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A great variety of back surgery alternatives are available to those suffering from back pain. While there are problems such as a severely ruptured intervertebral disc which require surgery, many orthopedic surgeons are recommending that their patients consider more conservative approaches for less serious issues. Therapies and disciplines such as acupuncture, Rolfing, Neuromuscular Therapy, chiropractic, yoga, tai chi, and Pilates are providing viable options and doctors are beginning to take notice. The reason for increased caution regarding spinal surgeries is due to the fact that many are simply not necessary. Some estimates suggest that as many as half of all spine surgeries may be unnecessary. Failed Back Surgery Syndrome Also known as FBSS, Failed Back Surgery Syndrome is a term often used to describe the condition of patients who do not experience relief of pain as a result of back surgery. FBSS is not really a syndrome at all but a post-surgical state many patients experience that occurs frequently enough to have acquired a name with an acronym. The two primary functions of back surgery are to 1) decompress a pinched nerve root or, 2) to stabilize a painful spinal joint. If one’s back pain is not being caused by one of these problems, then surgery will not be the answer. The most common cause of Failed Back Surgery Syndrome, by far, is that the spine was not the cause of pain to begin with. Muscular Strain and Spasm Back surgery alternatives are being sought and embraced by surgeons because the great majority of back pain is not caused by spinal problems requiring surgery but by muscular strain and spasm. To be sure, muscular strain or spasm has the potential to produce blinding pain, but you cannot cut out this type of pain. Such pain must be addressed at its source: the musculature. Unfortunately, X-rays and MRIs (Magnetic Resonance Imaging) cannot reveal the presence of muscular strain or spasm. This must be assessed by human eyes and touch. The technological focus of medicine has lured doctors away from becoming expert at this type of hands-on evaluation. X-rays and MRIs are certainly useful to determine the presence of disc disease, disc bulging, or herniation. However, even if such tests come back positive, there are back surgery alternatives that can be pursued. It’s no longer taken for granted that as soon as a bulging disc is present that you go ahead and schedule surgery to lop it off. It is possible to test positive for a bulging disc but for that not to be the actual cause of pain. The source of pain may be the body’s compensatory muscular effort to prevent the bulge from worsening. Information from the Experts Two books come to mind in order to help with the critical decision regarding surgery. Treat Your Back Without Surgery is a very comprehensive book covering a wide range of material including the basics of spinal anatomy, back surgery alternatives, mainstream and alternative approaches to non-surgical treatment, and new technologies for minimally invasive surgical techniques. The causes of back pain are described in plain language, and a variety of conservative approaches and strategies are discussed including first-aid remedies, spine injections, Tai Chi, and acupuncture. The book also describes lesser-known therapies, such as the Alexander Technique, Rolfing, reflexology, Aston Patterning, and Ayurvedic medicine. Clear, well-illustrated exercises show exactly what to do to make your back stronger, more flexible, and injury resistant. You'll learn a host of strategies to minimize back stress, and over 40 illustrations guide you through back exercises and demonstrate how to lift heavy objects safely. Also there’s a fully updated resource section about how to obtain health care information and back surgery alternatives using the internet. The second book, Do You Really Need Back Surgery?, is authored by Dr. Aaron G. Filler, MD, PhD, FRCS (SN). Dr. Filler is one of the world’s leading authorities on nerve and spinal surgery. He serves as the medical director for the Institute for Nerve Medicine and also the Center for Advanced Spinal Neurosurgery. The first section of this book provides an overview of spine health including a lively and accessible tour of the spine, the difference between acute and chronic pain, information about ergonomics, and an exploration of current schools of non-surgical therapy and back surgery alternatives. The second section is about spinal surgery itself including a chapter on percutaneous procedures done without incision, as well as a detailed account of the many available surgical techniques. Procedures to take pressure off a nerve, repair a broken spine, and major surgery for the low back (lumbar implants and fusion) are explicated in considerable detail. Featuring over 80 illustrations, this is an essential text for those who are seriously considering surgery as an option. When Your Doctor Has No Answers If you’re experiencing severe and/or continuous pain, it’s essential to be evaluated by a qualified physician to ensure there are no serious issues. However, if your X-ray and MRI come back negative, and/or your doctor is When doctors have no answers, chances are very good that the problem lies with functional and structural issues leading to compensatory muscular patterns. Physicians are not trained to evaluate the body as a whole, but to look at isolated parts. This can result in not seeing the forest for the trees. For example, a sedentary lifestyle can lead to a shortening of the hip flexors, which in turn might lead to a torsion of one side of the pelvis. Such a torsion may create a functional leg-length difference causing the body to lean to one side when standing or walking. A chronic leaning to one side will almost invariably cause compensation in the back muscles. Such constant compensation can result is very significant pain. Sophisticated postural analysis such as this is not the expertise of the typical physician. You need to seek out a qualified Neuromuscular Therapist or other manual therapist who is well-versed in this type of evaluation. If you plan to be in Vermont, contact me at
Neuromuscular Therapy of Vermont. Back Surgery Alternatives
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