Psychological Factors in Pain

While I agree that " fibrositis " as an inflammatory state of muscle fibres has been " debunked," yet it is muscle fibres that are at fault in 95 % of cases of backache, and it hardly seems correct to state that the treatment of backache " degenerates " when it is directed at the cause. I have, in a light-hearted but sincere contribution,' indicated a possible explanation of the difficulties which have arisen since every, pain not in the abdomen has come to be laid at the door of the intervertebral disk. To treat every backache as an articular lesion wastes far more patient and physiotherapist man-hours than correctly applied massage, for the latter can be curative in one treatment. And infinitely more patient-hours are wasted by labelling a patient with lumbago as a disk, and particularly by issuing him with a corset, for he is then an invalid for life. All that we require is for physiotherapists to re-learn how to treat " fibrositis " and for doctors (including orthopaedic surgeons and specialists in physical medicine) to re-learn how to diagnose it. Manipulation is a blunderbuss method of treatment which is sometimes successful, but Dr. Cyriax does not seem to have read on to Mr. Dillwyn Evans's remarks on treatment.-I am, etc.,