Management of Low Back Pain in Primary Care
1
Physiotherapy September 2003/vol 89/no 9 563 Book reviews Butterworth-Heinemann, Oxford 2001 (ISBN 0 7506 4787 6). 193 pages by Richard Bartley and P Coffey £23 This book is aimed at general practitioners and healthcare professionals treating lower back pain in the primary care sector. The book is based on the Royal College of General Practitioners guidelines and is a compilation of evidence- based literature reviews from the multiple disciplines involved in the management of lower back pain. It is not designed to be read from cover to cover but rather as 17 chapters of reference material. It is not a recipe book of how to treat lower back pain but does however give options and routes for practitioners to consider where to go within the multi-disciplinary teams. One of the strong themes throughout the book is the attempt to provide evidence for a correct and suitable referral to a consultant, while retaining the single largest cause of time off work in the primary care sector. The 17 chapters have been divided into six sections following Royal College of General Practitioners guidelines: Section 1 ‘Background’ gives the usual statistics, a summary of the Royal College of General Practitioners guidelines, yellow flags and practical advice when assessing/triaging patients. Sections 2, 3 and 4 follow the Royal College of General Practitioners sub-classifications of lower back pain, simple back pain, nerve root pain and suspected serious pathology respectively. I found the chapter on spinal stenosis help- ful for the differential diagnosis, while the chapter on neoplasms of the spine increases awareness of those rare patients with progressive symptoms. Section 5 gives good clear advice on requesting radio- logical and laboratory investigations. The sixth and final section discusses the management of lower back pain with regard to drug therapy, surgery and physical therapy (encompassing physiotherapists, osteopaths and chiropractors). As mentioned earlier this is not a recipe book and these final chapters offer concise information as to what is available, but not how to treat. An epilogue provides an interesting insight into the problems experienced with implementing the Royal College of General Practitioners guidelines. It explains the background to the introduction of the guidelines and why they have not been totally successful. The epilogue concludes with a short section on strategies of how to implement the guidelines in general practice. In conclusion I believe that this book has a great deal of sound practical advice with the grounding of recently researched material, which in its own right has been used extensively. It is certainly an excellent reference source for any practitioner or department dealing with spinal problems. I found it easy reading with references that would be valuable for further research, should you wish to explore a difficult case. Robert Alexander MCSP Management of Low Back Pain in Primary Care Open University Press, Maidenhead 2002 (ISBN 0 335 20718 9). 290 pages by Rowena Murray £17 This is a comprehensive text on how to go about writing a thesis, geared primarily towards doctoral students and supervisors. However, many of the principles are applicable to writing at all levels from BSc project reports through to papers for academic journals. The book deals with many aspects of writing, including initiating and formalising ideas, how to plan and structure the thesis, motivation for writing, and developing strategies to ensure that writers complete their work. The text leads writers through the process of initial planning, the research proposal and developing the first- year report. The author suggests the formation of ‘writers’ groups’ to provide peer support and to allow members to share and solve problems encountered when writing theses. The book covers many divergent themes and is sometimes hard to navigate. This may be because it addresses conceptual issues which do not fall along a structure time- line. However, familiarity with the text will allow readers greater ease of access to relevant sections. Strategies for dealing with writer’s block and the inevitable frustration that accompanies the revising process are discussed. Finally the book discusses vivas and further writing that is often required afterwards. At each stage, boxed inserts allow writers to question and cross-check that they have addressed the major themes and conventions. In summary, this is a useful resource for those wishing to develop clear writing skills. Michèle Harms PhD MSc MCSP How to Write a Thesis
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Transcript of Management of Low Back Pain in Primary Care
Physiotherapy September 2003/vol 89/no 9
563
Book reviews
Butterworth-Heinemann, Oxford2001 (ISBN 0 7506 4787 6). 193 pages
by Richard Bartley and P Coffey £23This book is aimed at general practitioners and healthcareprofessionals treating lower back pain in the primary caresector. The book is based on the Royal College of GeneralPractitioners guidelines and is a compilation of evidence-based literature reviews from the multiple disciplinesinvolved in the management of lower back pain. It is notdesigned to be read from cover to cover but rather as 17chapters of reference material. It is not a recipe book of how to treat lower back pain but does however give optionsand routes for practitioners to consider where to go withinthe multi-disciplinary teams. One of the strong themesthroughout the book is the attempt to provide evidence for a correct and suitable referral to a consultant, whileretaining the single largest cause of time off work in theprimary care sector.
The 17 chapters have been divided into six sectionsfollowing Royal College of General Practitioners guidelines:
Section 1 ‘Background’ gives the usual statistics, asummary of the Royal College of General Practitionersguidelines, yellow flags and practical advice whenassessing/triaging patients.
Sections 2, 3 and 4 follow the Royal College of GeneralPractitioners sub-classifications of lower back pain, simple
back pain, nerve root pain and suspected serious pathologyrespectively. I found the chapter on spinal stenosis help-ful for the differential diagnosis, while the chapter onneoplasms of the spine increases awareness of those rarepatients with progressive symptoms.
Section 5 gives good clear advice on requesting radio-logical and laboratory investigations.
The sixth and final section discusses the management oflower back pain with regard to drug therapy, surgery andphysical therapy (encompassing physiotherapists, osteopathsand chiropractors). As mentioned earlier this is not a recipebook and these final chapters offer concise information as towhat is available, but not how to treat.
An epilogue provides an interesting insight into theproblems experienced with implementing the Royal Collegeof General Practitioners guidelines. It explains thebackground to the introduction of the guidelines and whythey have not been totally successful. The epilogueconcludes with a short section on strategies of how toimplement the guidelines in general practice.
In conclusion I believe that this book has a great deal ofsound practical advice with the grounding of recentlyresearched material, which in its own right has been usedextensively. It is certainly an excellent reference source forany practitioner or department dealing with spinalproblems.
I found it easy reading with references that would bevaluable for further research, should you wish to explore adifficult case.
Robert Alexander MCSP
Management of Low Back Painin Primary Care
Open University Press, Maidenhead2002 (ISBN 0 335 20718 9). 290 pages
by Rowena Murray £17This is a comprehensive text on how to go about writing athesis, geared primarily towards doctoral students andsupervisors. However, many of the principles are applicableto writing at all levels from BSc project reports through topapers for academic journals.
The book deals with many aspects of writing, includinginitiating and formalising ideas, how to plan and structurethe thesis, motivation for writing, and developing strategiesto ensure that writers complete their work.
The text leads writers through the process of initialplanning, the research proposal and developing the first-year report. The author suggests the formation of ‘writers’
groups’ to provide peer support and to allow members toshare and solve problems encountered when writing theses.
The book covers many divergent themes and is sometimeshard to navigate. This may be because it addressesconceptual issues which do not fall along a structure time-line. However, familiarity with the text will allow readersgreater ease of access to relevant sections.
Strategies for dealing with writer’s block and the inevitablefrustration that accompanies the revising process arediscussed.
Finally the book discusses vivas and further writing that isoften required afterwards.
At each stage, boxed inserts allow writers to question andcross-check that they have addressed the major themes andconventions.
In summary, this is a useful resource for those wishing todevelop clear writing skills.
Michèle Harms PhD MSc MCSP
How to Write a Thesis
