| T O P I C R E V I E W |
| Dave |
Posted - 05/23/2005 : 13:54:08
Another story indicating back surgery does not work, though it was pitted against "intensive rehabilitation" with a passing mention of cognitive behavioral therapy. Still waiting for the study that uses no physical treatment at all...
By Patricia Reaney
LONDON (Reuters) - Surgery to relieve chronic lower back pain is no better than intensive rehabilitation and nearly twice as expensive, researchers said Monday.
Low back pain is one of the world's most common complaints. In the 25-nation European Union, it affects over 40 million workers and accounts for nearly half of all sick days.
Researchers at the Nuffield Orthopaedic Center in Oxford, England found little difference when they compared the effects of surgery with rehabilitation on nearly 350 sufferers.
"This is strong evidence that intensive rehabilitation is a good thing to do for people with chronic back pain who are thinking of having about having operations," said Jeremy Fairbank, an orthopaedic surgeon at the center.
"The ultimate outcome ... is there is not much difference," he told Reuters.
Fairbank and his colleagues studied 349 back pain sufferers who either had spinal fusion surgery or intensive rehabilitation involving exercises and cognitive behavioral therapy.
Thirty patients in the therapy group later had surgery.
The researchers, whose findings are reported online by the British Medical Journal, concluded that there was no evidence that surgery was any better.
But the average cost for a surgery patient was 7,830 pounds ($14,400), compared to 4,526 pounds for rehabilitation.
"In the short term, compared with intensive rehabilitation, surgical stabilisation of the spine as first line treatment for chronic low back pain patients who have already failed standard non-operative care seems not to be cost effective," said Helen Campbell of the University of Oxford in the journal.
Doctors suspect chronic back pain is caused by a combination of normal wear and tear on the joints of the back and poor muscle control. It is treated with physiotherapy, osteopathy, chiropody and surgery or a combination of treatments.
"The peak prevalence is in young middle age," said Fairbank.
He added that surgeons offering spinal fusion surgery, in which one or more vertebrae of the spine are joined to stabilize a section of the spine, should explain all the options to patients.
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| Stryder |
Posted - 05/25/2005 : 19:44:17
quote:
Originally posted by Dave
"The peak prevalence is in young middle age," said Fairbank.
Dr. Sarno wins again. Simply amazing. -Stryder |
| alanc |
Posted - 05/25/2005 : 10:11:04
{Doctors suspect chronic back pain is caused by a combination of normal wear and tear on the joints of the back and poor muscle control. It is treated with physiotherapy, osteopathy, chiropody and surgery or a combination of treatments.
"The peak prevalence is in young middle age," said Fairbank}
Kind of an oxymoron and leads into Sarno's theory that pain would be more prevalent as people get older.
I'm new here. I just finished Healing Back Pain three days ago and have virtually no pain after three years of limping around with butt, hip and leg apin. I think it's a miracle. |
| Dave |
Posted - 05/25/2005 : 07:38:56
quote:
Originally posted by smth416
Unfortunately, although the study is a strike against surgery, it seems to reccommend physical therapy, which kind of goes against the TMS theory, right?
Yes, the article definitely misses the boat.
So far I have seen no reports that claim psychological issues can be the primary cause of back pain, though several have said that stress can make symptoms [of an underlying physical problem] worse.
I doubt we'll see any such reports in our lifetimes. Dr. Sarno has chosen the path of healing people rather than performing clinical studies. |
| smth416 |
Posted - 05/24/2005 : 16:41:03
Unfortunately, although the study is a strike against surgery, it seems to reccommend physical therapy, which kind of goes against the TMS theory, right? |
| n/a |
Posted - 05/24/2005 : 02:37:26
I've felt for some time that the UK's health care system lends itself to Dr Sarno's ideas - most of us rely on the National Health Service for all health care. We don't pay anything when we need treatment - it's funded through income taxation and something called National Insurance contributions which are deducted from our salaries. We don't need any other medical insurance or health plan, although plans are available and some people avail themselves of these. Our waiting lists for treatment and specialist consultation can be too long and these insurance plans allow a person to be seen very quickly.
Of course, when our NHS was set up in 1947, the huge advances in medical care were not foreseen and the costs of many treatments are horrendous, so the government are always looking for ways to save money. It would be very cost effective to treat people via Sarno when compared to the costs of major surgery etc.
I read that report yesterday and as Dave says it's unfortunate that CBT and rehabilitative physical care are seen as the alternatives to surgery, but at least it's got people reconsidering conventional treatments to chronic pain. |
| Allan |
Posted - 05/23/2005 : 19:34:24
A very interesting post Dave.
It reinforces Fred Amir's reference to a study in Appendix C of his book, "Rapid Recovery. . ." cited on the tms.help home page for related books.
Appendix C on page 270 refers to research done by the U. S. Dept of Health and Human Services in 1994, eleven years ago, this study of 10,000 found that "Surgery has been found helpful in only one a hundred cases of low back problems. In some people, surgery can cause more problems."
This reference got my attention because I had been scheduled for surgery, a laminectomy of S-4 and S-5 whereby a huge chuck of the vertebrae is removed to allegedly remover the pressure on the nerve.
Being skeptical of the study, I wrote to Rockville, MD and got a copy of it. There is was in black and white. The study had been done to determine the efficacy of federal funds spent on back surgery. IMHO next to worthless. I am sure it is filed somewhere and the federal government is still wasting money on back surgery.
Nice to know that the British have caught up with us on a similar finding.
Good job Dave. We need these reports.
Allan. |
| tennis tom |
Posted - 05/23/2005 : 18:39:33
Thanks for that informative post Dave. Several lines from it reminded me of a point made by Sarno, that back problems, (TMS), are more prevalent in middle-age and subside in old-age.
These two lines from ths study point out the contradiction:
"The peak prevalence is in young middle age," said Fairbank.
"Doctors suspect chronic back pain is caused by a combination of normal wear and tear on the joints of the back and poor muscle control."
As Sarno pointed out in one of his books, if "normal wear and tear" caused back pain then the numbers would increase steadily as we get older and wear and tear accumulates over time but the numbers decrease as we get older instead. |
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