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Causes Of Back Pain and Is Surgery Your Best Choice Of Treatment

Posted Jan 27 2012 5:12am

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.

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.

Pain is subjective, and what one patient perceives as debilitating pain, another will not. Each person experiences pain uniquely because of many factors. Our brain interprets pain subjectively, and each person is affected by their own physical and emotional factors, for instance, preconceived ideas about pain and previous episodes of pain, genetic makeup, physical makeup, personality, and underlying health conditions. Pain cannot be seen, so a patient's level and type of pain is determined by intensity of pain (measured on a scale from 1 to 10), duration of pain, source and location of pain within the body. The source of pain may be determined by examinations, X-rays, blood samples, and other tests, yet pain itself cannot be seen.

It is common that some people who are suffering from back pain may be unaware of the escalation of their condition, as back pain is not always the result of an immediate accident or injury. It is often due to long-term repetitive actions such as poor posture, altered body mechanics, lack of physical fitness, improper lifting, and carrying and repetitively lifting heavy objects such as purses and children. Also, attitudes and even influences from cultures will play into why some choose to ignore changes of pain progression - pain changing from intermittent to constant and increased tingling and numbness in the extremities. Some disregard their pain, while risking permanent changes and nerve damage, until it is interfering with their ability to work and their daily requirements.

The most common causes I see in my practice are degenerated discs and herniated discs. Symptoms include 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 up straight.

Commonly associated with herniated or degenerated discs is sciatic pain (sciatica). This pain is along the length of the sciatic nerve, the largest bundle of nerves in the body. The sciatic nerve branches off the spine at the pelvis and travels down each leg. Irritation at the root of this nerve, where the nerve exits the spine, may cause pain the entire length of the leg, and this can be accompanied by leg weakness. Sciatic pain can be severe and debilitating. Patients often misinterpret this as a problem with their legs, when the primary cause is the result of a bulging disc compressing a nerve at the base of the spine. Sometimes, with severe inflammation, pain will also be in the hips and buttocks.

Our natural aging process can cause our spinal discs to degenerate and create spinal stenosis. The spinal cord is protected by the vertebrae and spinal fluid. Bulging disc can cause pressure and inflammation of the soft tissue around the spinal cord, and when tissue pushes into the spinal canal there will be narrowing and compression of the spinal cord. Even though age is generally associated with spinal stenosis, spinal injuries or abnormal narrowing can be the cause in younger people. Scar tissue from previous surgeries of the back or neck can cause spinal stenosis. Also arthritis and scoliosis can be causes. Spinal stenosis is most often in the low back. It can occur in the neck and mid-back. Some symptoms can be pain in the skin, buttocks and legs resulting from inflamed, compressed nerves in low back.

When doctors talk about arthritis in your back, they may be talking about your facet joints. These joints are next to the spinous process, the bumpy part you feel when you run your hand on your spine, and this is where your ligaments and tendons are attached. They are similar to other joints, such as the knees and hips, and they are for strength and flexibility for each section of the spine. When you turn your head and feel grinding in your neck, this could be your facet joints or arthritis in the neck. This may be painful and disturbing.

Surgery is a risky proposition because there are inherent risks, and preexisting medical conditions can be complicating factors. Outcomes from back and neck surgeries are variable because of the complexity of the spine and the closeness of the discs to the spine. Scar tissue from surgery can cause pain, as a side effect, and scar tissue can cause nerve damage. I have treated many cases of failed back and neck surgeries. Some of my patients have had more than one failed surgery, and many did not have any relief from pain and symptoms. Unfortunately, the likelihood of surgical failure increases with each revision surgery. There are never any guarantees that you will be pain-free and experience long-term success, and surgery can have its own complications and consequences.

For all these reasons, you can not be guaranteed you will be free of pain or have long-term good results from back or neck surgery. Some surgeries are successful, and there are specific conditions that will require surgery. However, complications and negative consequences can happen.

It can be confusing for the patient when they hear different medical terms for the same or similar medical conditions. It can be confusing when you hear pinched nerve, bulging disc, slipped disc, prolapsed disc and ruptured disc. Patients can even be confused about what to do for treatment, and not even know what questions to ask.

Medicare statistics show that surgery is more highly recommended in certain cities and states. Why no one really knows. According to Prevention Magazine, July 2008, it could be considered a practice signature and doctors also do what other similar doctors do in their area. Surgery should be the absolute last treatment choice. Explore every treatment option to avoid surgery, unless it is an emergency condition such As Cauda Equina Syndrome, and condition where there is loss of bowel or . Remember surgery can always be performed, but it can never be undone.

Have more questions about back pain treatment . then visit Dr. Richard E. Busch III's site on how to avoid surgery neck pain for expert information.


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