“We have very little confidence to conclude whether surgical treatment or a conservative approach is better for lumbar spinal stenosis, and we can provide no new recommendations to guide clinical practice. . . However, it should be noted that the rate of side effects ranged from 10% to 24% in surgical cases, and no side effects were reported for any conservative treatment.” In the medical journal Spine 2016 Jul 15;41(14):E857-68.
Many times a patient will come into our office with a nondescript diagnosis of back pain and/or accompanying hip pain. Despite numerous treatments which may include epidural steroid or cortisone injection, the patient still has pain and now has been recommended to a spinal procedure because something has shown up an an MRI. But is it in fact the disc problems on MRI causing the patient’s pain? Medical investigators are asking, “maybe we should look at the spinal ligaments?”
In our practice we often see patients who are in severe back pain. They have an MRI, X-ray and/or scan that shows an inaccurate picture of what is causing their pain. The MRI cannot show muscle spasms from a simple back strain which can cause excruciating pain. Conversely, the MRI can show a large herniated disc which may be completely painless. Yet that large herniated disc will send the patient to surgery. As you will read in the research below, this was considered “unsupported enthusiasm for the surgical management of discogenic back pain.” Now surgeons are publishing new data with a tempered enthusiasm.
We receive many emails from patients who have undergone numerous spinal procedures. The question they all ask is: “Can you help?” Because of the complexities of spinal surgery, especially in patients with numerous procedures, this question must be answered following a physical examination and consultation where realistic healing options can be discussed.
Doctors in Australia wanted a better understanding of what goes through a patient’s mind when they have chronic back pain, specifically what they think their chances are for a recovery.
I am going to get to that research later in this article. First I want to help describe what is going through our patient’s minds when they first reach out to us about bone marrow derived stem cells and platelet plasma rich treatments and their potential for healing. (more…)
Epidural steroid injection is the most frequently performed pain procedure. It is becoming clear that epidural steroid injections for various spinal conditions are best used for a patient who is in pain and waiting for back surgery. If you have decided that you are getting a spinal surgery, then an epidural may be the procedure you want prior to surgery.