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Why Spinal Surgery Doesn’t Solve Back Pain (According to a Spine Surgeon)

This interview is from the Like Mind, Like Body podcast. You can listen to the full interview below, on iTunes or Google Podcasts.


David Hanscom, MD, explains why spine surgery is not the antidote that so many people with chronic back pain seek.

Dr. Hanscom is a board-certified orthopedic surgeon specializing in complex spine problems at Swedish Medical Center in Seattle, WA. His expertise is in adult and pediatric spinal deformities such as scoliosis and kyphosis. Learn more about him and his background here.

"Spine surgery is a major problem because we're operating in the face of bad data. In other words, data says we address sleep, stress, medications, life outlook, nutrition, etc. before we do surgery. If you perform surgery without addressing the known risk factors that return poor outcomes, the patients don’t do well. When you have a structural problem with matching symptoms, surgery works really well. The metaphor I like to use is going to the dentist, if you have a cavity filled people do fine. If you go to the dentist with mouth pain and you don’t know where the pain’s coming from and you start doing random procedures, of course it’s not going to work.

We generally don’t know where back pain comes from. And this is where spine surgery, probably 70% of it, should not be done. We do know very clearly that disc degeneration has nothing to do with back pain. So arthritis, bone spurs, bulging discs, herniated discs, ruptured discs… disc degeneration has nothing to do with back pain. Yet we are doing probably 400-500 thousand [spinal] fusions this year for back pain - and that’s why our success rate it 20-25%.

You have to know where the pain is coming from before you do surgery. Back pain is not a structural problem. It’s non-specific, and it’s probably muscular in nature. The problem with muscular pain is that it hurts … just because you can’t see it on a test doesn’t mean it doesn’t hurt."

For more information on Dr. Hanscom's books, visit his website Back In Control.

[This was an excerpt. Listen to the full podcast above]

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More Resources

What’s Crooked About the $100 Billion Back Pain Industry

New York Times Bestselling author and investigative journalist Cathryn Jakobson Ramin spent 6 years researching back pain. Join us as she discusses the startling discoveries she made about the back pain industry, including: why largely ineffective spine surgery is still performed regularly and more.

Pain is the Worst: How the Curable Founders Recovered from Chronic Pain

In the years before the Curable App was born, its three founding members were plagued by dozens of unexplainable symptoms and chronic ailments. One of the founders, John, shares his story of 10+ years of pain stemming from a herniated disc that turned into sciatica, knee pain, calf pain, foot pain and more.
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