I thought my late father was cynical when he said that surgeons only had two answers to give: cut or not cut. People use what they have. Like the old Mark Twain quote. I've read a number of times...
I thought my late father was cynical when he said that surgeons only had two answers to give: cut or not cut.
People use what they have. Like the old Mark Twain quote.
I've read a number of times that studies have found that physical therapy can remove the need for back surgery.
I've used physical therapy a number of times myself and I have been impressed.
Physical therapists go to school for advanced degrees. They clinically backed science for evaluating the imbalances in your muscoskeletal system and in prescribing the correct clinically backed exercises for you.
I've been impressed when I've asked physical therapists about a given exercise and they tell me something like research has show that exercise to do/not do X and that this new exercise does X.
It is based on science and science that is improving.
Fifty!!! What insanity pushes people to coin flip on chronic pain and medical debt?! Ah, yes, economic pressures and a society with no safety net. I don't think these people are choosing back...
FBSS (failed back surgery syndrome) rates vary by procedure, but lumbar fusion sits at the high end with failure rates nearing 50 percent. (Incidentally, revision surgeries pay more than the primary surgery.)
Fifty!!! What insanity pushes people to coin flip on chronic pain and medical debt?!
she tried physical therapy and acupuncture a few times, but none of it was helping, at least not fast enough. “I remember being in the hospital and the surgeon and his partner arguing at the foot of my bed over whether I needed surgery,” she said. She was a single mom, and she wanted to work. She believed another fusion would help her. “At that point,” she said, “you’re grasping for anything and everything to try to get any kind of relief because you’re in more pain than you could ever imagine.”
Ah, yes, economic pressures and a society with no safety net.
I don't think these people are choosing back surgery based on lack of science realities, but I think many are choosing choosing them based on much moren pressing economic realities.
My own (Canadian, eg, flawed socialised medicine) will not pay for physiotherapy, but would pay for surgery if a surgeons says it's medically necessary. For folks who can't afford to pay physio out of pocket, their choices are the coin flip.
My sister went through a couple of years of physical therapy (and religiously doing the instructed exercises at home) and several more minor surgeries to try to treat her constant excruciating...
My sister went through a couple of years of physical therapy (and religiously doing the instructed exercises at home) and several more minor surgeries to try to treat her constant excruciating back pain because her doctor team (including the surgeon) very strongly believed the fusion risk/benefit did not make sense for a 20 year old. They did the spinal fusion when she was 21. She was in the successful 50%, and is very happy with the outcome even now 20 years later.
Sending this to my mom. She's an OR nurse, one who's nearing retirement age. She hurt her back at work earlier in the year, and -- through workman's comp -- she quickly started going to PT. And...
Sending this to my mom. She's an OR nurse, one who's nearing retirement age. She hurt her back at work earlier in the year, and -- through workman's comp -- she quickly started going to PT. And also assigned light duties, luckily. Mostly desk work and inventorying. But after months of PT, she says it hasn't helped. That her back tends to hurt even more after PT. Not debilitating or anything, but painful nonetheless.
So she recently got a second opinion, and this new doctor is suggesting spinal surgery. I don't know what kind of surgery, but hopefully she remains aware of the risks. Obviously being a nurse, I'd think she probably has more awareness than the Average Joe that sometimes medical outcomes are not always the positives we hope for. That things can get worse and never get better.. But like anyone, medical professionals, too, can be blinded by the things they want. Whether that's pain relief or money.
I am not suggesting this applies to your mom, but there are nurses who are/were covid deniers. I think anyone in any profession can be swayed based on the messaging they're tuned in to (by choice...
Obviously being a nurse, I'd think she probably has more awareness than the Average Joe that sometimes medical outcomes are not always the positives we hope for.
I am not suggesting this applies to your mom, but there are nurses who are/were covid deniers. I think anyone in any profession can be swayed based on the messaging they're tuned in to (by choice or not).
If you are in a situation where you are in chronic pain and looking for a way out, I cannot blame anyone for seeking a way to remove or reduce that pain. Especially if a medical professional is the one suggesting a surgery. This is also a situation that can skew your perspective- it's hard to be objective when you're the one who is genuinely suffering.
My father had many months of PT for hip pain, and similarly had increased pain and frequency of muscle spasms in the day after each session, and zero improvement over weeks and months. He had a...
My father had many months of PT for hip pain, and similarly had increased pain and frequency of muscle spasms in the day after each session, and zero improvement over weeks and months. He had a hip replacement a few years ago, and that worked great.
My mother in law has had dozens of PT series for many different joint and back pain issues. Her experience has consistently been increased pain without any long term benefit. She knows many people with poor outcomes from surgery and doesn't want that, so she just lives with the foot/knee/back/shoulder/etc. pain.
It's so frustrating to me that physical therapists can have patients for months who make zero progress, and they just tell them to get more sessions instead of identifying that the PT is not helping this particular patient.
Very personally relevant to me. I’ve been on the fence about cervical fusion for a few years now. My symptoms are not unbearable but they are not great. I’ve never read anything good about fusions...
Very personally relevant to me. I’ve been on the fence about cervical fusion for a few years now. My symptoms are not unbearable but they are not great. I’ve never read anything good about fusions while staying active, and this article aligns with that. My ideal outcome would probably be an artificial disc, but the waitlist for a free one is years long and I’m pretty skeptical of going to America for anything right now.
