News | April 12, 2020
It is no secret that most people suffer from back pain.
In my day-to-day work as an orthopaedic surgeon, I am confronted with this issue several times a day. The level of suffering is usually high, as is the uncertainty.
Most patients consult the practice not because of the persistent pain, but because of the existing uncertainty. Anxiety and worry are usually worse than the physical pain.
First and foremost, there are 2 pillars of back treatment:
Surgery is only necessary in ABSOLUTE exceptional cases and should NEVER be the first choice. X-ray, CT and MRI images are not the yardstick for a possible operation, but ALWAYS the patient.
There are very adventurous or, in other words, horrible MRI images of the spine that do not cause the owner any discomfort. The other way around is much more common. Severe low back pain without a corresponding MRI.
Please remember: Only sudden paralysis, complete numbness of the legs or peeing in your pants without realizing it are indications that justify immediate surgery.
Everything else: In other words, although they have severe pain without the above-mentioned deficits, they can be resolved in almost ALL people without surgery.
The therapy: No surgery (i.e. conservative) therefore means:
Time, warmth and exercise. Plus a good dose of patience.
In order to restore the mobility of the spine, it can be supported with pain medication, (special) injections, acupuncture, physiotherapy, manual therapy, osteopathy, etc.
All of these forms of therapy support mobility and thus promote relaxation of the back muscles. Why is this so important?
Because MOST BACK PAIN IS PAIN IN THE MUSCLE.
Slipped discs, narrowing of the spinal canal, facet joint arthrosis, osteochondrosis, stress, too little movement, too much incorrect movement, etc. always lead to tension in the back extensor muscles. And relaxing them is the goal of all of us.
Back pain is usually medically harmless and annoying. Please do not misunderstand. EVERY pain and every patient should be taken seriously. An ailment should always be clarified and should never be trivialized. It is also important to clarify the cause. It is important to understand and know that most back pain disappears and in the rarest of cases becomes chronic or needs to be treated surgically.
It is also good to know all the alternatives and not to allow yourself to be persuaded to undergo therapies that do not seem logical or sensible to you.
Nothing and nobody can be judged in a generalized way. Surgery can be necessary if the indication is correct and is the only possible form of therapy for the individual. However, this is only a tiny proportion of the total number of back problems.
Hardly anyone with back pain needs an operation. Even less so if you are still walking to the doctor. Get several opinions if necessary and don't let yourself be talked into anything. They say "time heals all wounds", so most of the pain will go away.