Response to Francis Murphey's theory on lumbar disc disease: upon reflection

Abstract

Dear Editor, The reviewer is asking whether it is, in fact, independent of Murphey's theory, wise to continue to follow the practice that emerged from Murphey's theory, and if so, why [2]. In my view, medical ethics and cost containment are of concern to the practice of medicine in industrial countries. Intradisc procedures for the treatment of low back pain, including discography and discectomy, are, based on our assessment, experimental and should not be performed [1]. Research should be based on thorough knowledge of the scientific background and a careful assessment of risks and benefits, should have a reasonable likelihood of benefit for the population studied, and should be conducted by suitably trained investigators using approved protocols, subject to independent ethical review and oversight by a properly convened committee [4]. Furthermore, the annual cost of lower back pain in industrial countries is astronomical [3]. The elimination of unnecessary procedures, such as discography and the intradiscal procedures that ultimately have been a burden on taxpayers, is the objective of governments and healthcare providers in industrial countries.