22The Complete Guide to Low Back Pain — New chapter, ozone therapy.
MDec '21The Complete Guide to Low Back Pain — Correction, anticonvulsants chapter — I excessively demonized gabepentin and pregabalin based on an oversimplification of their legal history and inadequate attention to the evidence on efficacy for neuropathy. In fact, these drugs are efficacious for some neuropathies. While those were genuine errors in need of correction, the key message was accurate: they aren’t useful for back pain, and corruption is the only reason they were ever given to patients for that purpose.
LNov '21The Complete Guide to Low Back Pain — Major upgrade — Substantial clarifications and new information about ominous neuropathy symptoms, based primarily on Hoeritzauer and Angus, and initially inspired by Tom Jesson’s writing about the prevalence of cauda equina syndrome.
LNov '21The Complete Guide to Low Back Pain — New chapter, back pain as a disease of civilization.
S2021The Complete Guide to Low Back Pain — Science update — Added a citation and expert opinion.
S2021The Complete Guide to Low Back Pain — Minor improvements, alignment — Added some colour and did a little editing.
L2020The Complete Guide to Low Back Pain — New section, positional release — Adapted and expanded from an old chapter in my muscle pain book, with more detail and a back pain example.
M2020The Complete Guide to Low Back Pain — Science update, medications — Cited Ashbrook 2020 on the value of naproxen. Added some additional detail about how/why to experiment with different pain-killers.
M2020The Complete Guide to Low Back Pain — New section, back beliefs.
S2020The Complete Guide to Low Back Pain — 2020-07-09 — Added a doctor’s anecdote about treating many troublesome back mice over the years, both his own and his patients.
M2020The Complete Guide to Low Back Pain — More information, aging chapter — Discussed the prevalence of severe back pain in older patients, as a good exception-that-proves-the-rule.
S2020The Complete Guide to Low Back Pain — Edited — The standard one-week-later edit, but better than usual. The purpose of the chapter wasn’t as clear as it could have been on the first try. But I think I nailed it this time — this is about why “coping” is much better than it sounds.
L2020The Complete Guide to Low Back Pain — New chapter.
M2020The Complete Guide to Low Back Pain — Addition, back mice chapter — Added a fun pet theory and personal anecdote about the clinical relevance of lipomas.
M2020The Complete Guide to Low Back Pain — Expanded, specific back pain chapter — Some final elaborations and editing. This topic is now more or less completely addressed, I think.
S2020The Complete Guide to Low Back Pain — Polishing, hamstring stretching chapter — Miscellaneous editing and improvements.
M2020The Complete Guide to Low Back Pain — New sub-topic, oral corticosteroids — Compared and contrasted oral and injected corticosteroids; added some colour/context about anabolic steroids.
M2019The Complete Guide to Low Back Pain — Science update — This is probably the final update about antibiotics for back pain. It’s looking pretty closed. Famous last words? We’ll see.
L2019The Complete Guide to Low Back Pain — Major revision, hamstring stretching chapter — Although the bottom line remains essentially the same, this chapter is now much higher quality in every way. More information, clearer, and fully up-to-date scientifically.
L2019The Complete Guide to Low Back Pain — Rewritten again, sleep posture etc — This chapter was rewritten along with the chapter on causes of morning back pain, and is about double its previous size.
L2019The Complete Guide to Low Back Pain — Rewritten again, morning back pain chapter — This chapter is vastly expanded. In fact, it is now one of the largest chapters in any of my books.
L2019The Complete Guide to Low Back Pain — New section, sacroiliac joint dysfunction.
S2019The Complete Guide to Low Back Pain — Science update, yoga — A minor science update, long overdue. No change to the bottom line, just more evidence that yoga isn’t exactly curing most people’s back pain.
L2019The Complete Guide to Low Back Pain — Major revision, prolotherapy — Thorough science update and much more detail. Prolotherapy has gotten a bit of a revival in the last few years, and it’s persistence in the marketplace justifies more detailed coverage of the topic. Unfortunately, the bottom line hasn’t budged: still not recommended for back pain.
M2019The Complete Guide to Low Back Pain — Updated — Added some good expert quotes and optimistic perspective on pain education from Moseley.
