The Truth About Back Surgery
By Toni Gerber Hope & Susan Ince
Of the 56 million Americans who have back pain, only 5 percent need surgery.
Here's how to protect yourself and find relief that really works.
There's an old joke in medicine: A man goes to the doctor because he has a
miserable cold. His doctor prescribes some pills, but they don't help. On his
next visit, the doctor gives him a shot, but that doesn't do any good, either.
On the third visit, the doctor advises, "Go home and take a hot bath. As soon
as you finish bathing, throw open all the windows and stand in the draft."
"But Doc," protests the patient, "if I do that, I'll get pneumonia."
"I know," says the doctor. "I can cure that."
If you have back pain, you may feel like the guy with the cold. Your doctor
gives you one pill, then another kind, then a third. Maybe he sends you for a
shot. Or he advises cold, or heat, or alternating cold and heat. And then it
may be on to X-rays or scans. It's a scattershot approach based on often thin,
even contradictory, evidence of what actually helps.
And it has made bad backs big business. Americans spend nearly $86 billion a
year on their aching backs, which is just about on par with the outlay for
cancer treatment. Yet for all those dollars — doled out at doctors' offices and
hospitals, and for medications, manipulations, and pain-relief products to use
at home — there has been no improvement in how patients fare overall, say
researchers in a University of Washington study that compared reports from 1997
through 2005. In fact, today a larger proportion remain impaired by their back
troubles. "The truth is, we may have oversold what we have to offer," says
Richard A. Deyo, M.D., professor of evidence-based family medicine at Oregon
Health & Science University. "We're using tests and treatments more widely
than the science really supports."
A pill or heat belt that doesn't relieve pain is one thing. But what if you
undergo surgery, spend months in rehabilitation, and still feel no better?
That's what happened to Catherine Johnson, 50, a onetime competitive figure
skater who is "not the sedentary type," she says. Johnson, the mom of an
18-year-old daughter, has owned four businesses and was active in her New
Hampshire community. But for seven years, her life revolved largely around pain
from a slipped disc in her back. She'd tried just about everything, but was
still miserable: "My friends were sick of hearing me say, 'I can't do that
because of my back.' And I was sick of saying it."
So in 2004, Johnson underwent surgery to repair the disc. She'd had a
similar operation 10 years before and thought this one would be just as
helpful. It wasn't. She was still in a lot of pain, still telling friends she
couldn't do things. Three years later, in 2007, Johnson was injured further
when a drunk driver slammed into her car. Afterward, she suffered muscle spasms
and flares of pain so intense she often had to go to the emergency room for
heavy-duty drugs. Finally, a new doctor referred her to the Spine Center at
Dartmouth-Hitchcock Medical Center in Lebanon, NH. After 14 full days in the
functional restoration program, doing intensive physical therapy and learning
psychological techniques for managing pain, she found relief. In fact, the
turnaround was so great that in September Johnson moved to California, where
she hopes to get back to coaching skaters. "It's what I love most," she