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Doody's Review ServiceReviewer: Dana J Lawrence, DC, MMedEd, MA (Palmer College of Chiropractic)
Description: The authors' emphasis is on understanding the mechanical explanations for back pain; thus, the book examines anatomy and loads, forces, and pathology for the lumbar spine, with particular importance placed upon biomechanics (as opposed to psychosocial factors). A number of illustrative color photographs benefit the text, whose content includes discussions of functional anatomy of the low back, biology of spinal tissues, epidemiology, spinal loading, and mechanisms of injury. The book concludes with a disucssion of medicolegal issues.
Purpose: The authors' purpose is to examine all the factors that influence back pain, focusing on the mechanical factors in particular. Inasmuch as there has been an emphasis upon psychosocial factors for low back pain in the medical literature, this is a welcome change in direction, since its focus is on biomechanics. This is therefore a needed book and one that should be well accepted. It does exactly what the authors ask it to do, and it does it well.
Audience: This book is directed mainly at those who treat low back pain such as physiotherapists, osteopaths, chiropractors, general practitioners, and nurse and occupational health practitioners. Students in each discipline will find it quite useful as well. The authors are some of the most well-known people in this field in all the world. Their expertise cannot be faulted in any way.
Features: The direction that this book takes is to first discuss the general anatomy of the lumbar spine, from a perspective that goes beyond strict anatomical detail and combines the kinematics and biomechanics of this region. By presenting the musculature of the lumbar region, it is easier to understand how forces created by those muscles will affect the low back. Microstructure is described as well, making it easier to understand the physiology affecting this region. Descriptions of epidemiology help to understand the scope of the problem. Pathology is described in detail. Some detail on prevention is presented. Especially well done are the two chapters on mechanical function of the spine and mechanical damage to the spine. The color plates illustrate key concepts. Shortcomings include the fact that references do not appear at the end of each chapter but are grouped at the end of the text, making it hard to check references. Also, the information on manipulation is glossed over very quickly.
Assessment: This excellent book presents in one location a sythesis of much of the recent literature on the mechanical factors contributing to low back pain. The logic of the text is easy to follow and each chapter builds upon concepts and ideas presented in earlier chapters. This is written at a relatively sophisticated level and as a result provides a wealth of information. I can think of few books to compare to it. I recommend it highly.