M2019The Complete Guide to Low Back Pain — Science update — A particularly disappointing, predictable update on 2010’s overhyped news about methylene blue.
M2019The Complete Guide to Low Back Pain — Science update — A particularly disappointing, predictable update on 2010’s overhyped news about methylene blue.
M2019The Complete Guide to Low Back Pain — Upgrade, on the erratic quality of chronic low back pain — Modernized the trigger point content and added several paragraphs about sensitization as well.
S2019The Complete Guide to Low Back Pain — Science update — Pure reinforcement: cited Artus 2010 and Artus 2014, backing up Machado.
L2019The Complete Guide to Low Back Pain — New section, about the pros and cons of getting an MRI.
M2019The Complete Guide to Low Back Pain — Expansion, discussion of specific back pain — Today I added a little depth on a couple key points, and commentary on a really interesting example of specific spinal pain from Dr. Stu “There’s No Such Thing As Non-Specific Back Pain” McGill.
M2019The Complete Guide to Low Back Pain — Science update, medications — Finally added hard evidence of the obvious — over-the-counter pain meds don’t really work — and got into some nuances.
M2018The Complete Guide to Low Back Pain — Expansion — Continued the process of making this section into a more substantive exploration of the idea of specific back pain, and added a new example, a case study of back pain caused by a tumour on a nerve root.
M2018The Complete Guide to Low Back Pain — Example added — New sub-section, “A perfect example of a structural problem: cluneal nerve entrapment,” based on a fascinating case study reported by Aota.
M2018The Complete Guide to Low Back Pain — Substantial editing, neuropathy sections — Merged content from the back and neck pain tutorials, resulting in major upgrades to two important sections in both books.
M2018The Complete Guide to Low Back Pain — Substantial editing, neuropathy sections — Merged content from the back and neck pain tutorials, resulting in major upgrades to two important sections in both books.
L2018The Complete Guide to Low Back Pain — Science update, massage for back pain — Not just any science update, but a particularly important and intriguing flip-flop from the most important source in the field.
S2018The Complete Guide to Low Back Pain — Minor improvements — Discussed potential harms of strength training in a little more detail.
L2018The Complete Guide to Low Back Pain — New section — A new standard chapter for most PainScience.com tutorials summarizing several key concepts about placebo.
L2018The Complete Guide to Low Back Pain — Important update — Added an important new sub-section about anticonvulsants.
L2018The Complete Guide to Low Back Pain — Major science update, obesity section — New key new citations and thorough analysis.
L2018The Complete Guide to Low Back Pain — Upgraded — Added much more detail about the basics of neuropathy and revised everything else quite thoroughly. Expanded the discussion of implications of Jayson as promised last month.
S2018The Complete Guide to Low Back Pain — Science update, radiculopathy section — A science update … with quarter century old science about blood supply and radiculopathy (see Jayson). This is just a quick drop-in for now, but it’s fascinating, so I’ll be elaborating more in another update.
L2018The Complete Guide to Low Back Pain — New section, about back mice (lipomas)
L2018The Complete Guide to Low Back Pain — Major revision, introduction to care options — Phase 1 of a reboot of this part of the book. Today I’ve added much more detail to the intro, emphasizing good and bad reasons for seeking help.
L2018The Complete Guide to Low Back Pain — Major new section — Well, new to the book anyway. It has been available as a free article for quite a while, and it will remain so indefinitely. Although this content is not exclusive to the book, it definitely does belong here.
L2017The Complete Guide to Low Back Pain — New section.
L2017The Complete Guide to Low Back Pain — New section, needles for back pain.
L2017The Complete Guide to Low Back Pain — Major upgrade, diagnostic nerve blocks — The section has been re-written and expanded significantly, with a key change in position. After reviewing the same scientific papers previously cited more carefully, I decided that they were much less promising than I originally thought. The section has flip-flopped from optimism to pessimism about nerve blocks without a single change in what’s actually cited, just a change in the level of diligence in interpreting the science.
M2017The Complete Guide to Low Back Pain — Science update — An important follow-up on August’s major massage evidence update, I’ve now added a summary of the evidence for trigger point massage. Although the topic is not covered in detail here, much study went into making this summary possible.
