This bulky little paperback reprints two American books. The first of these, published I think in the early 1980s, though no bibliographic history is given, was compiled by advertising for back pain sufferers in various popular journals, mainly Family Weekly, and then interviewing the respondents to see what treatments they had used, and what benefits they thought they had received. This came up with some interesting results ‐ I must admit that I greatly enjoyed the fact that, though the majority of respondents felt that stress had played a part in increasing their back pain, there were more psychotherapists taking part in the survey than there were respondents who felt that psychotherapy had been of any help to them. Predictably perhaps, neither general practitioners nor orthopaedic surgeons nor chiropractors came off at all well in this informal survey. An astonishing variety of non‐medical therapists had been tried by various respondents, with varying reported success ‐ sclerotherapy, yoga, marijuana, an assortment of other herbal and dietary remedies, sinesiology, cryotherapy, the Alexander technique, gravity inversion, to name but a few. None of these came off particularly well; the best of them helped out about 50 per cent of those that tried them, several of the worst caused reported permanent harm to more respondents than it helped. There is a brief section on diagnostic methods, already badly dated ‐ I can’t imagine that many American hospitals are still using these myelographic techniques on a regular basis, and I am sure that in a survey taken ten years later far more people would have seen the benefits of NMR scanning.
The remainder of the book, originally published, I think, in the early 1990s, consists of exercise programmes. The one clear bit of evidence about chronic back pain is that the best way of alleviating it is a regular, consistent exercise routine. None of the exercises described in this book seems likely to cause any harm. The main difficulty is in getting people to stick to them for years, rather than expect a miracle cure, after which they can return to their former lifestyles.
Putting The Daily Telegraph in front of two American books does not really turn them into one English book. There is a brief introductory note saying that, for example, Bengay and Mobisyl are called Deep Heat in England, and that DMSO is not available in the UK (and quite right too ‐ it gives little benefit and has potentially dangerous side effects). Nor, of course, does putting 1999 on the back of the title page make this into a 1999 book. Nevertheless, I think it can be recommended. There are hundreds of thousands of people who suffer from low back pain, who have not gained any benefit from conventional medical services, and who are at risk from the activities of alternative practitioners. If this book can convince even a few of these sufferers of the long‐term benefits of regular mild exercise routines then it is likely to prove its value. Public libraries and public health information services will find it worth considering.
