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A STUDY OF 208 CASES OF LOWER BACK PAIN
J. R. KUTH
The Journal of Bone & Joint Surgery.  1922; 4:357-375 
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Abstract

1. Any injury or disease affecting the lower back structures (muscular, ligamentous, bursal, osseous or joint) may give rise to a similar symptom complex in cases of chronic low back pains.

2. Unfavorable static conditions in the lower back or extremities resulting from abnormalities in the lower extremities, postural or occupational strains, or from fatigue or weakness, frequently exist in these cases and operate as a cause in the production of symptoms either alone or in conjunction with other causes.

3. In all cases of low back pain, the possibility of a progressive disease of the spine or of the spinal cord should be kept in mind.

4. The best results from treatment were obtained in cases in which static abnormalities were corrected, in which lower back structures were protected or put at rest, and in which such structures, if shortened, were stretched.

5. Graduated systematic exercises are an important adjunct in the treatment of many of these cases.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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