L2017The Complete Guide to Low Back Pain — Major update — Rewritten and updated. I revisited all the evidence on massage for back pain, especially integrating Furlan et al (a major 2015 meta-analysis on this topic). The bottom line is now that the science is inconclusive and discouraging instead of optimistic. Sorry, everyone.
S2017The Complete Guide to Low Back Pain — Minor addition, introduction — Added an excellent recent example of awful back pain information.
S2017The Complete Guide to Low Back Pain — Minor update — Added discussion of orthotics to treat leg length differences for back pain.
L2017The Complete Guide to Low Back Pain — New section — An important and interesting acknowledgement that mechanical causes of back pain do exist.
M2017The Complete Guide to Low Back Pain — New subsection — Added content inspired by decades-old evidence of reduced spinal degeneration in “primitive” cultures where squatting is common. Some light editing of everything else in the chapter.
M2017The Complete Guide to Low Back Pain — Science update — Added a small but key new point and citation about genetic factors in degeneration; and an important new citation about the disconnect between imaging results and pain.
M2017The Complete Guide to Low Back Pain — Science update — Discussed important new review of SMT for acute low back pain. Significant revision of the section.
S2017The Complete Guide to Low Back Pain — Science update — Strong new reference to Andrade et al fully supports the main message of the section.
M2017The Complete Guide to Low Back Pain — Science update — Newer, better, evidence-based good news about disc herniation resorption.
M2017The Complete Guide to Low Back Pain — Science update — Updated references for debunking of TENS for back pain. Added ultrasound to the section.
S2017The Complete Guide to Low Back Pain — Minor improvement — Added a proper summary of Roffey et al, and a relevant personal footnote.
M2017The Complete Guide to Low Back Pain — Science update — Added discussion of a remarkable example of poor MRI reliability.
L2017The Complete Guide to Low Back Pain — Major correction — An evidence-based reversal of position and advice about sitting and back pain, correcting a long-standing error: my long-term assumption that too much sitting is a risk factor for back pain was never defensible.
S2016The Complete Guide to Low Back Pain — Science update — Added commentary on the “do not offer” acupuncture recommendation in the new NICE guidelines for back pain.
M2016The Complete Guide to Low Back Pain — Edited — Thorough revision and modernization. Although I revised this section just five years ago, it needed it again!
M2016The Complete Guide to Low Back Pain — Science update — There is now a good scientific concensus on the subject of spinal fusion, thanks to papers like Mannion 2013 and Hedlund 2016. Putting a spotlight on this called for some serious revision and editing. The whole section is greatly improved.
M2016The Complete Guide to Low Back Pain — Upgrade — Greatly improved information about opioids (and linking to much more information).
M2016The Complete Guide to Low Back Pain — Upgrade — Added much more information.
S2016The Complete Guide to Low Back Pain — Correction — Removed overconfident statements about the clinical significance of the effects of psychoactive drugs, plus related minor updates.
S2016The Complete Guide to Low Back Pain — Minor update — Some editing and new caveats.
S2016The Complete Guide to Low Back Pain — Science update — Some fresh citations that strongly reinforce the main point of the section, and a few entertaining new examples of weird placebo effects.
M2016The Complete Guide to Low Back Pain — Safety update — Updated opioid summary for consistency with new CDC guidelines.
S2016The Complete Guide to Low Back Pain — Update — Added new intro to section about distorted body image.
S2016The Complete Guide to Low Back Pain — Minor update — Clarification of the significance of some previously cited science, Ferreira et al.
S2016The Complete Guide to Low Back Pain — Science update — New citations and more information about spontaneously resolving herniations.
S2016The Complete Guide to Low Back Pain — Science update — Beefed up the evidence that vertebroplasty is an ineffective surgical fix for an allegedly structural problem.
S2016The Complete Guide to Low Back Pain — Minor science update — Added a note about the odds of back pain having a serious cause.
S2016The Complete Guide to Low Back Pain — Science update — Added some general explanation of cognititive-behavioural therapy, with a key reference.
M2015The Complete Guide to Low Back Pain — Science update — Added discussion of a popular acupuncture-for-back-pain paper, Cherkin 2009. Which is not fit to line a birdcage, in my opinion.
