The Back Pain Book: A Self-Help Guide for Daily Relief of Neck and Back Pain.

Hage M. Peachtree Publishers Ltd, Atlanta, GA 30324, 1992 paperback, 227 pp, $12.95.

The author's stated purpose of this book, to be a self-help guide for people who have neck or back pain, is well achieved. The book serves as an excellent text for patient education in an outpatient setting. Although it is intended for use by all clients--those with acute, subacute, and chronic pain--it emphasizes independence of care and early activation of the client. This approach, I feel, separates it from its competition.

The book starts out with an overview of the components of pain and pain perception. It quickly identifies key concepts of pain and comfort circuits, structural system balance, and muscle tension and tone. It offers "flare-up" plans that emphasize independence, activation, and proper pacing of activity. It also assists the patient in identifying activities and positions that may be increasing their pain level. Relaxation techniques, appropriate use of cold and heat modalities, and self-massage are all addressed.

I was very impressed to find straight-forward coverage of pain behaviors that focus on awareness of a client's general thoughts and emotional state.

Chapter 3 provides systematic, educational coverage of many different postures and habit patterns. Moving between postures and specific activities to perform following long periods of sitting are well illustrated. A discussion of footwear and proper body mechanics during standing and walking is included.

At the end of each chapter is a brief summary recapping the key concepts covered. Diagrams are very easy to understand, and the author's points are clearly made in the accompanying illustrations.

Chapter 4 goes through a full day's activities and addresses posture and positioning concerns. Relaxation, stress management, stretching, and proper body alignment are all concepts that are strongly reinforced throughout the book.

Chapter 5 provides a general introduction to anatomy, physiology, and exercise. Strategic exercises are taught, and a long list and illustration of stretches to avoid are provided. Both proper and improper techniques of certain trunk exercises are addressed and illustrated. The proper use of strengthening machines is also given. Aerobic exercise is also explained, including the rationale for its importance in a back and neck care program. Techniques, including target heart rate and warm-up and cool-down periods, are all outlined clearly.

The Back Pain Book is a self-help text and reference that allows patients to continue their own care and independent health and fitness maintenance program.

The advice is based on sound principles of neutral spine posture; proper body mechanics; and well-paced, appropriately prescribed exercise. After reviewing this book, I have incorporated it into our chronic back pain physical therapy program. I have found it to be easily understood and widely accepted by our varied client population.