"Defeat Chronic Pain Now:" Book Review

I recently found Defeat Chronic Pain Now at the library and read the first chapter last night. I was happy to see that the topic of chapter one is low back pain, which is terribly common, especially among sufferers of chronic pain. It was even better reading that the authors (Bradley Galer, MD and Charles Argoff, MD) recommend Physical Therapy within the first few lines!

Myofascial Cause of Back Pain?

They talked a lot about myofascial pain and trigger points as a main cause of low back pain (and referred leg pain), which I do not completely agree with. Being trained in the McKenzie method of Physical Therapy, which involves mechanical treatment of back pain (or moving the spine in specific directions in order to decrease pain), I have found that trigger points are not a great factor in treating low back pain.

Combining Treatments for Back Pain

I agree with Galer and Argoff about the need for a combination approach to treatment, which often includes medicine and "Active PT," the term they use to describe Physical Therapy that involves active exercise and movement to treat the painful condition. They discuss various medicines used for back pain and their benefits. 

Work Injuries and Chronic Back Pain

Page 15 briefly talks about chronic back pain related to being unhappy at work. There is research that shows a correlation between chronic back pain among those who are unsatisfied in their jobs. This is among individuals who have sustained a back injury at work. I totally disagree with their discussion of this research. Their second paragraph states that if you do not like your job, you are at risk for chronic low back pain. Research does not say why there is a correlation between work satisfaction and back pain. It only shows if there is a correlation among the researched population. Clearly, the population being studied included only those with work-related injuries. There is no endnote identified about this research, so it is hard to clarify this matter.  

I have never treated someone who developed low back pain because he/she was unhappy at work. Low back pain usually has a specific cause and can be treated very effectively. Individuals with work-related back injuries are a completely different demographic than the general population and any research involving them should not be applied to those without work-related back injuries.

Active Physical Therapy for Low Back Pain

Galer and Argoff list some other possible treatment options for chronic low back pain and briefly discuss their benefits and precautions. Again, they include Active Physical Therapy at the top of the list, which I truly appreciate and also highly recommend!

One statement I must rebuttal is: "Many--if not most--physical therapists are trained in only passive, 'feel good' therapies, such as warm baths, gentle massage, and ultrasound" (page 22). This may have been more true 50 or 30 years ago but not anymore. Passive modalities such as these were only part of one class out of my three years of graduate school, so clearly we are trained in much more than that. Otherwise our "Active PT" would not be so highly recommended throughout chapter 1.

Recommended Book for Chronic Pain?

So do I recommend this book? Based on chapter 1, yes. It is worth reading if you have chronic low back pain. But you may also want to look at some other back books to see how their treatment approach is different (such as Robin McKenzie's Treat Your Own Back).

Reference: Galer BS, Argoff CE. Defeat Chronic Pain Now! 2010: Fair Winds Press. Chapter 1: Beating Your Back Pain.