I have an anecdotal support for your point: I had an event that resulted in intense lumbar pain and I was duly referred to a well-known specialist at a very large hospital. While waiting for the specialist to come into the examining room, I was able to overhear the employee at the front desk making phone calls. She made the same call over and over: “The MRI shows you have a stenosis, for which the only treatment is surgery.” I thought that was a little curious and filed that information away. Finally, the specialist came in and, after perfunctorily taking my “history”, recommended an MRI. I think even he felt a little awkward that he never even really looked at me, and so had me briefly pull up my shirt and point to where it hurt. Sure enough, a couple of days after the MRI, I got the “stenosis” phone call. My intuition told me not to go, and I didn’t.
The pain subsided and was manageable for a few years, but again I went to a (different) specialist who duly ordered another MRI, after which he informed me that I was not a candidate for surgery (his words were essentially that I could go to someone else and get surgery, but he was confident that I would come back to him to fix their mess) and suggested physical therapy. When he asked me what I did for pain, I told him OTC analgesics. He gave me a peculiar look and said “I can prescribe something stronger if you want”. I didn’t want, but got benefit from the physical therapy and have taught myself how to manage the problem, within the bounds of the underlying condition, through proper stretching.
Now, of course I have no idea whether the surgery would have helped or harmed (I suspect the second specialist may have been right), but I’m done with doctors, and will just live within the limitations of my minor disability.
As always, reading your substack gives me valuable information and teaches me so much.
Thank you for your insight and for sharing so openly with us.
My son is autistic and it is from Tylenol. I hope one day that something might be done to help him and all others who were injured by this drug. I struggle with bitterness every day of my life about what happened to him and I worry about who will care for him after I'm gone. I hate even looking at Tylenol and I avoid it like the plague.
IMO I believe Physical Therapy is the best solution! They are highly trained to bring symmetry back to maintain spinal alignment and normal muscle tone!
I think you meant to write you CAN'T "undo" surgery, right? Sorry to be a grammar Nazi. I'm an editor. But boy are you right. I made the terrible decision to have back surgery on l4, l5, s1 (partial discectomy) when I was 23 in 1998 and my life has been a series of unending pain since then. Shortly after the surgery I noticed my spine was curving away from the original source of the sciatic pain, that my sacrum and pelvis were twisting inadvertently, and that all sorts of other muscular and tendon pain were showing up in other parts of the body (shoulder, legs, face, bladder, etc.). Once your spine is messed with in this way all sorts of other things go by the wayside too. Of course I didn't always make the right choices in terms of dealing with this kind of pain and self-medicated with booze and other stuff for years. The spine and sacrum should be thought of as sacred, no pun intended. The ease with which unscrupulous surgeons convinced me I needed to be operated, and my subsequent distrust of them no doubt played a role in my questioning the Covid narrative, though. Perhaps I can be facetiously "grateful" to them for that. Thank you for this post. It is invaluable.
I heal my back with a combination of Chiropractry, Acupuncture, physical therapy, massage with lineaments and hot tub and the only medicines that I use are turmeric with ginger and Boswelia, Ice packs and heating pads.
Never trusted medical doctors with my spine. All the want to do is cut on you and drug you up. The spine needs adjustments just like the body needs bathing. It doesn’t last forever. So I get monthly adjustments. Been doing that since I was 9 years old. Im in my 50’s now. My Dad did the same and it never failed him.
Oct 28, 2023·edited Oct 28, 2023Liked by A Midwestern Doctor
I absolutely love all of your incredibly informative articles! This week, in particular, I couldn't help but wonder how in the world you are able to put out so many highly researched articles.
This one was great, but I noticed that there was only one or two sentences that mentioned "adjustment", but didn't mention that that's what chiropractors do. I'm amazed at how many people I know that have no idea what a chiropractor does or what an adjustment is.
I would always try the least invasive treatment first and then move on to other options if necessary. Not to mention that, as you articulated, pain meds usually won't fix the underlying cause of the pain.
