COMPARING SPINAL DECOMPRESSION TO OTHER TREATMENT OPTIONS

Last month’s blog ended on a cliffhanger, stating that many patients living with chronic pain have tried every solution and it doesn’t resolve the issue. In this month’s blog, we are going to discuss the vicious cycle that patients go through before finding the best solution…spinal decompression.

The Vicious Cycle

The vicious cycle is explained to patients in the newsletter that we hand to decompression candidates at the conclusion of their first visit. If you would like a copy of the newsletter or know someone who you think would benefit from spinal decompression, let us know and we would be happy to provide one. 

The vicious cycle begins when patients begin experiencing pain. From there, patients make the conscientious decision to treat their pain medically or holistically. Those who take the holistic approach may choose treatments such as physical therapy, massage therapy, chiropractic or acupuncture. However, more than half of people will choose the medical route and look for medications, injections or surgery. 

When patients choose the medical approach, the vicious cycle continues its devilish pattern. Once the pain begins, patients refer to their primary care physician. The PCP then determines the pain level of severity and selects the best treatment. Usually, they start with medication, then steroid injections. If the pain doesn’t resolve, the next step involves meeting with a physical therapist for 4-6 weeks of vigorous treatments. 

When that doesn’t work, an orthopedist gets involved and will take diagnostic images using x-rays, MRI and/or CT scans. Once orthopedic testing is performed and diagnostic imaging is complete, the doctor determines if the patient needs minimally invasive treatment or more. Usually, orthopedists try minimally invasive treatment first and prescribe more medication, physical therapy and another dose of steroid injections. 

After some time when pain doesn’t subside, the orthopedist then recommends surgery. At this point, the patient must decide if surgery is the solution, or if the holistic approach is worth considering. This is approximately a 50/50 split decision. About 50% of individuals will choose the surgical route in hopes that they will be in immediate relief, but the other 50% recognizes that they have lived in pain a long time. What’s a little bit longer with a less invasive possible solution?

Those who choose the surgical route will undergo their procedure and the recovery process. Once the recovery process is complete, some patients feel better while others feel no different. Those who feel better may have two end results. They either never experience their pre-surgery pain again or the pain steadily returns over time. A little later, we will share some statistics on post-surgical results.

Those who feel no different go through more rounds of pain medication and steroid injections. At this point, most patients realize that they may have made a mistake going the surgical route; however, some patients still believe it is the right road to their solution. This patient usually goes through repeat surgeries, takes endless pain medication, experiences steroid injections every few months and makes regular visits to a pain management clinic.

That really is a vicious cycle. Pain management is the closing end to the circle. Once patients reach pain management, treating them with holistic care is recommended; however, results may be minimal due to the amount of scar tissue accumulated during multiple surgeries. Those patients who choose the holistic approach over surgery have a much greater chance of pain resolution.

Medical Approach Treatments

Over the next few paragraphs, we are going to identify the different medical and holistic treatments used for pain and give a brief description on their end result.

Pain Medication

When uneducated about natural health and modern medicine, individuals will resort to medicine to help with pain and illness. It usually starts with over-the-counter medicine such as Tylenol, Ibuprofen or Advil. When that doesn’t work, they go to their PCP for heavier prescription drugs. As patients try and fail with these next level medications, they are prescribed more intense medications such as opioid drugs (painkillers). 

Whether it’s over-the-counter medicine or painkillers, they all do the same thing and have the same result. Medicine only numbs the problem and doesn’t resolve the problem. Back/neck pain with or without radicular symptoms is often the result of nerve interference or discogenic causes. Medicine won’t correct the misalignments in the spine or reduce the nerve pressure caused by a herniated disc. Over time, the body becomes tolerant to drug use and the next step would be heavier drug use creating future problems with our nationwide opioid crisis.

Steroid Injections

Steroid injections are a medical procedure that involves injecting a corticosteroid directly into a specific area of the body to help reduce inflammation and provide relief from pain and swelling. Typically, these injections are inserted into areas of inflammation around joints, muscles, tendons, and ligaments.  

Just like anti-inflammatory drugs and opioids, there is no guarantee that the injections will work. When patients ask our opinion about steroid injections and their effectiveness, we give them three different possible answers.

1. You may get better.
2. You may feel no change.
3. You may feel worse.

Even if an injection relieves the pain, the chance that the pain will return when the injection wears off is likely. Injections aren’t necessarily the best course of action because they don’t fix the problem. Another downside is that injections can’t be performed more than four times a year because they will begin to breakdown and destroy cartilage.

Surgery is another medical approach treatment, but we will talk about this one later because we would like to spend more time on this treatment. Let’s briefly dive into holistic treatments approaches.

Holistic Approach Treatments

Holistic treatments include physical therapy, massage therapy, acupuncture and chiropractic.

Physical Therapy

Physical therapists have many goals for patients to achieve including pain reduction, increased range of motion and flexibility, increased strength and blood flow and improved quality of life. They achieve these goals by putting patients on a vigorous program 2-4 times a week that involves intense muscle strengthening exercises, balance and coordination movements and stretching techniques. These treatments are to be performed both on and off site.

