Hot Water Therapy.

Hot Water Therapy is a self-help text for persons who have back, neck, and shoulder pain. The goals of the text are to provide readers with independence in pain control and lasting relief of symptoms.

First, the rationale for hot water therapy is presented, based on basic anatomy and physiology. As the authors describe it, the self-help program begins with a self-assessment of pain, pain producers, and coping strategies. The management of pain and spasm, as presented in the book, emphasizes deep self-massage, exercise (primarily range-of-motion exercise), stretching, and hot water therapy using the shower (neck, back, and shoulders) and tub (middle and low back). Specific instructions and illustrations are provided for each of these body areas and treatment routines. Three relaxation techniques are presented. The authors also mention the negative impact of poor posture and poorly performed activities of daily living and describe the ideal performance of selected activities.

Strengths of this text include its conversational tone; simple, clear instructions; and multiple illustrations of the techniques. The authors seem to understand their audience well; the content is basic, and the procedures are designed to fit into a busy lifestyle. Potential problems, such as increased pain with exercise and dizziness after hot water therapy are addressed. The emphasis on self-management and long-term commitment to back care is commendable. The authors do note that readers should consult a professional for "serious back problems."

The text is comprehensive in its methodology to "break a pain cycle," but long-term concerns, such as strengthening and posture, receive minimal attention, and only a few activities of daily living are discussed. A final concern is that several positions used for low back exercise in the tub may initiate or aggravate upper back and neck problems.

The program as presented has many merits, but is limited in its scope. This text may be useful to the new clinician looking for an example of clear, concise teaching methods for the lay audience. The book could also be used as an adjunct to patient education and treatment.