Thank you so much for all of your hard work. You are helping so many people!
I will never forget when my Ivy League orthopedic surgeon found out I had read Dr.Sarno’s book (found on my own). He unironically said, “Well you won’t need to see me much anymore.” And he was right! He had studied under Sarno but continued to practice his profession without encouraging patients to read the works of Sarno. Through Sarno’s explanation and a shift in my perspective, I was able to overcome carpel tunnel syndrome. I agree with you that his suggestions for Freudian therapy are antiquated but his explanation of the pain dynamic in Type A personalities alone did it for me.
I’m happy to say that a orthopedic surgeon suggested that I try following the changes and exercises in “Treat Your Own Neck” by Robin McKenzie. That book kept me living my slightly risk-taking dare devil lifestyle without pain until I hurt my back. Fortunately, Robin had written “Treat Your Own Back” in the meantime. That book and a temporary back brace kept me off drugs once again. The Bible and the two books by Robin McKenzie have been the most important books in my life. They taught me there is a healthy solution to every problem we may face.
Twenty years ago it was suggested I should get back surgery for my bulging disc. Then I started taking pilates and yoga classes, I invested in a good tempurpedic mattress, and also started taking anti-inflammatory herbs and supplements. Back pain gone in 2 months.
Very insightful. Having gone thru a herniated disc i changed many things that I found out caused it. My yoga practice was extremely helpful and so was the loss of 67 useless pounds.
Great article covering many drugs commonly used and no relief gained. I took Nabumatone for several years for severe scoliosis. Now I only take a Tylenol if extreme pain from yard work. My scoliosis causes painful muscle tightness and nothing helps. I use a massager for minimal help but just have learned to live with it. Walking seems to help since sitting too long aggregates it. This article was extremely informative. Thanks.
Thank you for this thorough post on spine pain. In my 26 year neurosurgery solo practice, the nonsurgical pain was the most challenging to help. It is humbling for a surgeon to know spine surgery can’t fix everything. Since discovering BEMER powered muscle stimulator, I am now able to share a modality which is able to support self healing and discomfort recovery. I wish I had known about BEMER before retiring from my career. Now, I am dedicated to sharing this technology which has improved quality of life for over a million users for the past 25 years. https://daria-schooler.bemergroup.com
I remember seeing Andrew Saul in a documentary film saying: "If you go to a Chinese restaurant looking for Italian food you are not going to find it. It is just not on the menu" So if you go to a surgeon there is only one thing on the menu. You have to be responsible for your own healthcare and get 2nd, 3rd and maybe even a 10th "second opinion".
I have seldom used any drugs to treat neck and back pain. Several times I have been unable to move very much with these troubles. But I have always had very good success using a chiropractor. I have never seen a regular doctor for this type of pain. I can't imagine ever doing so.
Honors graduate of NY Chiropractic College in 1987 and worked as a full-time clinician in a solo practice and did a one year stint in a MD/DC/PT/Acupuncture multicare facility as the lead physician. I had upwards of 300,000 clinical encounters during this time. It was clear in the multicare clinic that some chronics had better outcomes following the addition of active exercises to their spinal adjustments aka spinal manipulative therapy (SMT). This was verified in a well done study published in 2003 or so that was very clear that a regimen of SMT plus active exercises resulted in a synergistic effect of 1 plus 1 equals 3 with regard to improved function and pain using Oswestry scales. Nothing else came close to that combo. I’ve personally seen and experienced the benefits of massage, manual trigger point therapy, and acupuncture added along with stretching for muscle pain relief as having benefits. Without the restoration of normal spinal biomechainics to restore mobility, the muscular system addressed through the above additions, the neuro system will continue to fire abnormally causing pain and disability. Surgery is only in consideration for patients with severe, intractable pain not relieved by conservative care, progressive muscle, weakening due to cord, or spinal nerve compression, or cauda equina syndrome with the loss of bowel or bladder function. Medication use should be reserved for short term situations while the other treatment modalities I’ve mentioned are being utilized.
