I have owned this book since it was first published and still continue to find it an extremely useful book in my clinical physiotherapy practice. The book remains relevant to practice and the content is supported by a developing evidence base.. This book covers neurodynamics, neurobiology and clinical reasoning. It is unique in its unravelling of the biopsychosocial framework and in developing better understanding and management of patients with neuro-musculoskeletal problems. The first four chapters teach the knowledge required to understand the basic pain and nervous system sciences. Much of this will not have been studied at undergraduate level but this will no doubt change as manual therapy and pain management approaches continue to develop. Theory is drawn into clinical application over the subsequent chapters. e.g. peripheral and central sensitisation. The physiotherapist is given the skills to understand pain where there is no tissue injury or inflammation, the physiological influence of psychological or social issues as well as understanding the involvement and relevance of other systems including the sympathetic and the immune. Two chapters present a clinical reasoning framework which is valuable for its inclusion of all the pathobiological mechanisms, as well as focusing on the dysfunction/s and providing a means to acknowledge the contributing factors. The chapter on neurological assessment has value for its acknowledgement of the variation between authors and researchers and presenting the best evidence in a clinically useful format (testing of peripheral and cranial nerves is included). Until recently this has been the only book to present comprehensive neurodynamic testing and the application of these tests is supported by a chapter on their reliability and validity and the application of research findings. The application to treatment is presented where this is researched and demonstrations linking the theory with problem-solving and clinical reasoning are included. This book uncovers a relatively new area for physiotherapy and its limitations will be that the supporting current evidence, although developing, remains lacking. I would encourage any neuro-musculoskeletal physiotherapist to read this book in depth.
Very well written. David goes into quite a bit of detail regarding the biochemistry of neurons and synapses, but just when you think it's getting too technical he'll zoom out and discuss how each topic relates to healthcare professionals - he makes the practical points to take away very clear. Whether you're a neurologist, massage therapist, psychologist or anyone else who sees people in pain, there is a lot to learn on modern pain science from this book.
If you've ever seen him speak (and I definitely recommend his youtube videos) you'll immediately recognize his rather unique way of putting things - I can definitely hear his voice in my head when I read.
This is certainly an interesting and novel area of clinical practice within physiotherapy. At the time of the author's first book, he brought together scattered bits research and clinical ideas into a the beginnings of a coherant paradigm. This book is flawed, however. After consulting this book at length to prepare some training for colleagues I became increasingly infuriated. It is poorly organised with too many chapters with irrelevant material. The pages and pages of basic sciences are poorly explained and are rarely successfully integrated into clincal science and practice, again possibly because of a lack of selectivity. You have to read large amounts of incoherant text to find something useful. And this would be my point: is this text useful? It adds very little useful clinical pointers. While research is sorely lacking on the use of AND techniques (as treatment techniques in particular) we must consider this work as speculative and this book as poorly written. The ideology in this book does seem to have risen to a level which is unjustified and while it continues to hold this mystique it preys on the anxious professional!