Mechanical Low Back Pain: Perspectives in Functional Anatomy, ed 2.

Mechanical Low Back Pain: Perspectives in Functional Anatomy, ed 2 Porterfield JA, DeRosa C. Philadelphia, PA 19106, WB Saunders Co, 1998, 298 pp, illus, $45.

As the authors so aptly indicate, present-day health care is changing on a continuing basis. This textbook has been revised to make it more current by including treatment guidelines that are scientifically supported and are consistent with the demands for efficiency placed on the clinician by managed care and prospective payment systems.

The 6 chapters in the book are well written and well presented. The first chapter, "Principles of Mechanical Low Back Disorders," provides an overview of factors that contribute to the presence of low back pain, including the role of anatomical structures, stress, and the effects of gravity. The terms "impairment" and "disability" are defined and consistent with the Guide to Physical Therapist Practice. Chapters 2 through 4 present detailed information about the neuroanatomy, musculature, and skeletal anatomy of the lower back and pelvis. Chapters 5 and 6 present evaluation and treatment principles and emphasize that the patient has the primary responsibility for his or her rehabilitation.

Each chapter is nicely illustrated with graphs, drawings and pictures. The anatomical illustrations in chapter 3, "Lumbopelvic Musculature: Structural and Functional Limitations," are particularly well done. In addition, each evaluation and manual treatment technique is clearly described and supported by a picture and a drawing to indicate the direction of force or the anatomical landmarks that are being palpated. All chapters include an extensive bibliography. The only criticism that I have about this book is that many of the references are from the 1970s and 1980s.

This book would be a welcome addition to the library of any orthopedic physical therapist or any physical therapist student. The anatomical review and biomechanical analysis of the low back enhance the evaluation and treatment philosophy and process as presented in this text. The authors have written a very useful reference book.

Randy Walker, PhD, PT
University of Tennessee at Chattanooga
Chattanooga, Tenn

Dr Walker is a UC Foundation Associate Professor and Director of the School of Rehabilitation Professions. His primary area of clinical and teaching expertise is orthopedic physical therapy.3