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Nine Ways to Avoid Back Surgery
Back pain has reached epidemic proportions in the United States. It is unbelievable that today alone there are over 1 million people in bed due to pain in the back. The cost annually is over $100 billion for back pain, and that includes both direct costs and indirect costs. With regards to spinal fusions, there has been a 15 fold increase over the last 10 years, and now over 400,000 are performed every year.
The vast majority of back surgeries in United States are elective. There are only really a few absolute indications for operating on one's back. The most prominent of these is called Cauda Equina syndrome, which is a condition that is an absolute surgical emergency. It involves pressure on the bottom part of the spinal cord and can affect permanent bowel and bladder function if not addressed right away. Unstable fractures of the back should be addressed in an emergency fashion as necessary. If the patient is having progressive neurologic deficit then that becomes a relative indication for surgery. Essentially what is being relayed here is that there are few relative and absolute indications for surgery, but the vast majority are actually elective.
Degenerative disc disease and spinal stenosis are diagnoses that patients have that are the most typical ones back pain patients deal with. These diagnoses are never fatal, and truly represent quality of life problems. Non-surgical therapies should be tried completely prior to undergoing a spinal surgery.
Is there a magical option to avoid back surgery? No there is not. No treatments exists that are magically effective and there is no holy Grail that can help individuals avoid back surgery. Here are 9 treatment options that have literature to back them up which can effectively avoid surgery for patients.
1. Activity modification-this refers to the old adage of if it hurts don't do it. Or simply do something else. For instance, if you are participating in a high stress activities such as jogging, that is probably not the best activity to pursue with significant degenerative disc disease. You'll probably be better off switching over to cycling or swimming. But benign neglect goes along with this and represents ignoring the pain if it's not too bad. These elective types of conditions by and large don't need prophylactic intervention.
2. Physical therapy and aerobic exercise-PT can strengthen the muscles around the spine, called the paraspinal muscles, and take pressure off the painful areas. A number of studies have shown that aerobic exercise maintains excellent results and is probably the single best activity for degenerative disc disease patients. Patients may need interventional treatments prior to undergoing PT to ensure their ability to perform the exercises properly. Especially if they are experiencing acute exacerbation of the pain.
3. Chiropractic therapy-this is now being covered by more insurance companies every year. Over 10% of the US public is now under the care of a chiropractic doctor at any one point. The literature has shown that chiropractic adjustments are effective for pain relief for a number of low back pain conditions.
4. Medications-chronic narcotics are a terrible idea for back pain and may lead to side effects such as depression, tolerance, and addiction. A better idea is to only use them on a short-term basis and stick with the tried and true Tylenol and NSAIDS. These are lower risk and very effective especially if taken within the manufacturers dosing recommendations. Muscle relaxers can help on a short-term basis, and as of recently Neurontin and Lyrica are being used effectively for low back pain with good success. Non-narcotic medications such as Ultram are also being used successfully for back pain. It is a good idea to utilize medications in conjunction with a comprehensive pain management program. That way not just throwing pills at the problem and you can obtain better results with less medications and side effects.
5. Interventional pain management treatments-continue to improve every year these injection type of procedures and they can truly make the difference between whether or not a patient needs back surgery. These treatments may include epidural injections, medial branch blocks, radiofrequency ablation, facet blocks, or spinal cord stimulator's. Disc injections are becoming much less common because some recent literature shows they may actually cause disc degeneration.
6. Spinal decompression therapy has been in existence since its FDA clearance in 1996. It is affordable, very effective, and maintains minimal risk area is indicated for facet arthritis, spinal stenosis, herniated or bulging discs, sciatica, back pain, or failed back surgery. It costs less than 5% that of spinal surgery.
7. Tens units-these are small devices that are battery-powered and about the size of an iPod. They are noninvasive, safe, and emit small electrical impulses to skin electrodes. They can help suppress pain and decrease the amount of pain medication necessary. They do not cure anything, they are simply pain relieving devices.
8. Bracing of the lumbar spine can be very effective for short term pain reduction. This can protect the muscles around the low back just like a splint does for wrist pain. They should not be used on a chronic basis because they can actually cause muscle deconditioning around low back.
9. Manipulation Under Anesthesia-this procedure is becoming more popular in the chiropractic community. It also can help patients avoid surgery and is typically done over 3 sessions on 3 consecutive days it can be an excellent resort unresponsive back pain to other treatments with intravenous sedation.
