Say No To Surgery For Your Herniated and Degenerative Disc Back Pain

By: Dr. Richard E. Busch III

Many patients believe that surgery will be a miracle cure for chronic back or neck pain. Although for many years, studies have shown the poor long-term outcomes of neck and back disc surgeries. Unfortunately these surgeries, especially fusion-type, fail or have only a shelf-life of two-to-five years leading to failed back surgery syndrome for the patient. Then, why is surgery so frequently the treatment of choice?
In the United States, back pain is one of the most common reasons for which people seek medical care, and it is the second leading cause of absenteeism from work. Back pain is so prevalent that 8 out of 10 people will suffer from it. It is estimated that the cost of back pain is between $25 billion to $50 billion US, as it is the leading cause of disability of people 45 years and younger. It is the most common occupational disability in the United States.
Back pain is pain in any area of the back, from the neck to the low back. When a doctor discusses back or neck pain, he or she will refer to four main spinal regions. One region is the cervical spine, consisting of 7 vertebrae, which begins at the base of the skull and continues to the base of the neck. The adjacent region, the thoracic spine consisting of 12 vertebrae, begins at the top of the shoulders and extends to the bottom of the rib cage. The next area is the lumbar spine, generally consisting of 5 vertebrae. Below that is the sacrum, more commonly referred to as the tailbone, which connects the spine to the pelvis.
Everyone experiences pain differently. Pain is subjective, and it is influenced by our many emotional and physical factors. Factors such as preconceived ideas about pain and previous episodes of pain, genetic makeup, physical makeup, personality, and underlying health conditions. Pain cannot be seen, so the level of pain for each patient is measured on an intensity scale from one to ten, as reported by the patient. Pain also determined by the duration of pain, source and location and type of pain through examinations, X-rays and other testing.
Back pain is not always the result of an immediate accident or injury, but often is due to long-term repetitive actions such as poor posture, or improperly lifting, or unevenly carrying heavy things such as purses and children. Altered body mechanics will contribute to it and definitely our lack of physical fitness. It is common that some people suffering from back pain may be unaware of the escalation of their condition. Attitude and even influence of our culture may play into why people tend to ignore and or even deny they are experiencing pain. A good example of pain progression would be increased tingling and numbness in the extremities - arms or legs - and the change from intermittent pain to constant pain. By the time pain has progressed to the point of interfering with daily life and the ability to work, there can be permanent changes and nerve damage.
In my practice, I see symptoms ranging from dull and/or sharp, shooting and stabbing pain, numbness and tingling, limited flexibility and stiffness, sharp and shooting pain into the legs, and not being able to stand straight. These are commonly caused by degenerated discs and herniated discs.
Sciatica is commonly associated with degenerated or herniated discs. The sciatic nerve branches off the spine at the pelvis and continues down each leg. Sciatic pain travels along the sciatic nerve, the largest bundle of nerves of the body, and this can be accompanied by weakness in the legs. Many patients think they have leg problems, because the pain is majorly of the legs. The actual cause is a bulging disc pressing on a nerve at the base of the spine. With severe inflammation, there can be also hip and buttocks pain, and the pain can be debilitating.
Spinal stenosis can be caused because the discs in our spine degenerate over time. Spinal stenosis may occur in younger people when there has been a spinal injury or there is an abnormal narrowing of the spinal canal. A major purpose of the spine is to protect the spinal cord. It surrounds the spinal cord with vertebrae and spinal fluid. The spinal cord becomes inflamed when a disc bulges and the soft tissue around it pushes into the spinal canal, which causes a narrowing. This results in compression of the spinal cord. Diseases such as arthritis and scoliosis can cause spinal stenosis, and so can scar tissue which forms from a previous back or neck surgery. Often spinal stenosis occurs in the lumbar region of the spine with symptoms of pain in the skin, buttocks and legs, although it can occur in the cervical and thoracic regions.
Many times, when a doctor speaks of arthritis in your spine, he or she may be referring to your facet joints, and these are next to the spinous process where ligaments and tendons attach. They are for strength and flexibility for each segment of the spine. Facet joints are similar to other joints such as knees and hips, and can cause a patient who has arthritis in the neck, for example, to hear grinding from the rough surfaces of the cartilage of a joint rubbing together, when turning the head. For many this is disturbing and can be painful.
I treat many patients with failed back or neck surgeries, some with more than one. Some patients never achieved any relief of symptoms after their surgeries, and sometimes their pain increased. Statistics show that surgeries that have to be redone are likely to be unsuccessful, and this increases with each surgery. The spine is complex and the discs are very close to the spine, and outcomes of surgery are risky and uncertain. Preexisting medical problems are complicating factors that increase the inherent risks of an operation and can definitely affect the outcomes. Scar tissue can be a residual effect, and this can cause nerve damage and more pain.
Patients that slowly redevelop pain, in the 6-12 week period- post back or neck surgery, may have developed scar tissue, the fibrous, connective tissue that is created for wound repair by the body, near a nerve root, and this can cause more pain and damage to the nerves. Originally post-surgery, these patients had pain relief and their surgery was considered successful. Other residuals, from what could be considered a successful back or neck surgery, are numbness and tingling in the extremities, muscle weakness which can change the patient's gait, stiffness and lack of flexibility and accelerated degeneration. When patients continue to suffer with pain and weakness after their surgery, they are very shocked and very upset.
Back surgery can be considered a success even when there are residual effects such as: numbness, tingling, change of gait due to muscle weakness, loss of flexibility, and accelerated degeneration. Patients are often upset after surgery and surprised, because they still have pain and weakness. After surgery, scar tissue, a fibrous, connective tissue, is created by the body for wound repair, and it is common for the scar tissue to form near a nerve root. Scar tissue can cause more pain and nerve damage. When this happens, patients will slowly begin to redevelop pain, 6-12 weeks, post surgery. These patients may originally had felt pain relief and now have what is considered a successful surgery.
You should explore every possible treatment option to avoid surgery, unless it is an emergency condition such As Cauda Equina Syndrome - where there is loss of bowel or bladder function. Surgery should be the absolute last treatment choice. Remember surgery can always be performed, but it can never be undone.

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Want more imformation on back pain treatment. then visit Dr. Richard E. Busch III's site on how to avoid surgery neck pain where his book is available.

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