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A Consultation with the Back Doctor    by Hamilton Hall order for
Consultation with the Back Doctor
by Hamilton Hall
Order:  USA  Can
McClelland & Stewart, 2004 (2004)
Hardcover, Paperback
* *   Reviewed by Hilary Williamson

Dr. Hamilton Hall is a world-renowned orthopaedic surgeon and founder of the Canadian Back Institute, who wrote the bestselling Back Doctor and More Advice from the Back Doctor. In his introduction, he reflects on the fact that, though his earlier books were perceived by many as radical, their commonsense approach, advocating activity instead of bedrest, is now widely accepted.

His general message is that there is no panacea for ageing and the neck and/or back pain that often comes with it, but that it can be controlled. He states that 'An unnecessarily desperate patient and an inappropriately confident surgeon are a dangerous combination', and also warns against a proliferation of 'largely inaccurate' information on the Internet and in the popular press. He advises that acute back or neck pain is usually a temporary condition, followed by full recovery, and that one should start exercising and return to a normal lifestyle as quickly as possible.

From his own thirty years of experience, Dr. Hall has categorized four patterns of back pain symptoms, and the most appropriate treatments for each. This and other topics, that range from chair ergonomics and snow shovelling to sexual activity, spinal fusion and tai chi, are covered in a question and answer format, rather like an extended Internet FAQ. He takes controversial positions on topics such as how modes of treatment of chronic fatigue and fibromyalgia often encourage 'pain-focused behaviours', turning patients into victims. And the book ends with an amusingly illustrated set of strengthening exercises.

Though he may not always say what we want to hear, it's well worth listening to Dr. Hall. Fans of his earlier books tell me that they were more informative about specific back problems while they find this one more useful as a reference. Certainly anyone contemplating back surgery, or whose life is being curtailed by back or neck pain, should rush to read Dr. Hall's More Advice from the Back Doctor or A Consultation with the Back Doctor for a bracing dose of medical common sense.

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