M2015The Complete Guide to Low Back Pain — Edited — Modernization of trigger point summary, more science, and more acknowledgement of controversies.
M2015The Complete Guide to Low Back Pain — Edited — Modernization of trigger point summary, more science, acknowledgement of controversies.
S2015The Complete Guide to Low Back Pain — Science update — Added surprisingly good news about methylene blue injections.
S2015The Complete Guide to Low Back Pain — Science update — Added surprisingly good news about methylene blue injections.
S2015The Complete Guide to Low Back Pain — Science update — There’s been more study of the role of bacteria in back pain. And still not enough!
M2015The Complete Guide to Low Back Pain — Science update — Added information and references about transitional vertebrae and Bertolotti’s syndrome.
M2015The Complete Guide to Low Back Pain — Science update — Added 3 good references and a diagram about how much “wiggle” room nerve roots have.
S2014The Complete Guide to Low Back Pain — Minor update — Added a reference for reassuring data about recovery rates.
L2014The Complete Guide to Low Back Pain — Major 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.
S2014The Complete Guide to Low Back Pain — Minor update — Added Digital Motion X-ray.
S2014The Complete Guide to Low Back Pain — Minor update — Plugged a good quality microbreaking reminder app Backache… which was actually inspired by this book. Very cool!
S2014The Complete Guide to Low Back Pain — Minor Update — Added some humour: a funny video about a core strengthening product.
L2014The Complete Guide to Low Back Pain — New 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.
M2014The Complete Guide to Low Back Pain — Rewritten — Cleaned up and modernized, more information, especially a more useful and evidence-based self-treatment tip.
M2014The Complete Guide to Low Back Pain — Rewritten — Cleaned up and modernized, more information, especially a more useful and evidence-based self-treatment tip.
S2013The Complete Guide to Low Back Pain — Minor 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.
M2013The Complete Guide to Low Back Pain — Expanded — Added subsection on electroacupuncture.
M2013The Complete Guide to Low Back Pain — Science update — Reporting on the greatest hits of back pain science (Machado 2009, a source of several important points here and in other sections).
S2013The Complete Guide to Low Back Pain — Science update — Some science showing that the effect of hamstring tightness on back function/pain isn’t exactly potent.
S2013The Complete Guide to Low Back Pain — Science update — Interpretation of a little junky new science about Pilates.
S2013The Complete Guide to Low Back Pain — Minor update — Added a quote that beautifully expresses the reason for treating chronic pain with … maturity.
L2013The Complete Guide to Low Back Pain — New section — Important new chapter about a hype-hot news item.
S2013The Complete Guide to Low Back Pain — New 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.
S2013The Complete Guide to Low Back Pain — Minor update — Interesting, useful new reference.
S2013The Complete Guide to Low Back Pain — Minor update — Upgraded risk and safety information about Voltaren Gel.
L2013The Complete Guide to Low Back Pain — Major update — All major professional treatment options now summarized.
L2013The Complete Guide to Low Back Pain — New 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.
L2013The Complete Guide to Low Back Pain — Major update — All major self-treatment options now summarized.
M2013The Complete Guide to Low Back Pain — Edited — Nothing in particular has changed, but it’s definitely a better chapter now.
S2012The Complete Guide to Low Back Pain — Science update — Added (more) evidence showing the role of smoking in chronic back pain.
S2012The Complete Guide to Low Back Pain — Science update — New reference strongly supporting a key, controversial point.
S2012The Complete Guide to Low Back Pain — Minor update — Added an intriguing quote about evolution and the lack of back pain in hunter gatherers.
S2012The Complete Guide to Low Back Pain — Science update — Put “foot fear” in context with some reassuring high heels science.
S2012The Complete Guide to Low Back Pain — Science update — Added evidence that the stakes are high with chronic pain: it may even shorten lives.
S2012The Complete Guide to Low Back Pain — Minor update — Added a new suggestion for safe, pleasant self-tractioning.
L2012The Complete Guide to Low Back Pain — New section.
S2012The Complete Guide to Low Back Pain — Science update — Interesting evidence that massage therapists cannot reliably find the side of pain by feel.
