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Home Remedies
320
The Back and Beyond The definitive book on back care by Dr Paul Shenvood. Arrow Books Ltd, 20 Vauxhall Bridge Road, London SW1 VZSA, 1992, 2nd edn (ISBN 0 09 943841 0). Illus. 263 pages. f6.99.
This book is written to provide low back pain (LBP)sufferers with information about the causes and treatment of lumbar problems. It is well structured and laid out in 12 chapters which help readers to @gus on the various subjects covered. As the book is written for lay people, medical jargon is avoided and the text is complemented well with analogies and illustrations. The inclusion of clinical examples further enhances comprehension. The first three chapters focus on lumbar anatomy and then discuss how these structures can potentially cause symptoms. There is much interesting information included although some theories are based on clinical anecdote. In the following three chapters hypo-sympathetic tone is described a s a n integral part of spinal problems. Inter-relationship between the somatic and autonomic nervous systems is well documented. However, in chapter 7 the author discusses how spinal pathology can lead to various ailments via sympathetic nervous system malfunctioning (eg chronic fatigue syndrome, frozen shoulder, tennis elbow, duodenal ulcers, osteo-arthritis, arterial disease, etc). Certainly this book is written for non-medical readers, but such proposals would benefit from supportive references to published research findings. Although the aforementioned chapters do not adhere t o conventional beliefs some thought-provoking points are presented regarding LBP. However, it is the treatment sections that concerned me most. I was initially excited by mention of ‘a new and revolutionary treatment’ but was disappointed to read a somewhat prescriptive view. Chapter 10 outlines home exercises but fails to give guidance relative to each patient’s needs. Chapter 9, entitled ‘Notes for your therapist’, describes treatment techniques advised: faradism, ultrasound, massage and ten manipulative techniques. Furthermore, the author claims such treatment is available from many physiotherapists and implies
Physiotherapy,June 1997, vol83, no 6
that these modalities are the only tools required for successful treatment of LBP. As readers of this Journal will know, faradism is rarely used nowadays and where the nerve supply is intact, active exercises would surely produce similar benefits. In addition, the most suitable manipulative techniques are listed relative to the presenting symptom area. This gives the impression of the therapists a s ‘technicians’ rather than professionals in their own right. Overall, the book provides a n alternative view of LBP and its management. Various interesting points are raised, although the treatment described is very prescriptive for such a multi-faceted problem. In addition, we must continue t o promote our advancing scientific/clinical reasoning approach t o patient care. Unfortunately, this book does nothing to portray physiotherapists as autonomous professionals basing treatment on clinical findings and knowledge. It is for this reason that I would be reluctant t o provide our patients with this publication.
Louise Jenkins MSc MCSP MMACP
Going to Market Equipment and products for disabled and older people an overview by Michael Mandelstam. Disabled Living Centres Council, Winchester House, 11 Cranmer Road, London SW9 6EJ, 1996 (ISBN 1 901 17 1 00 8). 150 pages. f 75.
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In this distinctly readable report for the Disabled Living Centres Council (DLCC) it is stated: ‘Many older people and disabled people are not using, and do not even know about, equipment that could assist them.’ This is despite the benefits it might afford, the large quantities provided by statutory services, the hundreds of private companies trying to sell it and the gap between filled by several voluntary organisations. Why? Over nine chapters, sub-divided into short sections and boldly typed for easy perusal, the full spectrum of equipment provision is examined in an effort to analyse this paradox. For example: legislation, information, design, cost, choice and shape of the market are only a few of the aspects under discussion.
Positive and negative attributes are argued in each section, so upholding the DLCC’s pride in impartiality but making it somewhat confusing for readers. Nonetheless, there are some good ideas in here with the pros and cons already investigated and good insight gained on a subject about which ‘many health and social care professionals are surprisingly ill informed’. Your specific problem may be addressed but differences throughout the country mean there can be no formal answer and no conclusion is offered. The report should be in every library, accessible t o everyone therapists, GPs, managers, social services, and not least consumers, ie our patients.
E Hamilton MCSP
Home Remedies by James Le Fanu. Sponsored by The Daily Telegraph and published by Robinson Publishing, 7 Kensington Church Street, London W8 4SP, 1997 (ISBN 1 85487 91 1 1). Illus. 132 pages. f5.99.
It is now fashionable to claim that some old wives’ remedies have been ratified by modern science, and the author of this book, being a general practitioner, can justify many of these home treatments. A reference section supports many of the suggestions and individual correspondents are also listed. Using this book would save time in a doctor’s waiting room. With an NHS prescription charge currently S5.50 it would also be more economical as some of the remedies are re-usable (frozen peas) and others cost virtually nothing (water). Having been raised by a mother whose panacea was cold tea leavesI was pleased t o see that if you are lucky to have the right affliction, yoghurt, honey, whisky or chocolate (applied externally, alas) may be more effective. Less attractive are ear wax for cold sores and urine for eczema. Dr Le Fanu weaves in a great deal of common sense and general good advice among the more bizarre remedies, making his book an entertainment as well as a serious source of potentially useful information, even if you are lucky enough t o be quite well a t present.
