About 500,000 Americans have back surgery each year for pain relief, and according to the Agency for Healthcare Research and Quality (AHTQ), this costs about $11 billion a year. But what if I told you that only 5 percent of people who undergo back surgery actually need it — and worse — for many people the pain ends up coming back.
The American Society of Anesthesiologists estimates that 20 to 40 percent of back surgeries fail. If you’ve had repeated back surgeries, your risk of failure increases. Botched back surgery is so common that it got its own name – ‘Botched Back Surgery Syndrome’ – which occurs when you feel continuous pain in your neck, back or limbs after any surgery on your spine spine intended to reduce pain.
So why do we keep spending so much money on back surgeries when most people don’t actually need it and when half of the surgeries fail?
Back pain can be excruciating, debilitating, and have a significant impact on quality of life and happiness. If you find yourself in this situation and a respected surgeon tells you that surgery is your best option to take the pain out and get you back to living your life again, there’s a good chance you’ll jump at this opportunity. And most of the time – surgery takes the pain away – it initially is. But what surgeons don’t tell you is that your pain has a high chance of coming back. And if you’ve had one “successful surgery,” assume the next one will go the same. But as mentioned earlier, the more back surgeries you have, the more likely they are to fail and the vicious cycle begins.
So when should you go back to surgery? If you’ve had an accident or trauma that resulted in severe damage to your spine, you need surgery. If you have an urgent impairment of one of your spinal nerves, you also need surgery. But let me preface “urgent”. Your symptoms will be progressive and severe. Signs could include problems with your bowels and bladder, sudden and worsening foot drop (loss of strength and ability to lift foot and toes), walking will be difficult and progressively worse, and nothing will ease the pain – medications and rest will barely touch your symptoms. These cases are rare, but require surgery to quickly decompress the nerve before permanent damage results.
But 70 to 80 percent of the time, back pain is what we call nonspecific or mechanical. And surgery isn’t recommended — and rarely works for this type or back pain. Mechanical back pain can be acute and last for a few days, or it can be chronic and come and go. You may have nerve pain with numbness and shooting pain down your leg, but it won’t be as urgent as the situation described above. The pain you feel is typically caused by
irritation of soft tissue structures, discs, muscles and joints. But the root cause of this irritation comes from something else, and that’s what we need to worry about. This is why 50% of back surgeries fail.
Let me explain…
When you get an MRI to see “what’s causing” your back pain, it will typically show some form of bulging disc, degenerative discs, or lumbar stenosis. You’ll probably be told that these findings are what’s causing compression and irritation to your nerves. They might try injections and medications first, but when that doesn’t work, they’ll recommend surgery. But here’s the catch. These findings show up in 60-80% of all MRIs when you are over 50. But not everyone with these “abnormalities” has back pain. In other words, you can have two people of the same age, with the same MRIs, and one will have pain while the other will not.
How does it happen?
What research has shown over the years is that what appears in your images rarely correlates with what is causing your back pain. It’s why so many back surgeries fail — because we’re messing around with “abnormal” results that are actually quite normal for your age. So if facilities aren’t the problem, then what is? Most back pain comes from poor movement and lifestyle habits. Over time, repeated, unbalanced movements will exacerbate or cause irritation to these structures which are considered “findings.” But you can’t fix your back problem by just addressing where the symptoms are. You need to address the root cause, which is typically a combination of restoring full and free range of motion to the spinal joints and balancing flexibility and strength. When you move properly, these structures are no longer disturbed and neither is your back.
I know what you’re thinking: It sounds too simple and maybe you’ve already tried physical therapy or something similar and it didn’t work. Unfortunately, not everyone understands—or even agrees with—the concept of mechanical back pain the way I just explained it. But trust me, when you find someone who does, you’ll be amazed at how easy it is to fix your back and keep the pain away, without ever having to see the inside of an operating room.
Back surgery can be costly, both for your bank balance and for your mental well-being. That’s a lot of money to risk when there’s only a 50% chance that the surgery will work and an even greater chance that the pain will return. If there’s a complication of any kind, then you’re looking at more surgery and an almost certain loss of quality of life. Doing your due diligence is worth it. Find a movement specialist who understands mechanical back pain and can keep you out of the OR.
Dr Carrie Jose, Physiotherapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch or book a place in her next Masterclass for Back Pain and Sciatica Sufferers, visit her website at www.cjphysicaltherapy.com or call 603-605-0402.