Most Americans deal with some form of back pain nearly every day of their adult lives, with 80 percent of the population experiencing a completely disabling episode of pain every three to five years.
Back pain is the most common reason patients visit their doctors, and it's also the single biggest economic strain on our health care system today.
While most cases of back pain are quick to resolve on their own and the rest can usually be managed conservatively with physical therapy, chiropractic and medication modalities, a significant percentage of patients will require surgery to have any chance at leading a pain-free life.
For decades, however, spinal surgery has been shrouded with misconceptions and stigmas that have made it somewhat of a black sheep in our society.
Much of the apprehension toward back surgery originates from a small number of cases that failed to have a good outcome. As the saying goes, bad news travels fast — especially in health care.
Informing yourself of the risks and benefits of any procedure is, at the very least, prudent. So here are some facts about various lumbar decompressive surgeries that every patient should know before going into the operating room:
You'll likely be better than before. Many patients assume that once you touch the back with a knife it's never the same — and they're right. Surgery often alleviates mechanical compression and the symptoms you were experiencing. Bad outcomes are rare, so rest easy —most people are very satisfied at the three-month mark.
Recovery is long and enduring. Post-operative recovery varies broadly among patients, but you can bet it will be at least two months before you're fully functional. Many preoperative symptoms will be gone, but it'll take some time before you feel like you're your old self.
Not having surgery may not be an option. Most back surgery is elective, but scores of cases are considered medical emergencies. Severe nerve root compression or deformities of the spine must be corrected as soon as possible or those patients could be risking a catastrophic loss of function. Disc herniations and spinal stenosis are examples of disorders that if left untreated, could result in permanent sciatica or the inability to walk more than a few minutes at a time.
Operating on the lumbar spine shouldn't affect your neck. Some patients believe that if you alter one part of the spine, you'll change the whole thing because it's all connected. While the spine is a delicate, balanced structure, cervical procedures rarely impact the low back and vice versa. And conversely, don't expect a neck surgery to cure pain in your low back. Each area tends to give region specific pain only. So, for better or worse, the ramifications of surgery generally don't extend outside of the immediate area.
It's common to have post-operative pain. In fact, many patients wake up with more pain than prior to surgery. During the procedure, nerves and ligaments need to be mobilized, bones shaved down, muscles cut and retracted and skin sewn together.
That's quite a bit of trauma if you think about it. Give it a few weeks before you start to make a judgment about the pain you're in.
Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes "On the Mend" weekly. Questions may be submitted to Joe by email at joedivincenzo@comcast.net.
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