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L. Stanley Sell, M.D.
JAMA. 1952;150(10):987-990. doi:10.1001/jama.1952.03680100029009.
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In practicing medicine in an area where a large portion of the active male population is engaged in either farming or ranching, one is startlingly impressed by the high percentage of lumbar disk lesions in those patients who present themselves with a low back complaint. In my opinion, this is definitely not a chance correlation but is rather the result of certain occupational hazards. The main theme of this paper is that these disk lesions are all too frequently misdiagnosed and subsequently mismanaged by general practitioners and others unfamiliar with certain fundamentals of orthopedic practice.

More than 45 years have passed since Goldthwait and Osgood1 published their work on subluxations and strains of the sacroiliac joint, and the impact of their teachings on medical opinion is amply attested to by the fact that many physicians still attribute low back complaints to ailments having their origin in or around the


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