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Book Review
Low Back and Neck Pain: Comprehensive Diagnosis and Management, Third Edition. David G. Borenstein, Sam W. Wiesel, and Scott D. Boden. Philadelphia; Saunders, 2004, 729 pages, As the title implies, this 729-page textbook aims to provide a comprehensive description of the medical approach to back and neck pain. Its 20 chapters organized in 4 sections cover from basic anatomy and biomechanics to nosology, clinical evaluation, and therapy. On the plus side, the text is indeed comprehensive and authoritative, often providing clear direction and recommendations for assessment and management. It also shows awareness of recent research and the impact of psychosocial factors on the prognosis and response to treatment. The initial chapters on anatomy and biomechanics are concise and provide necessary background to grasp the complexities of neck and back pain. The chapters on alternative and complementary therapies are a welcome addition. On the minus side, the authoritative approach to the text gives the impression that we know more than we really do. It provides little discussion of concepts that challenge the traditional biomedical view of causation, such as referral pain patterns from somatic structures, central sensitization in chronic pain, and the theories of pain of muscle origin. A great part of the text (380 pages) is devoted to conditions seldom seen in primary or secondary medical practice such as tumors and rheumatic and endocrinology conditions. In some chapters the authors' recommendations seem somewhat unrelated to their assessment of evidence from trials, but to the authors' credit, the recommendations and trial sections are clearly marked. Overall, this is a useful reference textbook that will make a worthwhile addition to the libraries of practitioners caring for people with back and neck pain. It provides a comprehensive review of the multiple conditions that can produce these symptoms. Compared with textbooks on similar topics published by Alf Nachemson and Gordon Waddell this text provides more clinical advice, but perhaps less strict grounding on available scientific evidence. JAIME GUZMAN, MD, MSc, FRCPC, Assistant Professor of Medicine, University of toronto, Associated Scientist, Insittute for Work & Health, Clinician Investigator, Toronto Rehabilitation Institute, Toronto, ON, Canada. |