Low Back Pain: Surgery vs. Chiropractic?
Clear Lake City Chiropractor Comments: Low back pain (LBP) is the second most common cause of disability in the United States (US) and a very common reason for lost days at work with an estimated 149 million days of work lost per year. The total cost associated with this is astronomical at between $100-200 billion/yr, of which 2/3rds are due to decreased wages and productivity. More than 80% of the population will have an episode of LBP at some point in their lifetime. The good news is that 95% recover within two to three months of onset. However, some never recover which leads to chronic LBP (LBP > 3 months), and 20-44% will have a recurrence of LBP within one year with lifetime recurrences of up to 85%! What this means is that most of us have, have had, or will have LBP, and we’ll get it again! So the question is, what are we going to do about it?
Surgery has traditionally been considered a “last resort” with less invasive approaches recommended first. Chiropractic adjustments and management strategies have traditionally faired very well when compared to other non-surgical methods like physical therapy, acupuncture, and massage therapy. But, is there evidence that by receiving chiropractic treatment, low back surgery can be avoided? Let’s take a look!
A recent study was designed to determine whether or not we could predict those who would require low back surgery within three years of a job-related back injury. This is a very important study as back injuries are the most common occupational injury in the US, and few studies have investigated what, if any, early predictors of future spine surgery after work-related injury exist. The study reviewed cases of 1,885 Washington state workers, of which 174 or 9.2% had low back surgery within three years. The initial predictors of surgery included high disability scores on questionnaires, greater injury severity, and seeing a surgeon as the first provider after the injury. Reduced odds of having surgery included: 1) <35 years old; 2) Females; 3) Hispanics; and 4) those who FIRST saw a chiropractor. Approximately 43% of workers who first saw a surgeon had surgery compared to ONLY 1.5% of those who first saw a chiropractor! WOW!!! This study supports the FACT that IF a low back injured worker first sees a chiropractor vs. a surgeon, the likelihood of needing surgery in the three years after the injury would be DRAMATICALLY reduced! In fact, the strongest predictor of whether an injured worker would undergo surgery was found to be related to who they saw first after the injury: a surgeon or a chiropractor.
If this isn’t enough evidence, another recent study (University of British Columbia) looked at the safety of spine surgery and reported that (taken from a group of 942 LBP surgical patients): 1) 87% had at least one documented complication; 2) 39% of the 87% had to stay longer in the hospital as a result; 3) 10.5% had a complication during the surgery; 4) 73.5% had a post-surgical complication (which included: 8% delirium, 7% pneumonia, 5% nerve pain, 4.5% had difficulty swallowing, 3% nerve deterioration, 13.5% wound complication); 5) 14 people died as a surgical complication. Another study showed lower annual healthcare costs for those receiving chiropractic vs. those who did not. The “take-home” message is clear: TRY CHIROPRACTIC FIRST!!!
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] .
Low Back Pain and Failed Back Surgery
Houston Chiropractor Comments: Back surgery is quite common in the US with hundreds of thousands of operations each year. Sometimes these are laminectomies and diskectomies and other times the spine is fused together so certain joints no longer move, a critical spinal function. The conservative medical approach/thinking is rest, medications, exercise, and physical therapy. If these fail, then epidural injections are often used. If there is little relief, at this point in the patient’s course, chiropractic care is usually not considered, and many patients follow the medical trajectory toward surgery.
Although most surgeons wouldn’t consider an operation to be effective for back pain, most patients think this is the primary concern for the surgeon. In reality, the surgery is more indicated when the nerve root is compressed and there are neurological signs such as muscle wasting, foot drop, or numbness. If back pain is the primary problem and not leg pain or numbness, then surgery should generally be avoided.
But most patients with leg pain will also have low back pain, and this low back pain can be quite severe. The patients that have this continued pain or numbness are called surgical failures. The term for this is failed back surgery syndrome. Entire medical conferences have been devoted to the topic/problem. Patients are left with few medical options after a failure and re-operation is especially problematic. The patient may be prescribed an opiate patch, or perhaps an implanted spinal cord stimulator, or both. These devices send electrical impulses through tiny wires that carry the signal to different areas of the spinal cord.
Sometimes these approaches work, but too often they don’t. By their nature they cannot correct a joint problem. If you had a joint/disk injury before the surgery, it is likely it is still there. Post surgical cases should be evaluated by a chiropractor to see if there is an underlying joint problem that the can be adjusted specifically.
There may be some natural alternatives to electrical implants and long term opiate medications for pain control. Certain physiotherapy, ice and exercise can be incorporated into a comprehensive drugless management program. Even counseling and behavior therapy can help to lessen the need for medications. Usually patients can be safely adjusted after the initial surgery has healed (about six weeks). It is important to consider all options before repeat operations. Active rehabilitation combined with specific chiropractic care can be the solution for many patients.
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!
