ArizonaBackInstitute

By Randall C Pruitt, DC, DACNB, DAAPM, FACFN, MUAC, CES-NASM

I recently came across a study in the medical journal Spine that looked at the evidence surrounding invasive treatments for back pain. Guess what they found? Not a lot, and when I come across research like this it makes me mad…why? Because these treatments cost a lot of money and I see in my practice everyday people that have gone through them all and are no better and often worse. Some of the treatments and diagnostic protocols they review included discography, facet injections, epidural steroid injections, spinal cord stimulators and of course surgery of various kinds including disc replacement.

What is interesting is that none of these treatments really cut the mustard in efficacy. There is an interesting phenomenon in health care that when you challenge someones belief system or way of doing things they get a little angry about it so in the conclusions of this study phrases like “clinicians should employ a shared decision-making approach to x or y treatment” was included. I guess this phraseology takes a little of the sting out, but at least to their credit they would go on to say what the discussion should include. For example in the case of spinal cord stimulators they recommended that the discussion include the fact that the panel in this study could not find any sufficient evidence to recommend spinal cord stimulation for failed back surgery syndrome. And in the use of facet injections, prolotherapy and intradiscal steroid injections the panel again couldn’t find any compelling evidence that these treatments work, and they included IDET, medial branch blocks and radio-frequency ablation.

My point to all of this, is that in the world of back pain treatments you really should be informed about what options are available. I have seen thousands of what I would call “failed traditional” cases in the many years I have been practicing. In my opinion spinal decompression really is the most effective treatment I have ever seen in the treatment of chronic neck and back pain. Not to mention it’s safe and actually leaves your spine healthier, unlike most of the invasive treatments mentioned in the study. I see too often the results of long term mismanagement of these cases and it only makes it more difficult to treat. Many patients are left without a lot of options. So before you undergo an invasive procedure look into alternatives like spinal decompression. You’ll be glad you did.