Can Chiropractic Help the Post-Surgical Patient?
Clear Lake Chiropractor Comments: Low back pain (LBP) accounts for over 3 million emergency department visits per year in the United States alone. Worldwide, LBP affects approximately 84% of the general population, so eventually almost EVERYONE will have lower back pain that requires treatment! There is evidence dating back to the early Roman and Greek era that indicates back pain was also very prevalent, and that really hasn’t changed. Some feel it’s because we are bipedal (walk on two legs) rather than quadrupedal (walk on four limbs). When comparing the two, degenerative disk disease and spinal osteoarthritis are postponed in the four-legged species by approximately two (equivalent) decades. But regardless of the reason, back pain is “the rule,” NOT the exception when it comes to patient visits to chiropractors and medical doctors. Previously, we looked at the surgical rate of low back pain by comparing patients who initially went to spinal surgeons vs. to chiropractors, and we were amazed! Remember? Approximately 43% of workers who first saw a surgeon had surgery compared to ONLY 1.5% of those who first saw a chiropractor! So, the questions this month are, how successful IS spinal surgery, and what about all those patients who have had surgery but still have problems – can chiropractic still help them?
A review of the literature published in the Journal of the American Academy of Orthopaedic Surgeons showed that in most cases of degenerative disk disease (DDD), non-surgical approaches are the most effective treatment choice (that includes chiropractic!). They report the success rate of spinal fusions for DDD has been only 50-60%. The advent of artificial disks, which originally proposed to be a “cure” for symptomatic disk disease, has fared no better with possible worse long-term problems that are not yet fully understood. They state, “Surgery should be the last option, but too often patients think of surgery as a cure-all and are eager to embark on it.” They go on to write, “Also, surgeons should pay close attention to the list of contraindications, and recommend surgery only for those patients who are truly likely to benefit from it.” Another study reported that, when followed for 10 years after artificial disk surgery, a similar 40% of the patients treated failed and had a second surgery within three years after the first! Similar findings are reported for post-surgical spinal stenosis as well as other spinal conditions.
So what about the success rate of chiropractic management for patients who have had low back surgery? In a 2012 article, three patients who had prior lumbar spinal fusions at least two years previous were treated with spinal manipulation (three treatments over three consecutive days) followed by rehabilitation for eight weeks. At the completion of care, all three (100%) had clinical improvement that were still maintained a year later. Another study reported 32 cases of post-surgical low back pain patients undergoing chiropractic care resulted in an average drop in pain from 6.4/10 to 2.3/10 (that means pain was reduced by 4.1 points out of 10 or, 64%). An even larger drop was reported when dividing up those who had a combination of spinal surgeries (diskectomy, fusion, and/or laminectomy) with a pain drop of 5.7 out of 10 points!
Typically, spinal surgery SHOULD be the last resort, but we now know that is not always practiced. IF a patient has had more than one surgery and still has pain, the term “failed back syndrome” is applied and carries many symptoms and disability. Again, to NOT utilize chiropractic post-surgically seems almost as foolish as not utilizing it pre-surgically! GIVE US A CALL!!!
We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for back pain, we would be honored to render our services. . Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please e-mail them to [email protected]
What is a Degenerated Disc?
Houston Area Chiropractor Comments: A report from your doctor that you have a “degenerated disc” can sound scary until you realize that lots of people have degenerated discs and it does not mean surgery. It is important to understand how the disc works in the low back, how it is injured, and how it can be safely treated, to get the best results with your condition.
So what is a disc? A disc is nothing more than cartilage similar to the cartilage in your knee. Cartilage covers bones and connects them allowing a joint to be formed. Cartilage and ligaments are what make motion possible but they also restrain movements that are too large. In the case of the spine, there are 24 individual bones called vertebrae. The disc is a cartilage that connects each of these vertebrae.
The disc can be injured just like a knee or an ankle can be sprained. The injury will stretch the ligaments and cartilage and cause them to tear. Whenever the body is injured, inflammation follows which serves to begin the healing process. Damaged tissue is consumed and scars are laid down.
In the case of the disc, the degeneration is usually at the back portion of the disc, because that is the location of the original injury. The disc also contains a more watery center called the nucleus. When injury to the disc occurs, the joint does not move properly. Lack of movement can be just as detrimental as too much movement. With this lack of motion there is less movement of water, in and out of the nucleus. The nucleus then dehydrates and the disc begins to collapse under the weight of gravity.
You were likely shown an x-ray of the degenerated disc and told that the space between the vertebrae is smaller because the disc material is degenerating. An MRI or CT scan can also show the degenerated disc. However, it does not mean that you need surgery.
The body is meant to handle degeneration of the disc and many people do quite well despite what an MRI or x-ray may show. Other patients have a bulging of the disc along with the loss of height. This bulging, called a herniation, can press on the nerve and cause back or leg pain (sciatica).
If the pressure within the disc can be lowered, then it is possible to create a vacuum that draws the bulging disc away from the nerve. Decompression treatment uses this effect as a treatment for back pain and leg pain caused by a degenerated disc.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