I have an anecdotal support for your point: I had an event that resulted in intense lumbar pain and I was duly referred to a well-known specialist at a very large hospital. While waiting for the specialist to come into the examining room, I was able to overhear the employee at the front desk making phone calls. She made the same call over and over: “The MRI shows you have a stenosis, for which the only treatment is surgery.” I thought that was a little curious and filed that information away. Finally, the specialist came in and, after perfunctorily taking my “history”, recommended an MRI. I think even he felt a little awkward that he never even really looked at me, and so had me briefly pull up my shirt and point to where it hurt. Sure enough, a couple of days after the MRI, I got the “stenosis” phone call. My intuition told me not to go, and I didn’t.
The pain subsided and was manageable for a few years, but again I went to a (different) specialist who duly ordered another MRI, after which he informed me that I was not a candidate for surgery (his words were essentially that I could go to someone else and get surgery, but he was confident that I would come back to him to fix their mess) and suggested physical therapy. When he asked me what I did for pain, I told him OTC analgesics. He gave me a peculiar look and said “I can prescribe something stronger if you want”. I didn’t want, but got benefit from the physical therapy and have taught myself how to manage the problem, within the bounds of the underlying condition, through proper stretching.
Now, of course I have no idea whether the surgery would have helped or harmed (I suspect the second specialist may have been right), but I’m done with doctors, and will just live within the limitations of my minor disability.
As always, reading your substack gives me valuable information and teaches me so much.
Thank you for your insight and for sharing so openly with us.
My son is autistic and it is from Tylenol. I hope one day that something might be done to help him and all others who were injured by this drug. I struggle with bitterness every day of my life about what happened to him and I worry about who will care for him after I'm gone. I hate even looking at Tylenol and I avoid it like the plague.
IMO I believe Physical Therapy is the best solution! They are highly trained to bring symmetry back to maintain spinal alignment and normal muscle tone!
I think you meant to write you CAN'T "undo" surgery, right? Sorry to be a grammar Nazi. I'm an editor. But boy are you right. I made the terrible decision to have back surgery on l4, l5, s1 (partial discectomy) when I was 23 in 1998 and my life has been a series of unending pain since then. Shortly after the surgery I noticed my spine was curving away from the original source of the sciatic pain, that my sacrum and pelvis were twisting inadvertently, and that all sorts of other muscular and tendon pain were showing up in other parts of the body (shoulder, legs, face, bladder, etc.). Once your spine is messed with in this way all sorts of other things go by the wayside too. Of course I didn't always make the right choices in terms of dealing with this kind of pain and self-medicated with booze and other stuff for years. The spine and sacrum should be thought of as sacred, no pun intended. The ease with which unscrupulous surgeons convinced me I needed to be operated, and my subsequent distrust of them no doubt played a role in my questioning the Covid narrative, though. Perhaps I can be facetiously "grateful" to them for that. Thank you for this post. It is invaluable.
I heal my back with a combination of Chiropractry, Acupuncture, physical therapy, massage with lineaments and hot tub and the only medicines that I use are turmeric with ginger and Boswelia, Ice packs and heating pads.
Never trusted medical doctors with my spine. All the want to do is cut on you and drug you up. The spine needs adjustments just like the body needs bathing. It doesn’t last forever. So I get monthly adjustments. Been doing that since I was 9 years old. Im in my 50’s now. My Dad did the same and it never failed him.
I absolutely love all of your incredibly informative articles! This week, in particular, I couldn't help but wonder how in the world you are able to put out so many highly researched articles.
This one was great, but I noticed that there was only one or two sentences that mentioned "adjustment", but didn't mention that that's what chiropractors do. I'm amazed at how many people I know that have no idea what a chiropractor does or what an adjustment is.
I would always try the least invasive treatment first and then move on to other options if necessary. Not to mention that, as you articulated, pain meds usually won't fix the underlying cause of the pain.
Thank you so much for all of your hard work. You are helping so many people!
