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."