Reviewer: Gita Rupani, M.D.(University of Chicago Pritzker School of Medicine)
Description: In this overview of low back pain for patients, a pain management physician describes the anatomy and physiology of pain, how to choose a doctor and ask the right questions when getting medical help, available medications, surgical and nonsurgical treatments, exercise, and the impact on the individual, family, and society. Helpful illustrations describe the anatomy of the lower back in an attached appendix.
Purpose: Low back pain is one of the most common patient complaints in the United States, affecting almost 80% of the population at some point. This excellent book is intended to offer guidance to anyone who has been affected by low back pain. Some simple but real patient concerns may not be routinely addressed by one treating physician, and understanding the anatomical and emotional components will help these patients manage their pain.
Audience: Readers will appreciate that the management of low back pain is a shared responsibility between the patient and the practitioner. The book describes in simple terms the etiology of pain and the effect of stress management, exercise, medicines, pain clinics, and surgical interventions in simple terms. Throughout, the author arms readers with precautions and simple, important postural and lifestyle advice. Although the book answers a lot of patient questions that may not be answered convincingly by one treating practitioner, the author makes it clear that patients should work with their physicians and physical therapists. In addition to patients and their family members, the book also would be of interest to pain specialists and therapists.
Features: Depending on its severity and frequency, chronic low back pain can consume an individual. It can alter the individual's independence as well as affect family dynamics. It can cause and worsen depression and addiction and contribute to disability. The author points out, correctly, that "Anyone with back pain is going to do better if they understand anatomical and emotional component of the pain," and his objective is to empower the individual. The first part of the book covers the physiology of pain and describes the role of the physician and specialty physician, equipping patients to get the most out of their physician visits. It also describes the evaluation process, including the purpose of the examination and investigations so that patients can ask the right questions. The second part covers therapeutic measures, from tools to manage pain, exercise, and stress reduction to pain medication and interventional and surgical procedures. The final part covers insurance and disability issues, recognizing the personal cost of pain in terms of relationship breaches as a consequence of the illness. The author offers several valuable suggestions to improve communication and relationships. He also describes in simple terms a multipronged approach, surgical, and medical interventions for pain management along with their rationales and advantages and disadvantages. Many pain patients continue to receive blocks in pain clinics with short term pain relief, but are unable to carry out the exercise and weight loss advice. The chapters on exercise and stress reduction are motivating, describing the benefits of regular exercise, stress management, and back discipline so well that anyone will be inspired to start an exercise and meditation program after reading them.
Assessment: This small book should be read by all patients with low back pain. It also will be helpful to pain practitioners, not only as a source of relevant information for their patients, but also as a way to encourage their patients to get involved in their care. Experienced pain practitioners will appreciate the way this book reinforces the importance of exercise and stress reduction to patients. I highly recommend this book to medical students, residents, pain fellows, and pain practitioners, as well as any healthcare workers interested in low back pain. It will help them understand their patients and answer frequently asked questions.
