It is refreshing to see a book that interprets and integrates the literature instead of simply repeating studies.
W.S. Marras, Biodynamics Laboratory, Ohio State University
The book is one of the most evidence-based books on the market. The authors are research active and always updating their knowledge.
Principal Lecturer in Physiotherapy, University of Cumbria
"The third edition of The Biomechanics of Back Pain (previous editions 2002 and 2006) is a beautifully produced volume with extraordinarily clear text and superb, relevant colour illustrations of very high quality. All authors are recognized experts in biomechanics, anatomy, pain and spinal research.
The layout is very reader friendly. Each chapter may be read in isolation for reference; or for those with a more intense interest in all aspects of back pain the book can be read from cover to cover. It is primarily intended for practitioners who treat back pain-physiotherapists, osteopaths, chiropractors, general practitioners, nurses and occupational health (OH) professionals, including those involved in personal injury litigation.
There are 21 concise chapters. The first four set the scene by describing the anatomy of the vertebral column, muscles, fascia, nerves and blood supply. Other chapters in the first half of the book cover growth, aging and very detailed mechanical aspects of the back. Chapter five, on back pain itself, opens-'In principle, any of the structures of the lumbar spine that receives an innervation could be a source of back pain.' Further-'it is quite easy to invent an explanation of how any of these structures could be affected by injury or disease in order to become painful. It is another matter, however, to prove that such explanations are realistic and obtain in a given patient.'
A comprehensive but clear list of no less than 14 disorders that can cause back pain follows. The chapter concludes-' Although many lesions have been implicated as the cause of low-back pain, few are supported by objective evidence.' I was somewhat surprised by the comment, 'The best available data implicate the sacroiliac joint, the zygapophyseal joints and the intervertebral discs as the leading sources of chronic low-back pain.'
The chapter on 'Epidemiology of back trouble' will certainly be of considerable interest to all OH professionals and this together with the preceding short chapter on pain nicely encapsulates the cardinal issues faced in OH. The chapters on posture, prevention, conservative management and surgical treatments are of considerable interest. The penultimate section of the book deals with medico-legal considerations and will be of help and support to OH professionals.
The book is really well indexed and readers will have no difficulty in finding sources of information on specific topics. And for those who wish to explore further there is a list of 1639 references! A website contains useful PowerPoint presentations including an overview of the Psychological Flags Framework.
The final remarks of the authors include-'There is good evidence that the psychosocial characteristics of many patients with chronic back pain are not the underlying cause of the problem; rather they are a response to vague diagnosis,ineffective treatment and a "compensation culture”.' As more than half the content of this book is of direct relevance to OH professionals, I have no hesitation in recommending that it has a place on our bookshelves."
John Challenor, Oxford Journals Clippings, Occupational Medicine, vol 64, no 7, October 2014
About the Author
I commenced research into spinal pain, in 1972, when essentially nothing was known about the problem. There being no established groups or departments working on this problem, I forged my own career, using borrowed resources. I commenced in a Department of Anatomy, where I pursued the innervation of the vertebral column as a fundamental element in understanding the sources and mechanisms of spinal pain. Professor Jim Lance fostered this interest, and accommodated my PhD studies. In his department I continued my anatomy studies but was able also to commence clinical applications. I developed and tested new diagnostic and surgical procedures for back pain and for neck pain. While in Professor Lance's Department, I participated in laboratory studies of the mechanisms of migraine. At the University of Queensland I continued to develop and apply the diagnostic and surgical techniques that I started at the University of NSW, serving as an honorary medical officer at the Pain Clinic of Princess Alexandra Hospital. Meanwhile I supervised science and medicine postgraduate students who undertook basic science studies into the biomechanics of the back and neck. At the University of Newcastle, I had established a reputation sufficient to attract a grant from the Motor Accidents Authority of NSW to investigate the cause and treatment of neck pain after whiplash. The grant supported three PhD students over a six year period. They performed studies that validated the diagnostic procedures and which tested the surgical procedures in a placebo-controlled double-blind randomized trial. Having established an international standing in the development and testing of treatments for spinal pain, I participated in the design and analysis of controlled trials conducted elsewhere in Australia and in the USA. These tested the efficacy of: lumbar radiofrequency neurotomy for back pain, intradiscal electrothermal anuloplasty for back pain, prolotherapy for back pain, exercises for neck pain. Between 1997 and 2002 I conducted the National Musculoskeletal Medicine Initiative which developed and tested evidence-based practice guidelines for the management of back pain, neck pain, shoulder pain, knee pain, and pain in the foot, wrist, and elbow. My work has been awarded the Volvo Award for Back Pain Research, the Research Prize of the Cervical Spine Research Society, the Award for Outstanding Research of the North American Spine Society, and three times the Research Prize of the Spine Society of Australia. My students have been awarded research prizes by the International Association for the Study of Pain, the Australian Rheumatology Association, and the Australian New Zealand College of Anaesthetists. I have never had a funded department to which to attract investigators and academics. I have relied on scholarships for students, and the goodwill of private practitioners who wished to contribute to clinical research. Of late, I have been supervising Neurosurgery residents undertaking studies of the outcomes of treatment for Radicular pain and back pain.