Joshua Stern, LMTMemberFebruary 5, 2012 at 9:58 amPost count: 2
I am a massage therapist that works in a PT office. I often hear about patients that had back surgery such as fusion or discectomy and complain of as much if not worse pain after surgery. Often they say they wish they never had it done. Why is this so common? Is the surgeon performing the wrong type of surgery or in the wrong area? I really would like to understand this and why some surgeons are so knife happy instead of referring some patients to try therapy such as physical therapy for strengthening and massage therapy which I also hear clients say helps more than the surgery did. Thanks in advance for your responses.Donald Corenman, MD, DCModeratorFebruary 5, 2012 at 11:01 pmPost count: 8465
You touch on a very good point. Surgery has to have specific goals and the patient has to understand what the expectations for the results of surgery are.
Surgery comes in various forms from the microdiscectomy to the multilevel fusion. A patient with a lumbar disc hernation that has failed conservative treatment like that which you supply or a patient with motor weakness should have about a 90-95% success rate for surgery performed properly.
Now if there are 1000 patients that undergo surgery and you see 20 of those patients in your office who did not do well, you might think that surgery is an ineffective tool. You however did not see the other 980 patients who did well and make your assumption of unsuccessful surgery on a sampling error.
None the less, I think that indications for surgery should be strict and the surgeon has to give the patient all the information necessary to allow the patient to make a surgical decision. I think there are some surgeons who scare the patient into surgery and an uninformed patient has a much worse result. There is also no rating system for surgeons so even I cannot make a great selection if I personally need surgery other than the specialities that I know so well. (I am blessed if I need orthopedic surgery as my partners are the best in the world).
Dr. CorenmanJoshua Stern, LMTMemberFebruary 6, 2012 at 12:34 amPost count: 2
I would have to say that out of 10 people I see that said they had surgery, a good 8-9 out of 10 wish they never had it. That is 80-90% negative feelings towards having the surgery. I agree with you that there are probably many it works for, but why would a patient be in 5-10 times more pain after having a surgery that should help partially if not completely eliminate pain? I have a friend that had a discectomy and now is told she needs another surgery…Is this normal? After having the surgery, her disc ended up bursting.Donald Corenman, MD, DCModeratorFebruary 6, 2012 at 12:48 amPost count: 8465
I cannot comment on the population that you see but your experience is concerning. Patients should not have more pain than before surgery. That percentage should be less than 1% for all spine surgeries.
Your friend most likely had a microdiscectomy and then developed a recurrent disc herniation. I would hope she had great relief of her initial leg pain with the first surgery and then redeveloped leg pain. If not- the question has to be raised why she did not have pain relief after the first surgery.
I am currently writing a thread on failed spine surgery syndrome that will cover the reasons for failed results from surgery. Hopefully- it will be up on the website under “conditions” this week. Let me know if this helps you to understand what you are seeing at your office.
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