Am I smarter than a spine surgeon?


Whenever I run across episodes of Are Your Smarter Than a Fifth Grader on television, I have to stop my channel surfing and watch a question or two. While many of the answers are obvious, I’m always amazed at how wrong I can be about something that I think I know. Certainly I learned this information years ago! But now only a remnant remains, and sometimes that misleads me.

The official answers on back pain?

I was thinking about this as I was reading in the New York Times health archive about back surgery. They have an interesting article with a prominent spine surgeon who is also editor of America’s most respected research journal on back care.

Essentially it’s a Q&A, where you get the answers to all your need-to-know answers about back pain. And what’s interesting about it, is the story’s hook: it talks about the doctor’s own experience of debilitating back pain. (Even spinal surgeons get back pain too, just so you know!)

Like I just found a re-run of Are You Smarter Than a Fifth Grader, I immediately wanted to know: do my own answers line up with this famous spine surgeon? And what do his answers versus my answers tell us about the different paradigms in health care.

The doctor on the cause of spine pain:

Probably the most common causes of back pain are just — what’s the best word? — life’s events. People often go through life doing just what they normally do, and one-third of them on any given day will experience back pain.

What do I think? I think the human spine was made for dynamic motion, often to extreme limits. I’m amazed how much activity seems not to cause one person pain, and how little activity seems to cause so many problems in others. With the exception of direct injury to the spine, I don’t think “life events” are the cause of spine pain. You could call them “concussive forces.” I think life events uncover an imbalance in the spinal system that results in pain. Part of this imbalance may be de-conditioning. But a major factor is nervous system interference to the muscles that control the tone of the spinal musculature.

The pain isn’t necessarily a problem in of itself. It’s a warning that either we are stressing our body beyond its limits, or that there is another problem present.

The doctor on the use of pain killers for back pain:

I think we are an over medicated society, and I would not recommend narcotics for everyday back pain except for in most rare of circumstances. Some people think antidepressants, the S.S.R.I.’s, can be helpful for treating pain. Long-term opioid therapy for some has been recommended, but the drugs can also affect your mood and cause depression, so we don’t know that opioids improve function.

What do I think? I’m not in the business of prescribing drugs, so I cannot speak to what the doctor says clinically. But I find it promising that he recognizes that we are an over medicated society. It’s good to hear that a surgeon recognizes that drugs can affect mood, which is a phenomenon that many people don’t consider as they go about swallowing all their medications. I’m always a fan of a doctor who is not in a rush to recommend a drug.

The doctor on how spine pain resolves:

Usually, 95 to 98 percent of the time, it will get better by itself without any intervention. But that’s not the American way. We’ve built an incredible medical structure. People think, “I shouldn’t have to suffer for one day — there must be a pill or surgery that can help me.” I agree with how they feel, but certainly there’s over a 90 percent chance most people will get better with no intervention.

What do I think? I think the better question is not how the pain goes away, but how is the underlying problem resolved. Yes, pain will go away. But not necessarily because the mechanics of the body improve.  Sometimes our nervous system just learns to ignore the pain when we have the will to ignore it. Other times injured tissues heal over time (even in a stressed environment), while leaving a weakness in the area and a memory in the nervous system that makes the system more likely to experience pain in the future.

This is even seen in the experience of our surgeon, who says that his acute case of back pain resolved on its own, but that he still has episodes:

I spent a week that way, and I did get over it. I’ve had several recurrences, and it always takes five to seven days to get over it, no matter what I do. I think I have some aging of the joints and discs in my back, and I think when I just move a certain way it causes the muscles to go into spasm.

That doesn’t sound like complete healing to me. And if you’re curious enough to go see the picture of this physician, you’ll see that his whole spine is tilted off to his left. Perhaps a friend or family member will recommend a visit to an upper cervical doctor to help his nervous system balance out his spine a bit better?

So, what do you think? Am I smarter than a spine surgeon?

Or is it just the case of two different and necessary ways of looking at health problems, coming to different conclusions to the same information? Leave your comments below.

Written by Dr. Ward

Father. Foodie. And dedicated upper cervical chiropractor. Find me practicing gentle upper cervical care in Oakland County, Michigan. Have a question or comment? I'm at your service. Reach me at my Auburn Hills chiropractic practice: (248) 598-4002. Or on Google +, Facebook, or Twitter.

One Response to Am I smarter than a spine surgeon?
  1. […] Finally, not to get all John Madden with my pen, but when I look at Peyton Manning’s posture from the front I see real evidence that the underlying cause of his problem hasn’t been fixed. He has not exhausted natural options first. His neck is drifting off to the right. His head is tipping to the right. In my work we would call that a huge a lower angle with significant head tilt. Those lines are there to help you visualize what I see and how I look at the spine. […]