Currently viewing the category: "MRI"

Got MRI? Get Surgery

By On · Add Comment · In chiropractic, chiropractors, disc herniation, low back pain, MRI, surgery

Listen up: Get an MRI, get a surgery–that’s the way it works. According to a new study published in the journal Health Affairs, researchers found that the greater the accessibility to MRI machines, the more likely a low back pain sufferer would receive one. And here’s the kicker: Those people getting MRIs were more likely to be recommended and receive low back surgery. Nice.

For the layman, let it be known that low back surgeries are notorious for not doing diddly squat. That’s right, they are useless in a large number of low back pain cases. As I point out in my book, The Six Keys to Optimal Health, low back surgeries are one of the two most unnecessary surgical procedures prescribed today (the other one is hysterectomies). You should also know that MRIs are waaaay overused by medicos. MRIs are not definitive: plenty of asymptomatic people (no pain) have disc bulges showing on MRI, while plenty of people with low back pain (symptomatic) have normal MRIs. What can we conclude? Bulges are not the end-all-be-all of low back pain causes; or in other words, that $5000 (I’m probably under-estimating here) scan your ortho is sending you for might be rather useless within the big picture.

I don’t think this is merely a money game, not at all. What I really think this is a case of is modern medicine’s having a severely limited arsenal when it comes to treating low back pain. When it come to the lumbago, your medical options are:

  • the drug triad: pain killers, anti-inflammatories, and muscle relaxants.
  • physical therapy
  • low back surgery

The biggest problem in this whole mess is not the exhorbitant cost of this most-prdominant treatment protocol (these are the treatment options of choice for the majority of Americans), but instead how it’s crippling people. I speak from experience as my father has had two failed low back surgeries. I say failed because, after two times under the knife, guess what he still has? You’ve got it–low back pain! Oh he can walk alright, but we paid for that–you and me, suckers–because it also put him on early retirement and permanent disability. The surgeries…not the low back pain…just want to make that clear.

Notice you don’t see chiropractic referrals on that list of treatment options. That’s right, because god-forbid you should take that MRI $5000 and put it toward something useful. No, no, harumpfff, never. Good word, son…chiropractors hurt people. We’re better off maiming the poor bloke, wouldn’t you say? Keep it all in the family, you know.

Yes, we know.

Unnecessary Knee Surgeries

By On · Add Comment · In arthritis, arthroscopic, chiropractors, knee, MRI, orthopedic, pain, rehabilitation, surgery

Did you know that arthroscopic knee surgery is one of the most common operations carried out in the U.S. today? Now why do you suppose that? How about it’s quick, it’s easy and–cha-ching!–it pays. Well, the latest reports show that arthroscopic surgery for arthritis of the knee is no better than rehabilitation and medication. Hmm…can’t say I’m surprised by that.

Timing is impeccable as I’ve just written an article on the same subject, but the details are this: When it comes to relieving the pain and stiffness of moderate to severe knee arthritis, surgery is no better than physical therapy and medication. Further, that holy grail of orthopedic diagnostics–the MRI–is not the end all, be all when it comes to predicting surgical necessity. What this means–and something we know quite well in chiropractic–is that many MRIs show tears (and disc bulges) in non-symptomatic people while many with symptoms have no tears (or bulges) at all. What does this mean on a practical level? MRI results may be over-predicting the necessity of what are now routine orthopedic surgeries. And we now have the studies to prove it.

As musculoskeletal clinicians, chiropractors know quite well of this misdiagnostic and mismanagement practice. Practically every patient of mine who has walked into an orthopedists office with knee pain has been recommended a knee surgery, despite the fact that they were prime candidates for conservative rehabilitative care. The same is true for the low back pain patient with radiating pain into the leg. Many things cause radiation, but walk into an orthopods office and expect a surgical recommendation. Damn shame, considering many people still take the M.D.’s word as law. Guess what people? Arthroscopic knee surgery was a low risk money maker for your doctor. Cha-ching.

Here’s the bottom line: If you are having knee pain, stiffness and other symptoms, read this article before you make a treatment decision. It could save you an unnecessary trip to the surgeon. Many knee problems can be fixed through conservative rehabilitative care. You’ve got nothing to lose, and the surgery will always be there if you need it later.

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