04 Oct Back in business: surgery isn’t always the spinal answer. by Los Angeles Magazine’s Jenna McCarthy
Back in business: surgery isn’t always the spinal answer.
Los Angeles Magazine Jenna McCarthy
OH, MY ACHING back.” Take a random, informal poll of friends or colleagues and, research indicates, 9 out of 10 of them will admit to having uttered this phrase, or one like it. Even though a bothersome back is rarely a life threatening condition, Americans spend between $20 billion and $50 billion a year trying to find relief.
One of the most common causes of posterior pain is a herniated disk, also known as a slipped or ruptured disk. Disks are the soft, rubbery cushions of cartilage nestled between the bones in the spinal column, and they allow the back to flex and bend. As we age, disks, like most other body parts, begin to shrink and lose their flexibility. When a disk degenerates, its outer capsule may tear, allowing the core (or nucleus propulsis, for the detail oriented) to squeeze outward and put pressure on the surrounding nerves. The disk has now slipped, and the pain can range from dull to excruciating.
Although surgery is a common treatment option, its safe to assume that most folks would rather avoid vivisection, given the choice. “If someone walks into a surgeons office with back pain and the surgeon does an MRI [magnetic resonance imaging] and finds a herniated disk, he’ll likely recommend surgery,” says Marc Darrow, M.D., medical director of the Joint Rehabilitation and Sports Medical Center (www.jointrehab.com), a holistic healing center that Caters to L.A.’s busy bodies. “That’s how he pays his mortgage. But studies have proven that over 50 percent of people who have disk problems do not feel any pain at all, which means that a good percentage of the pain-free population would be told they need surgery unnecessarily. In our practice the goal is to rehabilitate and restructure the body so that surgery is not even an option.” For those that endure back or neck pains and don’t wish to risk having the surgery that could potentially have no benefit, looking into products to aid your own rehabilitation and increase the strength of your back muscles that support your spine and neck could be a beneficial alternative that could be worth trying. For example, look into the likes of inversion tables reviewed by websites like https://kamadevayoga.com/best-inversion-tables/ as an example. These tables are supposed to take the strain away from your spine and muscles, allowing you to strengthen and realign your spinal column.
CHILL ON THOSE PILLS When pain flares up, popping a few Motrin apparently is not the wise move. “Anti-inflammatory pills relieve the symptom but do nothing to cure the problem,” says Darrow. “You may be winning the battle, but you’re losing the war. While these drugs may reduce Inflammation, they also shut down the body’s natural healing process.”
The red-hot alternative at the Joint Rehab Center is Prolotherapy, a rather Orwellian name for a relatively painless and remarkably effective procedure. During a five-minute treatment, a benign combination of sugar water (dextrose) and a numbing agent (Lidocaine) is injected into trouble spots. The body recognizes the mixture as an irritant and responds by increasing collagen production in the area. This new collagen promotes healing by thickening and strengthening soft tissues while eliminating pain. “When a herniated disk is rubbing against a nerve, the way to stop the pain is to stabilize the back,” says Darrow. “Prolotherapy does this by increasing the strength and size of tendons, ligaments, and joint capsules. Ifs the same thing a surgeon would do with bone or metal, but we do it naturally.” Thus far insurance companies cover about 50 per, cent of patients receiving prolotherapy. While many feel relief from a single session, up to eight treatments ($250 each) may be required.
“The first thing we do when a patient walks in the door is take away their diagnosis,” says Darrow. “People say, `I have arthritis,’ or `I have a herniated disk.’ Who cares? That diagnosis usually has nothing to do with the problem. We give our patients the visualization that the body is healthy to move them into a healing consciousness. We don’t put a Band Aid on problems, we fix them.”
BABY GOT BACK (PAIN) At UCLA Medical Plaza’s Institute for Neurological Research (www.diskcure.com), the weapon is the same–a needle–but the ammunition is different. Patients undergoing the institute’s proprietary procedure, DiskCure, receive injections of an FDA-approved medication that acts as an antidote to the nerve toxins that are released when a disk is herniated. These toxins can be responsible for many of the symptoms associated with a ruptured disk.
“We have patients flying in from around the country, and the results have been nothing short of miraculous,” says Edward Tobinick, M.D., medical director of the institute and a professor of medicine at UCLA. “We haven’t publicized the procedure yet because we don’t have the capacity to treat the number of patients who are going to want it.”
DiskCure has been used successfully on both patients with acute (new) pain and those with chronic (lingering) pain. “The worse someone’s pain, the better they seem to do,” says Tobinick. Cost varies depending on the dosage and the number of treatments, but ifs fair to say that the necessary series will run in the $1,000 neighborhood. (back surgery, in comparison, runs in the considerably more upscale $50,000 to $100,000 suburb.) Because of the newness of the procedure, only a handful of insurance companies covers DiskCure.
GOOD NEWS FOR THE NEEDLE-SHY At the Shaw Health Center in Los Angeles, the Total Low Back Care Medical Group (www.lowback.com) encourages patients to take back pain lying down–on its Vertical Axial Decompression machine. VAX-D, developed by Canada’s former deputy minister of health, relieves chronic back pain by decompressing the spine. After a patient is strapped onto the VAX-D table, the table separates and the ends draw apart to stretch the spine, allowing fluid to circulate, which helps rebuild the damaged tissues surrounding the disks. “It’s basically self-healing,” says Barry Glockson, deputy executive director of TLC.
In a 1991 Canadian study of 700 patients, 70 percent were fully cured after VAX-D treatment and 93 percent showed significant improvement. “Those numbers blow back surgery out of the water,” says Glockson.
An average course of treatment consists of 25 sessions on the table at 30 to 45 minutes a pop, sometimes followed by ultrasound and/or massage. The recommended series can cost as much as a pre-owned SUV ($7,000 to $10,000), although insurance companies tend to like VAX-D.
SAD-BACK SYNDROME? Some experts believe that pain has emotional or psychological roots. “Forty years ago people didn’t get back pain,” says Darrow. “They got ulcers. That was the accepted way to sublimate one’s emotions. Then ulcers became so common, it was hard to get any sympathy. Today it’s low back pain.”
In his book Healing Back Pain: The Mind-Body Connection, John Sarno, M.D., gives the phenomenon a name: tension myositis syndrome (TMS). According to Sarno, stress, anxiety, or anger can result in TMS, a real physical disorder that can affect muscles, nerves, ten, dons, or ligaments. Though Sarno acknowledges that injuries can act as triggers, he believes that buried emotions are often at the root of physical pain. People may subconsciously focus on the pain to avoid facing their repressed feelings, he says, and by doing so “train themselves” to experience pain.
Sarno’s treatment protocol involves resuming physical activity, abandoning physical therapy, invoking daily affirmations (“My pain is due to TMS and not a structural abnormality,” “I will not be intimidated by the pain”), and in a small percentage of cases, seeking psychological help.
Ultimately, the cure must fit the patient. Says Darrow, “If one thing works for one person, I’m all for it.”
COPYRIGHT 2002 Los Angeles Magazine, Inc.
COPYRIGHT 2002 Gale Group
There are many healing arts. I think it is important for your doctor to be aware of many of them. I have personally found that prolotherapy, chiropractic, laser and strength training to be among to best non surgical options. My Sarasota practice offers all of them under the same roof. We are availible for consultations by calling 941 330-8553.