| T O P I C R E V I E W |
| balto |
Posted - 07/18/2011 : 19:28:33
A Knife in the Back
Is surgery the best approach to chronic back pain?
http://www.newyorker.com/archive/2002/04/08/020408fa_FACT
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| 3 L A T E S T R E P L I E S (Newest First) |
| guej |
Posted - 07/22/2011 : 09:48:05
I've seen that article before, and I think it's spot on (and the article is from 2002; I think there is even more evidence 10 yrs later against fusions, although they are still being done).
The doctor, Neil Kahanovitz, who was lobbying against the organization that questioned spinal fusions, was the doctor from NYU who did my spinal fusion for scoliosis when I was 16. That was the gold standard for severely crooked spines in those days, and I really did go almost 25 years without a single problem and I not limited at all in athletics. I still think that's different than advocating for spinal fusion for chronic pain when there is no clear evidence of what is causing the pain, although who knows.
Interestingly, when I was in the midst of severe chronic back pain 2 years ago, I tracked down Kahanovitz in his orthopedic practice in NJ. After putting me on my 3rd round of prednisone, and scratching his head, he just looked at me and said he didn't know why I was still in so much pain, and sent me off to a rheumatologist to be tested for lyme disease (a/k/a "just please get out of my office...I don't know what to do with chronic back pain patients...it's not my fault..."). I felt absolutely screwed and lost. That was in about Feb. 2009. I stumbled upon Sarno a few months later in June , and as they say, the rest is history. What a racket this industry is, but you have to go through a long bout of irretractable pain, trying everything under the sun, before you become informed. If the first orthopedic surgeon I had seen when first in pain had suggested further fusion of the disks below my original surgery, I would have run to the operating room in hopes of relief. I can easily see how people who are in pain and desperate for relief seek fusion as their hope. |
| Javizy |
Posted - 07/19/2011 : 07:41:19
You can find similar statistics for carpal tunnel surgery, and it wouldn't surprise me if many shoulder and knee ones showed a similar trend. You'd probably be giving physicians a bit too much credit if you thought unnecessary, potentially life-ruining surgeries were being carried out just because they're unaware of TMS; surgery is often recommended despite obvious, easily treatable physical/structural causes of pain, as well.
An example that would be comical if it wasn't for the human suffering involved is one of a man who had such tight muscles in his back that they were arching his spine like a bow. X-rays showed the seemingly unsupported arch, so surgery was performed to help the spine support itself. The fact that the muscles were right up against it giving it more support than it would ever need was never investigated. The patient risked potential paraplegia for a condition that could've been treated with some harmless, non-strenuous exercises, and of course, the surgery did little for the pain.
Chronic pain treatment within the modern medical community does extremely well as a business, and has probably made a lot of people very rich, but if its goals are actually helping people then it's little more than a bad joke. |
| luckyblindshot |
Posted - 07/18/2011 : 23:22:27
I'm of the opinion that most treatments for back pain are misguided. I've been put on muscle relaxers and anti-inflammatory drugs to no avail. Back surgery was never offered to me, but if it was I wouldn't have taken it.
Modern medicine is of the frame of mind that we need to treat symptomatically. Doctors have been taught that expensive magic pills and synthetic substances will cure ailments while being taught practically nothing about nutrition and the body's natural healing processes. Instead of having faith in the body's mechanism to repair itself, we bombard it with substances it was never designed to cope with.
A similar attitude is taken with pain and surgery. Going into the body shouldn't be necessary unless there is something structurally wrong that is causing a patient distress. Instead of addressing nutritional or emotional problems that might be causing the pain, we blindly set knives to skin and bone.
quote:
Last year, approximately a hundred and fifty thousand lower-lumbar spinal fusions were performed in the United States. The operation, which involves removing lumbar disks and mechanically bracing the vertebrae, is of tremendous benefit to patients with fractured spines or spinal cancers; more frequently, however, it is performed to alleviate chronic lower-back pain. But how effective is it? That’s a question that many of the doctors who perform the fusions, and the insurers who pay for them, appear reluctant to ask.
It's sad that people reach a level of desperation where they would be willing to disfigure their spinal cord in a procedure like this. What's even more sad is that doctors will perform these procedures with no clear indication as to whether they're effective or not. What purpose does going in and maiming the body serve when there is no structural damage to be repaired? |
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