These 9 treatment methods can help patients avoid surgery over 95% of the time. Patients should try several or all of these prior to undergoing the knife for spinal fusion.
The vast majority of back surgeries in United States are elective. There are only really a few absolute indications for operating on one's back. The most prominent of these is called Cauda Equina syndrome, which is a condition that is an absolute surgical emergency. It involves pressure on the bottom part of the spinal cord and can affect permanent bowel and bladder function if not addressed right away. Unstable fractures of the back should be addressed in an emergency fashion as necessary. If the patient is having progressive neurologic deficit then that becomes a relative indication for surgery. Essentially what is being relayed here is that there are few relative and absolute indications for surgery, but the vast majority are actually elective.
Degenerative disc disease and spinal stenosis are diagnoses that patients have that are the most typical ones back pain patients deal with. These diagnoses are never fatal, and truly represent quality of life problems. Non-surgical therapies should be tried completely prior to undergoing a spinal surgery.
Is there a magical option to avoid back surgery? No there is not. No treatments exists that are magically effective and there is no holy Grail that can help individuals avoid back surgery. Here are 9 treatment options that have literature to back them up which can effectively avoid surgery for patients.
1. Activity modification-this refers to the old adage of if it hurts don't do it. Or simply do something else. For instance, if you are participating in a high stress activities such as jogging, that is probably not the best activity to pursue with significant degenerative disc disease. You'll probably be better off switching over to cycling or swimming. But benign neglect goes along with this and represents ignoring the pain if it's not too bad. These elective types of conditions by and large don't need prophylactic intervention.
2. Physical therapy and aerobic exercise-PT can strengthen the muscles around the spine, called the paraspinal muscles, and take pressure off the painful areas. A number of studies have shown that aerobic exercise maintains excellent results and is probably the single best activity for degenerative disc disease patients. Patients may need interventional treatments prior to undergoing PT to ensure their ability to perform the exercises properly. Especially if they are experiencing acute exacerbation of the pain.
3. Chiropractic therapy-this is now being covered by more insurance companies every year. Over 10% of the US public is now under the care of a chiropractic doctor at any one point. The literature has shown that chiropractic adjustments are effective for pain relief for a number of low back pain conditions.
4. Medications-chronic narcotics are a terrible idea for back pain and may lead to side effects such as depression, tolerance, and addiction. A better idea is to only use them on a short-term basis and stick with the tried and true Tylenol and NSAIDS. These are lower risk and very effective especially if taken within the manufacturers dosing recommendations. Muscle relaxers can help on a short-term basis, and as of recently Neurontin and Lyrica are being used effectively for low back pain with good success. Non-narcotic medications such as Ultram are also being used successfully for back pain. It is a good idea to utilize medications in conjunction with a comprehensive pain management program. That way not just throwing pills at the problem and you can obtain better results with less medications and side effects.
5. Interventional pain management treatments-continue to improve every year these injection type of procedures and they can truly make the difference between whether or not a patient needs back surgery. These treatments may include epidural injections, medial branch blocks, radiofrequency ablation, facet blocks, or spinal cord stimulator's. Disc injections are becoming much less common because some recent literature shows they may actually cause disc degeneration.
6. Spinal decompression therapy has been in existence since its FDA clearance in 1996. It is affordable, very effective, and maintains minimal risk area is indicated for facet arthritis, spinal stenosis, herniated or bulging discs, sciatica, back pain, or failed back surgery. It costs less than 5% that of spinal surgery.
7. Tens units-these are small devices that are battery-powered and about the size of an iPod. They are noninvasive, safe, and emit small electrical impulses to skin electrodes. They can help suppress pain and decrease the amount of pain medication necessary. They do not cure anything, they are simply pain relieving devices.
8. Bracing of the lumbar spine can be very effective for short term pain reduction. This can protect the muscles around the low back just like a splint does for wrist pain. They should not be used on a chronic basis because they can actually cause muscle deconditioning around low back.
9. Manipulation Under Anesthesia-this procedure is becoming more popular in the chiropractic community. It also can help patients avoid surgery and is typically done over 3 sessions on 3 consecutive days it can be an excellent resort unresponsive back pain to other treatments with intravenous sedation.
These 9 treatment methods can help patients avoid surgery over 95% of the time. Patients should try several or all of these prior to undergoing the knife for spinal fusion.
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