Book review: Manual Therapy for the Peripheral Nerves

Book review
J.-P. Barral and A. Croibier, Manual Therapy for the Peripheral Nerves , Churchill Livingstone (2007) ISBN 0-4431-0307-0 288 pages, £34.99.

Karen McCreesha, Department of Physiotherapy, University of Limerick, Limerick, Ireland


The aim of this text is to present, from an osteopathic perspective, a new system of assessment and treatment of dysfunction of the nervous system. The book is an English translation from an original French text, which was published in 2004. The authors are osteopaths with extensive experience in the practice and teaching of manual therapy and visceral manipulation. It is intended for practising manual therapists in osteopathy, chiropractic and physiotherapy.

The book is well organised, with the first three chapters dedicated to a detailed and comprehensive review of the anatomy, physiology and pathology of the peripheral nervous system. These would make useful reading for any therapist interested in revising their knowledge of these areas, and gaining further knowledge on mechanisms of neural blood flow, intra- and extraneural pressure and links to the visceral system. Subsequent chapters are devoted to an explanation of the authors’ system of assessment and treatment of nerves, dealing separately with the cervical, brachial, lumbar and sacral plexuses, with additional detailed review of the topographical anatomy of each area. The techniques are well illustrated; however, as is often the case with practical skills, it is difficult to gain an exact understanding of the ‘listening’ and ‘manipulation’ techniques described. This issue is often addressed in other comparable textbooks by supplying an accompanying CD-ROM with demonstrations of the techniques, which could be considered for future editions of this text.

The early chapters reference much of the classic literature in the areas of neuroanatomy and physiology. However, there is no reference to the more recent, extensive body of published work in the area of nerve movement, which, in the context of this book, would seem a significant omission. It is also disappointing that the text contains both unsubstantiated assertions and clinical anecdotes, detracting from the potential of this text as an evidence-based educational resource.

From a physiotherapy perspective, this text is interesting in that it demonstrates another profession’s approach to the management of neural pathology. As a complete text, it would be of use to experienced manual therapists as a practical and clinical guide to this particular treatment approach, while the anatomy and physiology sections would be a useful refresher for all therapists treating pain of neural origin.