A common misconception in the general population is that surgery is the recommended treatment for a disc herniation. I want to inform you that it is not the only option for a disc herniation. In fact, it’s the last option to consider. If you have low back pain due to a disc herniation there are a couple important things you should know and research before you strongly consider it. When is Surgery strongly considered, and what are the adverse effects of surgery. Consider these points of advice.
- Findings on X-ray or MRI should not be the only determining factor surgery. Studies have shown that spinal degeneration shown on imaging has no correlation to pain levels experienced by patients (many individuals have degeneration or disc herniation with no low back pain; many with low back pain have no degeneration or disc bulges).
- Surgery goes in to “cut” the pain out, but also cuts through healthy tissues (muscles, ligaments, etc.) to get to reach the spine. This can cause problems that were there to begin with. You are also at risk for infections with surgery.
- Surgery does nothing to address the cause in injury (unless from major trauma). If the cause of low back pain is not address the risk of recurrence is very high months or years later. (1)
- Risk of infection is to me noted as antibiotic-resistant pathogens are noted in medical facilities and can cause long lasting effected. (2)
So when should you consider surgery? Here are a couple examples when you should strongly consider surgery.
- Major Trauma (MAJOR car accident for example): A life threatening trauma injury or puts you at risk of further complication, don’t wait.
- Worsening of neurological function: Progressive weakness, changes in bowel or bladder habits indicate a neurological issue that needs to be addressed ASAP.
- Loss of Function: If the pain is so severe that it enables you from performing any daily function or leaves you in bed all day.
- Unresponsive to conservative care: General consensus says that failure of conservative care after 3 months can indicate a surgical approach.
- 3 months time span was determined by muscular studies in rats
- Not all conservative care is created equal. 3 months of passive therapies (chiropractic, massage, acupuncture) without any sort of active care (exercise prescription) leads to short term relief without providing the long term results that patients need. Conservative care must include active and passive care.
If you don’t fit one of these categories, then surgery is not your best option. Follow Steve Kerr’s (Golden State Warriors head coach) after surgery, he said “And I can tell you if you’re listening out there, if you have a back problem, stay away from surgery. I can say that from the bottom of my heart. Rehab, Rehab, Rehab. Don’t let anybody get in there.” Don’t be afraid of a second opinion.
Take the advice of from another, Dr. Stuart McGill, world renowned low back expert and researcher, who said:
“If your surgeon can’t provide a GUARANTEE that surgery will get rid of your pain for good, a conservative approach is the best way to manage your back pain.”
- Watters WC 3rd, McGirt MJ. An evidence-based review of the literature on the consequences of conservative versus aggressive discectomy for the treatment of primary disc herniation with radiculopathy. Spine J. 2009 Mar;9(3):240-57
- http://www.theatlantic.com/health/archive/2015/10/how-antibiotic-resistance-could-make-common-surgeries-more-dangerous/410782/