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APS Bulletin • Volume 14, Number 4, Summer 2004

Resource Reviews

John D. Loeser, MD, Department Editor

The Pain-Free Back

Reviewed by John D. Loeser, MD

Harris H. McIlwain, MD, and Debra Fulghum Bruce, PhD, New York, Henry Holt and Co. 2004. Soft cover, 298 pages. ISBN 0-8050-7326-4. $15.

This is yet another self-help book for chronic back pain sufferers. The “six simple steps to end pain and reclaim your active life” are exercise, diet, use of natural herbs and plant substances outside of the traditional formulations of allopathic medicine, posture, relaxation therapies, and healing touch therapies. In addition there are chapters on establishing a diagnosis and the role of prescription drugs and surgery for back pain. At the end of the book are depictions of exercises, lists of resources, some references, and an index.

What is right about this approach is the emphasis upon the work—emotional and physical—that the patient must do. What is wrong is the failure to discriminate things that have evidenciary support from superstitious and politically correct healthcare advice. Massage or chiropractic manipulation may make one feel better, but mechanisms of action are not well-established and the relative contribution of nonspecific treatment effects and the therapy utilized remain unstudied.

So this book is aimed at patients and its advice will not hurt them.

Used in conjunction with a multidisciplinary pain program, it may have some utility. Not many chronic back pain patients will be able to use it as a stand-alone method of healing themselves. As Fordyce said years ago: “Information is a low power way to change behavior.”

Dr. Lipman is Professor of Pharmacotherapy, College of Pharmacy, Adjunct Professor of Anesthesiology, School of Medicine, and Director of Clinical Pharmacology, Pain Management Center at the University of Utah Health Sciences Center in Salt Lake City.

Reviewer content represents the opinion of the reviewer, not APS.

Please direct your suggestions for future Resource Reviews to John D. Loeser, MD, Department Editor, at jdloeser@u.washington.edu

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