Imagine having back pain for a year, five years, or even a decade, and finally getting so frustrated you opt to go for a surgery that the doctor assures you will get rid of your pain and allow you to regain a normal lifestyle again. This is the exact story that was reported on MSNBC just a short while ago. In the next few paragraphs we can briefly recap the story of Ms. Scatena, but before we do I am going to some something completely out of the ordinary for my monthly newsletter. I'm going to let the cat out of the bag and give you the punch line right off the bat.
Patients who opt to have back surgeries and spinal fusions are way less likely to go back to work and are in desperate need of more opiates. Now this is NOT my opinion. I'm going to take a neutral stance on this and just going to lay down the story, give a few references as to where these statistics are coming from, give you insight into what a majority of "celebrity" back surgeons and pain management doctors have to say about it, and leave it at that. So let's get started. The story starts in the town of Scottsdale Arizona in the blazing heat. There was a woman, in great physical shape except for excruciating back pain. She jumped from doctor to doctor and after thinking she was getting the best advice and doing her research she finally decided to opt for surgery. She suffers from spinal stenosis of the lumbar spine. For those of you that are wondering what spinal stenosis is, it is generally a narrowing of the canal through which the spinal nerves travel. It puts pressure on the nerves which in turn cause pain, and if you've been reading this monthly newsletter for any length of time, you're well aware that....
Pressure = Pain Pressure causes pain fibers to experience pain, causes rubbing, irritation, and then the insuring inflammation to compound the problem. So Nancy opted to try and alleviate the pain by going through a "spinal microsurgery procedure". Immediately following the surgery Nancy Scatena was concerned she may have made the wrong decision. Just a month after surgery her pain was back in full swing and more excruciating than ever. So there she sat with unrelenting back aches and pain and her doctor prescribing medication after medication. None of which did more for her than barely taking the edge off. And just like the 27 million other Americans that suffer back pain every year she sat (or actually tried to sit comfortably) wondering what her next move should be. So just like many of us, she turned to a friend that recommend she go see yet another surgeon who her friend referred to as...
A Miracle Worker This new miracle worker-as she was referred to-assured her that this second operation would fix everything. And she decided to go with her friends' recommendation and have the surgery. And for just a few weeks the pain was better. Then It Came Roaring Back On MSNBC they say that about 600,000 Americans opt for back surgeries of some sort. But they go on to say that many surgeons and pain management experts say that most, back surgery is full of empty promises. And here are the facts as to why. And these numbers are actually from a study done in Ohio. I'll take out all the "doctor-ese" of the story and just lay out the facts. They looked at just under 1500 patients in the workers compensation system, half of them had surgery, half of them did not. So here is how it breaks down.
- 26% of those that had surgery returned to work
- 67% of those that did not have surgery returned to work.
So if that isn't troubling enough, the real shocker is that those that did have surgery for their back pain had a...
41% Increase in Pain Medications! So what does that actually mean? Well the head researcher in the study was a doctor named Dr. Traung Nguyen who is a researcher from the University of Cincinnati. Medical Colleagues claim that this study is evidence that back surgeries don't alleviate pain from degenerative discs.
Why Would They Continue To Do Procedures That Studies Show Don't WORK?
You're completely on point if you're asking yourself that same question. After all, the study provides "clear evidence". Some sources say economics. Spinal surgery is a lucrative procedure. In the Spine Journal, they report an EIGHT fold increase in invasive procedures that fuse two or more vertebrae over the past 15 years. This the little know dirty little secret that has public health experts and surgeons up in arms about back surgery.
In fact, one of the leading experts is publicly stating back surgery and the legitimate need for spinal fusions has gotten "WAY BEYOND WHAT IS REASONABLE AND NECESSARY" Another interesting statistic is that there are some parts of the country where spinal fusions are FOUR times more likely than the national average. All this comes from Charles Burton who is THE medical director for the Center for Restorative Spine Surgery in St Paul.
Is He Alone? Nope. Not at all. Dr William Webb who is the chairman at the University of Pennsylvania and the Chief of Neurosurgery of Pennsylvania Hospital says that "there is some success in treating back pain but as a whole we are less successful at treating back pain." As if that isn't convincing enough that surgery for back pain is the last resort, if it even should be an option at all (surgery is only clinically indicated when muscles begin to atrophy or there is bladder or bowel incontinence, otherwise it is an elective procedure). Dr. Dorisk Cope, who is a professor and chair for pain management at the University of Pittsburgh School of Medicine, admits that....
"It's a case of, if you have a hammer, everything looks like a nail." So that brings us back to this month's newsletter message. The hammer and nail analogy refers to a "carpenter" trade. You wouldn't go to the carpenter and ask him to fix your plumbing. Why? That's not his specialty, in fact he probably doesn't know much, if anything about plumbing at all. Just like surgeons don't know much about Non-Surgical Methods. And we should be thankful about that. After all, if the surgeon was spending time to learn about Non-Surgical technologies and procedures then he is not getting better at surgery which is what we really want him to be good at right? The truth of the matter is that if someone has bowel or bladder incontinence, or muscle wasting or damage to the nerves, then more than likely they need to see a surgeon ASAP.
But Pain By Itself? Based off what many in the research, teaching, and neurosurgical circles are saying it just not as effective as the general population, portal of entry doctors, and the surgeons themselves would like to think. While I agree that for many there is no magic bullet, what I am saying is that if someone has a pressure "diagnosis', a herniated, bulging disc, a disc pressing on a nerve cause stenosis, sciatica or neuropathy, or they have a failed surgery, there may still be hope. If you have a compression problem, if you're suffering from pain, void of bladder, bowel or muscles wasting problems then maybe non-surgical spinal decompression is the answer.
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