I will never forget when my Ivy League orthopedic surgeon found out I had read Dr.Sarno’s book (found on my own). He unironically said, “Well you won’t need to see me much anymore.” And he was right! He had studied under Sarno but continued to practice his profession without encouraging patients to read the works of Sarno. Through Sarno’s explanation and a shift in my perspective, I was able to overcome carpel tunnel syndrome. I agree with you that his suggestions for Freudian therapy are antiquated but his explanation of the pain dynamic in Type A personalities alone did it for me.
I’m happy to say that a orthopedic surgeon suggested that I try following the changes and exercises in “Treat Your Own Neck” by Robin McKenzie. That book kept me living my slightly risk-taking dare devil lifestyle without pain until I hurt my back. Fortunately, Robin had written “Treat Your Own Back” in the meantime. That book and a temporary back brace kept me off drugs once again. The Bible and the two books by Robin McKenzie have been the most important books in my life. They taught me there is a healthy solution to every problem we may face.
Twenty years ago it was suggested I should get back surgery for my bulging disc. Then I started taking pilates and yoga classes, I invested in a good tempurpedic mattress, and also started taking anti-inflammatory herbs and supplements. Back pain gone in 2 months.
This is relevant to my aching interests........
Very insightful. Having gone thru a herniated disc i changed many things that I found out caused it. My yoga practice was extremely helpful and so was the loss of 67 useless pounds.
Thank you so much.
Great article covering many drugs commonly used and no relief gained. I took Nabumatone for several years for severe scoliosis. Now I only take a Tylenol if extreme pain from yard work. My scoliosis causes painful muscle tightness and nothing helps. I use a massager for minimal help but just have learned to live with it. Walking seems to help since sitting too long aggregates it. This article was extremely informative. Thanks.
Thank you for this thorough post on spine pain. In my 26 year neurosurgery solo practice, the nonsurgical pain was the most challenging to help. It is humbling for a surgeon to know spine surgery can’t fix everything. Since discovering BEMER powered muscle stimulator, I am now able to share a modality which is able to support self healing and discomfort recovery. I wish I had known about BEMER before retiring from my career. Now, I am dedicated to sharing this technology which has improved quality of life for over a million users for the past 25 years. https://daria-schooler.bemergroup.com
I remember seeing Andrew Saul in a documentary film saying: "If you go to a Chinese restaurant looking for Italian food you are not going to find it. It is just not on the menu" So if you go to a surgeon there is only one thing on the menu. You have to be responsible for your own healthcare and get 2nd, 3rd and maybe even a 10th "second opinion".
I have seldom used any drugs to treat neck and back pain. Several times I have been unable to move very much with these troubles. But I have always had very good success using a chiropractor. I have never seen a regular doctor for this type of pain. I can't imagine ever doing so.
Honors graduate of NY Chiropractic College in 1987 and worked as a full-time clinician in a solo practice and did a one year stint in a MD/DC/PT/Acupuncture multicare facility as the lead physician. I had upwards of 300,000 clinical encounters during this time. It was clear in the multicare clinic that some chronics had better outcomes following the addition of active exercises to their spinal adjustments aka spinal manipulative therapy (SMT). This was verified in a well done study published in 2003 or so that was very clear that a regimen of SMT plus active exercises resulted in a synergistic effect of 1 plus 1 equals 3 with regard to improved function and pain using Oswestry scales. Nothing else came close to that combo. I’ve personally seen and experienced the benefits of massage, manual trigger point therapy, and acupuncture added along with stretching for muscle pain relief as having benefits. Without the restoration of normal spinal biomechainics to restore mobility, the muscular system addressed through the above additions, the neuro system will continue to fire abnormally causing pain and disability. Surgery is only in consideration for patients with severe, intractable pain not relieved by conservative care, progressive muscle, weakening due to cord, or spinal nerve compression, or cauda equina syndrome with the loss of bowel or bladder function. Medication use should be reserved for short term situations while the other treatment modalities I’ve mentioned are being utilized.