The Sting of Back Pain: Do You Really Need Back Surgery?
Reported November 9, 2005
LEBANON, N.H. (Ivanhoe Broadcast News) — According to the North American Spine Society, 22 percent of Americans have difficulty driving because of back pain; 31 percent have difficulty just lying in bed; and 32 percent say they can’t lift heavy objects because of chronic pain in their back. Back pain sufferers often turn to surgery, but should they?
Noah Hano is a tri-athlete. Jay Perera is a grandmother. They’ve both battled intense back pain for years. One had surgery. One didn’t. Both recovered. To operate or not to operate? That’s the question orthopedic surgeon James Weinstein, D.O., hopes to answer.
“These patients are in pain. How do we help their pain? And is surgery the best answer? And I would argue that most of the time, it is not,” Dr. Weinstein, of Dartmouth Medical Center in Lebanon, N.H., tells Ivanhoe.
This editor-in-chief of the journal Spine is using $14 million from the National Institutes of Health to find out the effects of back surgery. As he says, “You can’t undo what you do, so once you’ve had a back operation, you can’t go back and undo it.”
Half of the 2,600 study patients will have surgery. Half won’t. He says he doesn’t know what the results will be, but he has a hunch. “Right now, I think we do too much spine surgery in the United States.”
In fact, Americans have back surgery two-times more than people in other countries; 10-times more than the United Kingdom. We also have the highest rate of failed back surgeries.
“The question is, when you don’t really know how to help them exactly, do you still try to do something that may not be effective because you’re a physician and want to be healing?” Dr. Weinstein says.
A herniated disc was the source of Hano’s pain. His doctor at the time told him to stop exercising. “I was in pretty severe pain to the point where a couple of times, I remember my eyes getting watery. It was just unbearable pain.” He was ready to agree to surgery, but his new doctor — Dr. Weinstein — prescribed exercise instead.
Today, Hano’s pain is all but gone. “It continues to sort of baffle me as to why I feel so good, but I do.”
Then, there’s Perera. As arthritis ravaged her spine, she had to learn to garden lying down. She had a fusion 10 months ago. She still has minor pain sometimes, but she is back to gardening on her feet.
Dr. Weinstein knows it could have gone either way for her or Hano. “We often believe in our minds what we’re doing is the right thing,” he says. “Yet I think we’re challenged by the public more and more that ‘is it really correct?'” He hopes his study will give some clear-cut answers for the future.
An earlier study done by Dr. Weinstein shows 85 percent of the time doctors can’t even say exactly what’s wrong with a person’s back.
