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The Psychophysiology of Low Back Pain by Nichola Adams. Churchill Livingstone, Edinburgh, 1997 (ISBN 0 443 05259 X). €22.50.2 19 pages.

This has been a difficult review since there are some very good points in this book. However, a clin- ical psychologist colleague working in the field of chronic pain agrees that on the whole this book is lacking in accuracy and is outdated, ignoring much of the recent neuro- physiological literature and most of the psychological and psychosocial literature on the subject of pain and low back pain (LBP).

It lacks the patients’ perspective, and does not relate to the problems that patients have with being misunderstood and mismanaged. Instead it goes down the road of patient labelling and patient blaming that often make matters worse, not better.

The chapter on neurophysio- logical and biochemical factors in back pain is inadequate and like the rest of the book contains nearly twice as many references from the 1970s as from the 1990s. Even the 1960s have as many as half the references of the 1990s.

In a chapter on psychological models of chronic pain, 13 pages are devoted to an outdated explanation of disease-based psychodynamicl personality models. Words like hysteria, hypochondriasis, malin- gering and neuroticism are used, none of which are included or alluded to in the International Association for the Study of Pain’s definition of pain. There is as yet no evidence for (and some against) their validity, diagnostic reliability or clinical usefulness.

Five pages are devoted t o behav- ioural and cognitive-behavioural models. This is surprising consid- ering the vast literature on these approaches and their utility and proven efficacy in experimental and therapeutic trials.

Apart from mentioning operant learning, the chance to describe the principles and practices of the behavioural approach, so valuable in physiotherapy, movement rehab- ilitation and pain management, is completely missed.

Cognitive restructuring is poorly explained with an unhelpful exam- ple of an unusual case.

The chapter on psychophysiolog-

ical and psychological techniques for treatment, including relaxation and interdisciplinary chronic pain management, is much better, though i t suffers from not being able to relate well to the poorer theoretical chapters.

This book states that it is written for the professionals who treat LBP patients. I would not recommend this book at all for anyone thinking of embarking on working in LPB or chronic pain management. Much better would be Psychological Approaches to Pain Management edited by R J Gatchell and D C Turk

(1996, Guilford Press, London). Many excellent texts and reviews

exist on the neurobiological mecha- nisms of pain - physiotherapists could do worse than the workbook that accompanies the Neuro- Orthopaedic Institute’s course ‘Clinical biology of aches and pains’. For the patients’ perspective Neville Shone’s Coping Successfully with Pain (1992, Sheldon Press, London) and Physiotherapy: A psychosocial approach edited by Sally French (2nd edn 1997, Butterworth Heine- mann, Oxford) are recommended.

Vicki Harding MCSP

Creative Relaxation in Groupwork by Irene Tubbs. Winslow Press, Bicester, 1996 (ISBN 0 86388 143 2). Illus. 193 pages. f23.95.

This book is written for practi- tioners working to reduce stress and tension in group settings. I t is presented in clear sections sepa- rating the theory of relaxation from practical workshop ideas and alter- native therapies.

Information and ideas are pres- ented clearly for beginners and more experienced therapists.

As the title suggests, the book includes a breadth of creative approaches with specific plans for sessions and warm-ups. The groups are encouraged to discuss a range of related topics, including body language, recognising and releasing

tension, use of the voice and certain words to describe feelings. Dance, imagery, breathing techniques and touch are all explored as aids to relaxation.

The loose-leaf pages and ring- binding allow the book to remain open with a plan for a session visible for reference. The book is most usefully read by dipping into a rele- vant section. It would be a helpful addition to a physiotherapy library in specialties which employ relax- ation.

Because of the use of peripheral approaches I would see this volume as complementing some of the more physically based relaxation methods of Laura Mitchell and Jane Madders, not replacing them.

Diana Beaven MCSP

Overcoming Panic A self-help guide using cognitive behavioural techniques by Derrick Silove and Vuaya Mani- cavasagar. Robinson Publishing, London, 1997 (ISBN 1 85487 701 1). 143 pages. €6.99.

This useful book comes as the fourth in the ‘Overcoming’ series of self- help guides, following others on bulimia, depression and anxiety. Cognitive behaviour therapy has been shown to be highly effective and some of the techniques in this book will already be familiar to physiotherapists, eg diaphragmatic breathing, relaxation, regular exer- cise and keeping a diary.

Less familiar to some, but equally important, are the ways to chal- lenge negative thoughts, to rehearse

coping in stressful situations, and positive ideas for addressing relapse. This book is easy to read, gives clear explanations of the problem, and is informative for sufferers and clinicians alike. There are a number of useful charts for monitoring progress, and advice for preventing setbacks.

The book would be a useful adjunct to anxiety and stress management groups, or for the indi- vidual treatment of hypervent- ilation, but I guess there are few sufferers of panic attacks who would find the book sufficient cure on its own.

Further titles to look out for are Overcoming Anorexia and Over- coming Low Self-esteem.

Tina Everett MCSP

Physiotherapy, September 1997, vol83, no 9