S2012The Complete Guide to Low Back Pain — Minor update — Added a fine example of taking yoga very, very seriously as an option. See first footnote in section.
M2012The Complete Guide to Low Back Pain — Update — Editing, and several new paragraphs about safety issues.
S2012The Complete Guide to Low Back Pain — Minor update — Some simple revision for clarity and quality, and a bit more content.
M2012The Complete Guide to Low Back Pain — Science update — More science, and a few substantial new footnotes fielding common concerns and questions.
M2012The Complete Guide to Low Back Pain — Science update — Clarified information about pelvic tilt, and beefed it up with some more science.
S2012The Complete Guide to Low Back Pain — Minor update — Important new, skeptical footnote about the dangers of the powerful narcotic drugs.
M2011The Complete Guide to Low Back Pain — Science update — More evidence of the exercise effects are limited and non-specific. See the paragraph starting “Does spinal function improve … ”
L2011The Complete Guide to Low Back Pain — New section.
M2011The Complete Guide to Low Back Pain — Updated — 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.
S2011The Complete Guide to Low Back Pain — Minor update — Minor, but fun — a great quote about models of slipped discs, and a good new image to help it along.
M2011The Complete Guide to Low Back Pain — Rewritten — 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.
L2011The Complete Guide to Low Back Pain — Major 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.
S2011The Complete Guide to Low Back Pain — Minor update — Added a couple great points/quotes from doctors about overuse of MRI, as reported by Gina Kolata for the New York Times.
S2011The Complete Guide to Low Back Pain — New science — I stumbled across a fantastic scientific paper about the prevalence of nerve pinches (hint: it’s low). Excellent perspective.
L2011The Complete Guide to Low Back Pain — New 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.
L2011The Complete Guide to Low Back Pain — New 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.
S2011The Complete Guide to Low Back Pain — Minor update — A few new paragraphs summarizing an important new study of massage for low back pain with disappointing results.
S2011The Complete Guide to Low Back Pain — Minor update — Added a reference about the poor overall quality of online information about common injuries. See Starman et al.
L2011The Complete Guide to Low Back Pain — New section — More information about an important characteristic of muscle-dominated back pain.
L2011The Complete Guide to Low Back Pain — Major 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.
L2011The Complete Guide to Low Back Pain — Major 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.
S2011The Complete Guide to Low Back Pain — Minor Update — Added evidence that spinal fusion surgeries are not just ineffective but often harmful (Nguyen).
S2011The Complete Guide to Low Back Pain — Minor update — Added a fascinating science item about the effect of anti-inflammatory gels on back pain (Huang).
S2011The Complete Guide to Low Back Pain — Minor 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).
S2011The Complete Guide to Low Back Pain — Minor Update — Added some interesting references about sensation (Luomajoki) and the relationship between back pain and a disrupted “body schema” (Bray).
M2011The Complete Guide to Low Back Pain — Upgraded — New artwork from PainScience.com artist Gary Lyons, plus some important new references.
S2011The Complete Guide to Low Back Pain — Minor Update — Added a fun and informative quote from the TV show House.
M2011The Complete Guide to Low Back Pain — Updated — Added some new evidence about back pain and aging, and a nice new graph.
S2011The Complete Guide to Low Back Pain — Minor 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.
S2011The Complete Guide to Low Back Pain — Minor update — Some editorial cleanup on core strengthening, and I a link to a good summary of recent research.
L2010The Complete Guide to Low Back Pain — Like new — Re-written and significantly expanded.
L2010The Complete Guide to Low Back Pain — New section.
L2010The Complete Guide to Low Back Pain — Major Update — Rewriting and expansion of the Special Supplement on spinal manipulative therapy.
M2010The Complete Guide to Low Back Pain — Updated — Added a much more detailed description of the Hancock et al study, and in fact turned it into the main substance of this section.
M2010The Complete Guide to Low Back Pain — Updated — 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.
M2010The Complete Guide to Low Back Pain — Upgraded — 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.
L2010The Complete Guide to Low Back Pain — Like 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!
S2010The Complete Guide to Low Back Pain — New cover — At last! E-book finally has a “cover.”
