How to crack a back | |
Back pain and spinal manipulation: a practical guide. 2nd ed. Murtagh J, Kenna C. Oxford: Butterworth-Heinemann 1997 (x + 470 pp.). ISBN: 0-7506-2185-0. |
This is a
"how-to" manual which contains little in the way of evidence
or outcomes. The unbiased reader will come away with the impression
that there are few, if any, contraindications to spinal
manipulation. If you have a hankering to "do something" to most backs
and necks you see, this is the book for you!
It provides a firm framework from which to learn spinal diagnosis, offering the theory of Maigne to explain the vast majority (over 80%) of spinal pains for which no clear diagnosis can be made. The diagnostic approach is generally sound and exhaustive, and the caveats comprehensive. However, I question the authors' description of the straight leg raise test, and the crossed straight leg raise test (which, when positive, is pathognomonic of disc protrusion, and indicates a low chance of spontaneous recovery) is not mentioned at all. Other signs, theories and diagnoses are presented which have yet to be scientifically validated. An unfortunate omission is a detailed discussion of illness behaviour. The book is well presented, easy to read and relatively inexpensive. Michael D Ryan
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