Back Strain and Sciatica

Frank Roberts Ober (1881–1960) was born in Mount Desert, Maine, and lived all of his life in New England. After obtaining his medical degree from Tufts in 1905, he began postgraduate training in Boston. Moving through the orthopedic training programs and the junior staff positions, he finally became the John B. and Buckminster Brown Professor of Orthopaedics at Harvard. He served in World War I and became a close friend and associate of Robert Jones, with whom he co-authored a book. In addition to his extensive practice, Ober was active in medical affairs, serving as President of the Massachusetts Medical Society from 1941–1942 and as President of the American Orthopedic Association in 1943. At the time of the publication of his papers on section of the iliotibial band for low back pain and sciatica, the etiology of many of the low back syndromes was obscure. A popular operation was the trisacral fusion with arthrodesis of L5-S1 and both sacroiliac joints.1 The observations of Mixter and Barr2 on the herniated intervertebral disc had just been published. Ober advised his procedure only for those patients whose spinal roentgenograms showed no disease. He may have seen a substantial number of patients with low back pain and sciatica with contractures of the iliotibial band associated with poliomyelitis, which was endemic in New England during the early part of this century. Certainly, Ober's test, described in this Classic, was a regular part of the evaluation of the postpoliomyelitis patients. In a second paper, published the same year, Ober gives the results of his procedure; of 42 patients, 23 were reported “well,” ten “improved” and nine were “unimproved.”3