I was a bit skeptical of this article, until this part: This makes it sound like dental work. There's a popular story (that is somewhat old now - from the 1990s) about a person who saw a fairly...
I was a bit skeptical of this article, until this part:
To New York spine surgeon Jonathan Stieber, though, the problem isn’t inherent to the industry. Bad actors, he said, have inflated rates of back surgery across the country, and there is research that supports that belief. An update to the Lown Institute’s report, which will be published later this fall, shows that rates of spine surgery vary vastly across institutions; often, an area with extremely high rates of surgery can be traced back to one specific hospital — or one specific surgeon.
This makes it sound like dental work. There's a popular story (that is somewhat old now - from the 1990s) about a person who saw a fairly large number of dentists across the US and received wildly varying treatment advice. Very few basically said "you're fine" - others suggested root canals and other interventions for someone seemingly healthy.
I would like to think the licensure for medical surgeons (not dental surgeons) is more stringent. But unlike dentists, who fairly often own or have a large stake in a practice, surgeons seem to be at the mercy of the hospitals they practice in, who may also be adding unjust pressure to perform more surgeries than needed (per the article).
I thought my late father was cynical when he said that surgeons only had two answers to give: cut or not cut.
People use what they have. Like the old Mark Twain quote.
I've read a number of times that studies have found that physical therapy can remove the need for back surgery.
I've used physical therapy a number of times myself and I have been impressed.
Physical therapists go to school for advanced degrees. They clinically backed science for evaluating the imbalances in your muscoskeletal system and in prescribing the correct clinically backed exercises for you.
I've been impressed when I've asked physical therapists about a given exercise and they tell me something like research has show that exercise to do/not do X and that this new exercise does X.
It is based on science and science that is improving.
Fifty!!! What insanity pushes people to coin flip on chronic pain and medical debt?!
Ah, yes, economic pressures and a society with no safety net.
I don't think these people are choosing back surgery based on lack of science realities, but I think many are choosing choosing them based on much moren pressing economic realities.
My own (Canadian, eg, flawed socialised medicine) will not pay for physiotherapy, but would pay for surgery if a surgeons says it's medically necessary. For folks who can't afford to pay physio out of pocket, their choices are the coin flip.
My sister went through a couple of years of physical therapy (and religiously doing the instructed exercises at home) and several more minor surgeries to try to treat her constant excruciating back pain because her doctor team (including the surgeon) very strongly believed the fusion risk/benefit did not make sense for a 20 year old. They did the spinal fusion when she was 21. She was in the successful 50%, and is very happy with the outcome even now 20 years later.
Sending this to my mom. She's an OR nurse, one who's nearing retirement age. She hurt her back at work earlier in the year, and -- through workman's comp -- she quickly started going to PT. And also assigned light duties, luckily. Mostly desk work and inventorying. But after months of PT, she says it hasn't helped. That her back tends to hurt even more after PT. Not debilitating or anything, but painful nonetheless.
So she recently got a second opinion, and this new doctor is suggesting spinal surgery. I don't know what kind of surgery, but hopefully she remains aware of the risks. Obviously being a nurse, I'd think she probably has more awareness than the Average Joe that sometimes medical outcomes are not always the positives we hope for. That things can get worse and never get better.. But like anyone, medical professionals, too, can be blinded by the things they want. Whether that's pain relief or money.
I am not suggesting this applies to your mom, but there are nurses who are/were covid deniers. I think anyone in any profession can be swayed based on the messaging they're tuned in to (by choice or not).
If you are in a situation where you are in chronic pain and looking for a way out, I cannot blame anyone for seeking a way to remove or reduce that pain. Especially if a medical professional is the one suggesting a surgery. This is also a situation that can skew your perspective- it's hard to be objective when you're the one who is genuinely suffering.
My father had many months of PT for hip pain, and similarly had increased pain and frequency of muscle spasms in the day after each session, and zero improvement over weeks and months. He had a hip replacement a few years ago, and that worked great.
My mother in law has had dozens of PT series for many different joint and back pain issues. Her experience has consistently been increased pain without any long term benefit. She knows many people with poor outcomes from surgery and doesn't want that, so she just lives with the foot/knee/back/shoulder/etc. pain.
It's so frustrating to me that physical therapists can have patients for months who make zero progress, and they just tell them to get more sessions instead of identifying that the PT is not helping this particular patient.
Very personally relevant to me. I’ve been on the fence about cervical fusion for a few years now. My symptoms are not unbearable but they are not great. I’ve never read anything good about fusions while staying active, and this article aligns with that. My ideal outcome would probably be an artificial disc, but the waitlist for a free one is years long and I’m pretty skeptical of going to America for anything right now.
I was a bit skeptical of this article, until this part:
This makes it sound like dental work. There's a popular story (that is somewhat old now - from the 1990s) about a person who saw a fairly large number of dentists across the US and received wildly varying treatment advice. Very few basically said "you're fine" - others suggested root canals and other interventions for someone seemingly healthy.
I would like to think the licensure for medical surgeons (not dental surgeons) is more stringent. But unlike dentists, who fairly often own or have a large stake in a practice, surgeons seem to be at the mercy of the hospitals they practice in, who may also be adding unjust pressure to perform more surgeries than needed (per the article).
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