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]
The Curable app uses proven mindbody techniques to reduce chronic pain symptoms.
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The Curable app delivers evidence-based methods for chronic pain self care. It guides users through easy-to-understand pain science education, and hundreds of exercises designed to break the cycle of pain. With Curable, chronic pain sufferers can self-manage their symptoms safely, effectively, and inexpensively.
The program is based on a "biopsychosocial" approach to chronic pain relief. We built our program on the same principles and techniques that have shown significant results across clinical studies. These methods are used by leading physicians, specialists, and psychologists at institutions like Mayo Clinic, Johns Hopkins, Stanford, Northwestern, and NYU - many of whom helped us to build the app.
How it Works
When pain persists, becoming “chronic,” it also becomes more complex. Modern pain research shows that psychological and emotional elements can play a major role. These non-physical components can help the brain “learn” to be in pain, re-wiring the body’s neural circuitry to perpetuate the sensation of pain.
With proper therapeutic attention the brain can "unlearn" pain, paving the way to physical pain relief. Research shows that methods like education, writing, meditation, visualization, and cognitive behavioral therapy can successfully help the brain to stop this recurring pain cycle.
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