Marc Heller, DC

Marc Heller, DC

Yesterday, one of my patients, who has similar challenges to the ones I face with my back, asked me to write a blog about my own back pain issues.  I thought, really.

I obsessed about my friend who recently died 5 years after a failed back surgery. One of my back surgeon friends has said, “The only thing worse than a bad back is a bad back after a botched surgery.”

I don’t think my friend who died really had a botched surgery. I do think that he and his surgeon had not explored all of the non invasive and less invasive options, and that he happened to have an unusually severe inflammatory reaction to his surgery, which led him into a vicious cycle leading to 5 years of severe nerve pain. He had a whole series of health problems further complicated by severe chronic pain that led to an early death.

I know this is a bit dark but it does have an underlying purpose. Maybe someone who reads this will put off the magic bullet of surgery, and commit him or herself to attempting to get well the hard way.

In our culture we want quick fixes. We want to take a pill, and make the pain go away. We want someone to cut out the pain, and let us get on with our lives. We want our doctor to be a home run hitter.

But life is messy. Unintended consequences are always around the corner. A less invasive option, epidural steroid injections which often do a marvelous job of helping break the pain cycle especially for sciatica, has begun to be questioned. Women who get these injections have long term increased risk of osteoporosis and spinal compression fracture. Steroids are not innocuous or safe.

I recently had a flare up of my lower back pain. It was not mild; my pain levels were about an 8 for the first few days. My magic bullet is taking oral steroids, half of a Medrol dose pack for 4 days or so. But I had just taken a set of these two months ago. I know if I do it too often I put myself at risk for diabetes and other long-term chronic illnesses. The steroids solve the problem in 3 days. If I wait, and live with my pain, and take a few days of ibuprofen, and religiously do my exercises, the problem will usually resolve within 2 weeks. I telemark skied Mt Bachelor yesterday 3 weeks after my flare up. Yay!!

I am not saying that back surgery is not useful. It can be amazing. I am saying weigh risks and benefits. In a vast majority of cases, one should wholeheartedly do the less invasive route first, and realistically assess your own responses. Go to the chiropractor, PT, acupuncturist and bodyworker, do the exercises, eat an anti-inflammatory diet. The goal is to make the pain no longer the center of your life. If you can move the pain out to the edge you have won.