S2010The Complete Guide to Low Back Pain — Minor update — Added a scientific thumbs down for transcutaneous electric nerve stimulation (TENS).
L2010The Complete Guide to Low Back Pain — New section — A surprising scientific thumbs up for comfrey ointment was worth a whole new small section.
S2010The Complete Guide to Low Back Pain — Minor 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.
L2010The Complete Guide to Low Back Pain — Major upgrade — Rewritten and significantly expanded information about medications.
L2010The Complete Guide to Low Back Pain — New section.
L2010The Complete Guide to Low Back Pain — New section — An important update: a major new section that goes a long way to substantiating one of the most important points of this tutorial.
L2010The Complete Guide to Low Back Pain — Major upgrade — Rewritten and significantly expanded information about medications.
L2010The Complete Guide to Low Back Pain — New section — Having debunked expensive spinal traction using expensive decompression machines, here are some ideas for cheaper and safer methods of tractioning.
L2010The Complete Guide to Low Back Pain — New section.
L2009The Complete Guide to Low Back Pain — New 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.
M2009The Complete Guide to Low Back Pain — A 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.
L2009The Complete Guide to Low Back Pain — New 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.
L2009The Complete Guide to Low Back Pain — Overhauled 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.
M2009The Complete Guide to Low Back Pain — Polished and expanded the section, “.”
S2009The Complete Guide to Low Back Pain — Added 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.
L2009The Complete Guide to Low Back Pain — The sections on and have been condensed into finely tuned summaries, and link to external articles covering these topics in much greater detail.
M2009The Complete Guide to Low Back Pain — Small 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.
L2009The Complete Guide to Low Back Pain — Important 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.
S2009The Complete Guide to Low Back Pain — Minor update. Started a new section, “.”
S2009The Complete Guide to Low Back Pain — Minor update. Added a solid new reference concerning the overuse of X-ray and MRI.
L2009The Complete Guide to Low Back Pain — Another 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 “.”
L2009The Complete Guide to Low Back Pain — Substantive 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.
M2009The Complete Guide to Low Back Pain — Small new section, based on some persuasive scientific reviews recently published in the journal Spine: “.”
L2009The Complete Guide to Low Back Pain — The 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.
L2009The Complete Guide to Low Back Pain — Two 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 “.”
S2009The Complete Guide to Low Back Pain — Minor update: added/clarified a good reference to the scientific literature regarding acupuncture for low back pain.
L2009The Complete Guide to Low Back Pain — Added 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: “.”
M2009The Complete Guide to Low Back Pain — Some 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?.
L2009The Complete Guide to Low Back Pain — New section about sleeping factors, “
M2008The Complete Guide to Low Back PainPhysical 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 “.”
L2008The Complete Guide to Low Back Pain — I 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.
L2008The Complete Guide to Low Back Pain — Some 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.
M2008The Complete Guide to Low Back Pain — Integrated 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.
L2008The Complete Guide to Low Back Pain — Added valuable new section, “.”
M2008The Complete Guide to Low Back Pain — Edited and expanded a few footnotes for clarity and to add a little more scientific evidence to the pile.
L2007The Complete Guide to Low Back Pain — Today 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 “.”
M2007The Complete Guide to Low Back Pain — Added 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 Neuropathies Are Overdiagnosed.
L2007The Complete Guide to Low Back Pain — Added 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.
L2007The Complete Guide to Low Back Pain — Added new section “” based on interesting new evidence from Archives of Internal Medicine.
L2007The Complete Guide to Low Back Pain — Added a new section based on terrific new science from Archives of Physical Medicine & Rehabilitation. See “.”
L2007The Complete Guide to Low Back Pain — Confused 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.
L2007The Complete Guide to Low Back Pain — A new study of back surgery published in New England Journal of Medicine inspired a major expansion and upgrade to the section, “.”
L2007The Complete Guide to Low Back Pain — Added 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.
L2007The Complete Guide to Low Back Pain — Added the “” and “” sections to bulk up this important subject matter.
L2007The Complete Guide to Low Back Pain — Added 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!
M2007The Complete Guide to Low Back Pain — 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!
L2007The Complete Guide to Low Back Pain — Thoroughly 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.

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