Buchbinder and Underwood are to be commended for providing useful information regarding back pain.1 However, they may not have had problems in understanding heterogeneity between studies outlined in a related CMAJ article2 had the studies taken physical examinations into account.
Chronic back pain may be due to either an ongoing nociception or neuropathy affecting spinal nerves, both of which have different causes and therefore present with completely dissimilar physical findings.3 A correct diagnosis and proper treatment would lead to a quicker resolution. Without a correct diagnosis, treatment would be empirical and haphazard.
References
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