Like chiropractors, physical therapists cannot prescribe medication to their patients. The issues that we hear from patient experiences with their physical therapist is that they give patients very difficult exercises to perform at home that may cause more strain to the muscles and stress to the joint spaces. Physical therapy can help with muscle and soft tissue injury, but nerve interference is not typically on a PT’s table of treatments. Decompression candidates who undergo physical therapy have poor outcomes.

Massage Therapy

Massage therapy is a holistic treatment used to reduce tension within soft tissue structures such as muscles and joints. Massage can be performed by a massage therapist using their hands, or by someone using an instrument. Massage has many benefits including:

• Eleviates muscle tension.
• Improves circulation.
• Stimulates the lymphatic system.
• Reduces stress hormones.
• Induces relaxation.
• Increases joint mobility and flexibility.
• Boosts skin tone.
• Facilitates soft tissue injury recovery.
• Heightens mental alertness.
• Relieves stress.
• Reduces anxiety and depression.

Massage therapy can be a relaxing form of treatment, but results with discogenic pain are poor. Just like physical therapy, massage may only be temporary for decompression candidates.

Acupuncture

Acupuncture is a traditional Chinese medicine that involves placing thin needles into the skin on certain points of a meridian. These needles are then activated by the provider’s hands or through electrical stimulation. Acupuncture points are believed to stimulate the central nervous system. This releases chemicals into the muscles, spinal cord, and brain. These biochemical changes may stimulate the body’s natural healing abilities. They may promote physical and emotional well-being.

Although acupuncture helps with hundreds of medical conditions from different body systems, decompression candidates have seen little to no pain improvement.

Chiropractic

At this point, we have shared a lot of information on chiropractic care in its benefits. Therefore, we are not going to discuss chiropractic, but what we will share is that decompression candidates only get temporary relief from chiropractic care alone.

Spinal Decompression VS Spinal Surgery

Surgery should always be a last case scenario, but patients still choose to undergo it without knowing that spinal decompression is the answer all along. There are several different types of spinal surgeries to treat pain, but the three most common are spinal fusion, laminectomy, and discectomy. Below is a description of each.

1. Spinal Fusion

Spinal fusion involves removing the spinal disc between two or more vertebrae and then fusing the adjacent vertebrae using bone grafts or metal devices secured by screws. A spinal fusion results in a restricted range of motion and flexibility. Once a fusion is performed, the surgery is permanent and cannot be reversed.

The purpose of a spinal fusion is to eliminate motion between vertebrae. It also prevents the stretching of nerves and surrounding ligaments and muscles. It is an option when motion is the source of pain. This is commonly seen in patients with arthritis or degenerative disc disease. 

The downside of a spinal fusion is that it doesn’t seem to be very effective with pain management or reduction in degenerative vertebrae. Pain from arthritic changes continues to be problematic after surgery.

2. Laminectomy

The lamina is an arch-like feature on the back side of the vertebrae that attaches to the bony prominence, the spinal process, which are the little bumps that we can feel down the central region of the back. A laminectomy involves removing these arch supports and spinous processes from a vertebra to help create more space for an injured disk.  

The downside of a laminectomy is that it doesn’t fix the bulging or herniated disc. A laminectomy makes the space wider for a damaged disk to grow larger. Eventually, the disc has the potential to outgrow the space, and previous symptoms return.

A laminectomy is trouble waiting to happen because now, the disc and symptoms are worse than pre-surgery. The likelihood of pain returning after a laminectomy procedure is greater than successful treatment.

3. Discectomy

A discectomy is the most common type of spinal surgery performed in the United States. A discectomy involves removing the injured part of a spinal disc. The entire disc is not removed like during a spinal fusion.

The downside of a discectomy is that a repaired disk can be reinjured, due to repetitive motion, trauma, obesity, or aging factors. A laminectomy and discectomy are usually done together, but not always. If a disc is reinjured, the surgeon may suggest a spinal fusion. 

Spinal surgery comes with several complications and risks including lengthy recovery, infection, blood clots, nerve damage and paralysis. Also, surgery has only a 20% success rate, compared to spinal decompression’s 93% success rate. In addition, surgery has an 80% likelihood of a second surgery compared to spinal decompression’s 2%.

Along with all the negative outcomes for spinal surgery, the cost even with insurance is outrageous. People think that insurance picks up all medical expenses, and in rare cases, it might, but your insurance has to be incredible to cover everything. Spinal decompression is an investment in health, because it’s not nearly as costly as surgery and evidence shows that the results are so much better.

The Wrap Up

Now you can see why we split spinal decompression into a few different blogs. There is too much important information that needs to be shared.

Spinal decompression is a one-of-a-kind rare service that we offer in our office that many chiropractors do not, making us a leading disc specialist in the area. Over the past several months, we hope that you learned something useful. We are happy to answer any questions you may have regarding spinal decompression, whether for yourself of someone you know.

Overall, there are three take aways we want you to have from our spinal decompression series. First, find a doctor who correctly advertises spinal decompression and not spinal traction. Second, surgery isn’t always the answer. Third, know that your health and quality of life are the best investments you can make. 

In next month’s blog, we will begin to discuss our neuropathy management program. If you have any questions about spinal decompression or any of our treatment programs, please call us at (724) 547-3377 and check out our website at www.laurelmountainchiro.com for more content.

Yours In Health,

Brian M. Steinert, DC