JW
The Back and Beyond The definitive book on back care by Dr Paul Shenvood. Arrow Books Ltd, 20 Vauxhall Bridge Road, London SW1 VZSA, 1992, 2nd edn (ISBN 0 09 943841 0). Illus. 263 pages. f6.99.
This book is written to provide low back pain (LBP)sufferers with information about the causes and treatment of lumbar problems. It is well structured and laid out in 12 chapters which help readers to @gus on the various subjects covered. As the book is written for lay people, medical jargon is avoided and the text is complemented well with analogies and illustrations. The inclusion of clinical examples further enhances comprehension. The first three chapters focus on lumbar anatomy and then discuss how these structures can potentially cause symptoms. There is much interesting information included although some theories are based on clinical anecdote. In the following three chapters hypo-sympathetic tone is described a s a n integral part of spinal problems. Inter-relationship between the somatic and autonomic nervous systems is well documented. However, in chapter 7 the author discusses how spinal pathology can lead to various ailments via sympathetic nervous system malfunctioning (eg chronic fatigue syndrome, frozen shoulder, tennis elbow, duodenal ulcers, osteo-arthritis, arterial disease, etc). Certainly this book is written for non-medical readers, but such proposals would benefit from supportive references to published research findings. Although the aforementioned chapters do not adhere t o conventional beliefs some thought-provoking points are presented regarding LBP. However, it is the treatment sections that concerned me most. I was initially excited by mention of ‘a new and revolutionary treatment’ but was disappointed to read a somewhat prescriptive view. Chapter 10 outlines home exercises but fails to give guidance relative to each patient’s needs. Chapter 9, entitled ‘Notes for your therapist’, describes treatment techniques advised: faradism, ultrasound, massage and ten manipulative techniques. Furthermore, the author claims such treatment is available from many physiotherapists and implies
Physiotherapy,June 1997, vol83, no 6
that these modalities are the only tools required for successful treatment of LBP. As readers of this Journal will know, faradism is rarely used nowadays and where the nerve supply is intact, active exercises would surely produce similar benefits. In addition, the most suitable manipulative techniques are listed relative to the presenting symptom area. This gives the impression of the therapists a s ‘technicians’ rather than professionals in their own right. Overall, the book provides a n alternative view of LBP and its management. Various interesting points are raised, although the treatment described is very prescriptive for such a multi-faceted problem. In addition, we must continue t o promote our advancing scientific/clinical reasoning approach t o patient care. Unfortunately, this book does nothing to portray physiotherapists as autonomous professionals basing treatment on clinical findings and knowledge. It is for this reason that I would be reluctant t o provide our patients with this publication.
Louise Jenkins MSc MCSP MMACP
Going to Market Equipment and products for disabled and older people an overview by Michael Mandelstam. Disabled Living Centres Council, Winchester House, 11 Cranmer Road, London SW9 6EJ, 1996 (ISBN 1 901 17 1 00 8). 150 pages. f 75.
-
In this distinctly readable report for the Disabled Living Centres Council (DLCC) it is stated: ‘Many older people and disabled people are not using, and do not even know about, equipment that could assist them.’ This is despite the benefits it might afford, the large quantities provided by statutory services, the hundreds of private companies trying to sell it and the gap between filled by several voluntary organisations. Why? Over nine chapters, sub-divided into short sections and boldly typed for easy perusal, the full spectrum of equipment provision is examined in an effort to analyse this paradox. For example: legislation, information, design, cost, choice and shape of the market are only a few of the aspects under discussion.
Positive and negative attributes are argued in each section, so upholding the DLCC’s pride in impartiality but making it somewhat confusing for readers. Nonetheless, there are some good ideas in here with the pros and cons already investigated and good insight gained on a subject about which ‘many health and social care professionals are surprisingly ill informed’. Your specific problem may be addressed but differences throughout the country mean there can be no formal answer and no conclusion is offered. The report should be in every library, accessible t o everyone therapists, GPs, managers, social services, and not least consumers, ie our patients.
E Hamilton MCSP
Home Remedies by James Le Fanu. Sponsored by The Daily Telegraph and published by Robinson Publishing, 7 Kensington Church Street, London W8 4SP, 1997 (ISBN 1 85487 91 1 1). Illus. 132 pages. f5.99.
It is now fashionable to claim that some old wives’ remedies have been ratified by modern science, and the author of this book, being a general practitioner, can justify many of these home treatments. A reference section supports many of the suggestions and individual correspondents are also listed. Using this book would save time in a doctor’s waiting room. With an NHS prescription charge currently S5.50 it would also be more economical as some of the remedies are re-usable (frozen peas) and others cost virtually nothing (water). Having been raised by a mother whose panacea was cold tea leavesI was pleased t o see that if you are lucky to have the right affliction, yoghurt, honey, whisky or chocolate (applied externally, alas) may be more effective. Less attractive are ear wax for cold sores and urine for eczema. Dr Le Fanu weaves in a great deal of common sense and general good advice among the more bizarre remedies, making his book an entertainment as well as a serious source of potentially useful information, even if you are lucky enough t o be quite well a t present.
JW