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bbronk -> surgery is NOT the answer for back pain (March 3, 2008 5:03:41 AM)
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Excerpts from medical journals:
“Conclusions. Examination of patients expectations of and satisfaction with surgery revealed that patients frequently had unrealistic expectations of their surgery and as a consequence tended to have lower levels of satisfaction.” SPINE Volume 27, Number 13, pp 1471 - 1477 The evaluation of the surgical management of nerve root compression in patients with low back pain.
(Comment: Perhaps if they quit selling blue sky, patients might not have such high expectations. This year a man came to town for treatment telling me this story: He’s a male, 30’s, his back goes out. He gives it a year to heal on it’s own. After that year he estimates he’s 70% better. His surgeon convinces him his condition can be improved upon with surgery. It takes him a year to recover from the surgery and in the end he is no better than before. He is convinced to have another and another. After the 4th surgery he is now tilted over to one side.)
“Conclusions. Previous back surgery is associated with significantly worse general health status than those without surgery” SPINE Volume 29, Number 17, pp 1931 - 1937 The effect of previous low back surgery on general health status.
“Conclusion. This pilot study showed no difference between surgical or medical management for recovery or improvement in patients with discogenic paresis.” SPINE Volume 27, Number 13, pp 1426 - 1432 A pilot study on the recovery from paresis after lumbar disc herniation.
discogenic paresis is muscular weakness, or partial paralysis, currently thought to be caused by nerve damage from a disc.
“Conclusions. Patients whose outcome after lumbar disc surgery does not remain stable present a major problem in the calculation of prognostic factors.” . . . . “The indication for surgery was either radicular pain that was resistant to conservative treatment or radicular neurologic deficit.” SPINE Volume 24, Number 8, pp 807 - 811 Variability of outcome after lumbar disc surgery.
“Conclusions. “In the majority of our patients, standard decompression and fusion procedures were not “successful.” . . . “A number of patient characteristics have been found to correlate with the outcome of surgery: in particular, young patients and women have fared best.” . . . “Loss of neurological function (strength, sensation, bowel and bladder conotrol) was reported by patients more often than improvements.” Neurosurgery Vol 28, No. 5 pp 685 - 689 Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operations.
(Comment: Did you notice how surgery works best on the young? Because their bodies are resilient, more like a hot dog vs bacon.)
“Conclusions. There is conflicting evidence regarding the efficacy of prolotherapy injections in reducing pain and disability in patients with chronic low back pain.” SPINE Volume 29, Number 19, pp 2126 Prolotherapy Injections for chronic low back pain.
“Since that time spinal surgery has witnessed an industrial explosion, resulting in a multibillion dollar industry.” . . . “Now consider the ‘fusion cage explosion.’ In the year after the 1996 approval of the BK and Ray cages, sales in excess of $100 million were realized. Four years later the efficacy of these stand alone devices is very questionable.” SPINE Volume 26, Number 18, pp 1947 - 1949. Presidential Address: Surgeons, Societies and companies: ethics and legalities.
Here’s another interesting story. Male, 50’s comes in. He’s had 4 disc surgeries, and after the fourth one he’s had sciatica every day since. He’s learned to live with it, and actually came to me for treatment of numbness and tingling in his hands as he works with them. After a number of sessions working his arms, hands and neck he tells me that since I started working on him his sciatica has completely disappeared. And I’ve not touched him below the level of his neck!
What to make of this? I call it putting slack in the system. Our muscles are all connected, just as one freeway leads to another. By putting slack anywhere in the system, it can help the system as a whole.
This is my theory as to why surgery ever works at all: by cutting through muscles they may put some slack in the system.
THE BOTTOM LINE
Surgery is NOT the answer for back pain.
Orthopedists, through no fault of their own, are operating, literally, on a flawed premise.
Successful surgery for low back pain is the exception and not the rule. They are selling people blue sky. And who would have surgery if their doctor sounded less than confident in the diagnosis?
Do your own personal survey of those who have had surgery. Are they their old selves again? Look at chronic back pain blogs on the internet. Many people are having multiple procedures done to them, and continue to suffer immensely.
Patients are so brainwashed into thinking a disc is pinching a nerve, the most minimal improvement is seen as success, and well, what more can you expect? You feel you are permanently flawed.
Disc theory has been engrained in us for generations. I was raised on it, and used to believe in it myself. How else to explain radiating pain, or chronic pain that fails to resolve with conservative measures?
Any radiating pain is given the catch all term “sciatica”. It’s automatic. It’s how we’re taught. I used to do it myself.
It is not recognized that muscles can cause radiating pain, or nerve symptoms. As Dr Sarno has observed, there is no apparent spasm. And he’s right, it is not apparent.
If it’s in the muscles, why doesn’t massage work?
What is being taught in massage schools does not work on tough cases, and in some situations makes people worse. I’ve heard it many times from patients over the years - deep muscle therapy made their condition worse.
Here’s a recent example: I left a student to care for a difficult case while I was out of town. We’d been working together on her and making consistent progress after she’d been laid up 7 weeks straight sleeping on the floor of her living room, life having stopped in it’s tracks, unable to stand, sit or walk, radiating pain and tingling down the leg, her foot would be numb for weeks at a time. We were making consistent progress and I encouraged her to continue with my student while away.
Because he was just out of massage school he didn’t yet realize the limitations of what he’d been taught. Instead of continuing as I’d shown him, he had to try out some of what he’d learned at school. He thought he was being very gentle, and even she said he was very caring and in constant communication with her to make sure she was “relaxed”, but she had difficulty getting up off the table after the treatment and spiraled downward from there as though she was back to square one. When I called to check on her she was in tears, and inconsolable. It’s because many forms of muscle therapy are over pressing and irritate the pattern. Resuming with proper treatment, it took a month of therapy to get her sitting and driving again, and another month to get her back to work. Two doctors had told her she needed surgery for a disc.
Sometimes you can get away with what I consider over pressing forms of massage, and sometimes you can’t. That’s why we are stuck on the disc theory of back pain.
I have students right now who just paid 12k for a year of massage school and they’ve never seen anything like what I teach them.
There is a better way to treat muscles, and it solves the mystery of back pain.
I simply ask the patient where it hurts and think of associated patterns. Working together as a team, I put them in touch with the exact source of their pain, and without fail they will exclaim “that’s it, that’s my problem”.
It’s hiding in the muscles. We just haven’t been treating them correctly.
AMR is new, most medical professionals have not heard of it. It will amaze you. It is uniquely tapped into the deeper truth of back pain.
Please see ****.com for more info.
Dr B
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