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Low Back Pain: A Symptom-Based Approach to Diagnosis and Treatment

Muellner, Michelle MD

Section Editor(s): Berry, , Michael J. Ph.D., FACSM

Medicine & Science in Sports & Exercise: March 2002 - Volume 34 - Issue 3 - p 565

(Rehabilitation Institute of Chicago)

Low Back Pain: A Symptom-Based Approach to Diagnosis and Treatment

Editors: Rucker, Karen S., MD (Virginia Commonwealth Univ); Cole, Andrew J., MD (Univ of Washington); Weinstein, Stuart M., MD (Univ of Washington), Bibliographic Data: (ISBN: 0-7506-9485-8, Butterworth-Heinemann, 2001, $59.99) 15 chapters, 394 pages, Contributors, soft cover. Audience: Physical Medicine and Rehabilitation Specialists, Physical Medicine and Rehabilitation Residents Subjects: Physical Medicine and Rehabilitation, Neurosurgery, Physical Therapy

DESCRIPTION: This is a thorough but concise book about one of the most common human ailments. As the title suggests, it does not speak in isolation about various diagnoses, but seeks to understand the presentation and problems of each patient and assist that patient in the most complete recovery possible. PURPOSE: The editors’ stated purpose is to highlight the importance of thorough clinical assessment of patients with low back pain (LBP) and a treatment plan that grows directly out of that assessment. They also seek to present the work of authors whose clinical expertise and grounding in scientific literature combine to make them authorities in LBP care. They have achieved these goals and have produced a quality work. AUDIENCE: Although the intended audience is not specified, this would be an ideal book for medical students and residents in physiatry, internal medicine/family practice, rheumatology, and orthopedic/neurological surgery. Since internists and family practitioners are often the first to encounter the patient with back pain, it is vital they are exposed to the concepts in this book. It also may be useful to physical and occupational therapists. The editors are all recognized experts in physiatric musculoskeletal medicine and have chosen authors who clearly integrate their clinical acumen with knowledge of the medical literature to provide solid, practical advice. FEATURES: The book begins with overviews of back pain problems in adolescents, adults, and the elderly. The assessment section begins with a particularly good chapter on biomechanical low back evaluation; this will be especially helpful to non-physiatric physicians who may not be familiar with many of these concepts. The chapter on radiographic assessment is quite complete with excellent reproduction of images; a minor improvement of this chapter would be to include more clinical information on timing and choice of various tests. The chapter on physical therapy treatment is thoroughly referenced and promotes the goal of patient self-management. The chapters in the last section of the book are filled with valuable, practical advice on preventing the development of chronic back problems, understanding the medicolegal arena and the particular value of the interdisciplinary treatment model for chronic low back pain. In general, most chapters could benefit from more discussion of outcome studies, when available. ASSESSMENT: This is an excellent, readable book that gets to the core of what physicians need to know about low back pain. SCORE: Weighted Numerical Score: 80 - ***

©2002The American College of Sports Medicine