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 Surgery or exercise for bad back debated in study
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Dave

USA
1864 Posts

Posted - 11/22/2006 :  09:39:45  Show Profile  Reply with Quote


Surgery or exercise for bad back debated in study

CHICAGO (Reuters) - Choosing back surgery over exercise to treat a herniated disc generally provides more relief, but the difference is minimal and fears related to skipping surgery are unfounded, researchers said on Tuesday.

A study involving more than 1,200 patients at 13 U.S. hospitals found either surgery to remove a bulging back disc or a course of physical therapy both helped ease the pain and discomfort two years after treatment.

A herniated disk, where the doughnut-shaped soft tissue cushioning the vertebra protrudes and impinges on nerves running along the spine, is a common problem that can recede with time and with the help of exercise, the report in the Journal of the American Medical Association said.

"Patients in both the surgery and nonoperative treatment groups improved substantially over the first two years," said lead author James Weinstein, one of the Dartmouth Medical School researchers who conducted the four-year study. The medical school is located in Hanover, New Hampshire.

Based on patients' responses, surgery tended to provide somewhat more relief than physical therapy, especially at first, for their sciatica and other pain. However the difference was not statistically significant, narrowed over time, and likely was exaggerated because worse-off patients opted for surgery and tended to believe that surgery must be more effective, the study showed.

"These findings suggest that in most cases there is no clear reason to advocate strongly for surgery apart from patient preference," wrote Dr. Eugene Carragee of Stanford University Medical Center in an accompanying editorial.

Widespread concerns that a bulging disc left untreated will result in worsening back problems, neurological deterioration, and numbness and even paralysis of the legs, buttocks or genitals, were shown to be unfounded, he added.

"The fear of many patients and surgeons that not removing a large disk herniation will likely have catastrophic neurologic consequences is simply not borne out," Carragee wrote.

Stryder

686 Posts

Posted - 11/22/2006 :  12:49:58  Show Profile  Reply with Quote
Oh brother. Studies like this just feed the medical/industrial complex.

...patients opted for surgery and tended to believe that surgery must be more effective...

I wonder where patients learned _that_ belief? Can you say placebo? Say it, society. P-l-a-c-e-b-o. Aaaaaaaah, dont you feel better now.

-Stryder

Edited by - Stryder on 11/22/2006 13:57:10
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Littlebird

USA
391 Posts

Posted - 11/22/2006 :  14:58:34  Show Profile  Reply with Quote
This is an interesting conclusion: "The fear of many patients and surgeons that not removing a large disk herniation will likely have catastrophic neurologic consequences is simply not borne out," Carragee wrote. I wonder how long it will take for this information to become common knowledge, if it does. But it should be very encouraging for the people who know about TMS but still feel a little worried about developing future damage if they don't have surgery for their disks.
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tennis tom

USA
4749 Posts

Posted - 11/22/2006 :  16:27:48  Show Profile  Reply with Quote
"I wonder how long it will take for this information to become common knowledge, if it does."
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Information like this does become public knowledge, but only for a day or two, then it fleetingly gets erased from the public memory.

In just the past year or two I have seen newsreports stating the long-awaited hard science results from reputable institutions, debunking popularly used supplements and therapies such as accupuncture, glucosamine-chrondroitin, st. john's wort, and marijuana. The studies have proven that these things have NO medical or health value. The news of the study is reported in the media for 24 hours and then disappears into the dust-bin of current event history. There is no money interest in keeping the story going.

The people who have a money interest in the useless products and services more than over-power the hard science reporting with comercieals or spokespersons who twist, take out of context and obfuscate the results to make it sound like the voo-doo they are selling works.
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