Just Say No
It happened again last week. A young man in another state leaned over and twisted to lift something. He felt a snap and sudden pain in his back. He fell to the floor unable to move for about three hours until someone checked on him.
He went to a walk-in clinic. As they were unable to do musculoskeletal diagnosis, they sent him inappropriately for an urgent MRI, hoping the radiologist could do the diagnosing. The MRI did show to disc bulges. Immediately, he was referred to a neurosurgeon for unnecessary surgery. His mother and my wife have been acquainted since college. She called me in some desperation to see what to do. I was appalled that someone would commit medical malpractice by sending someone directly to a surgeon without even considering conservative care. She brought him from a neighboring state for evaluation. Upon exam, it was apparent that the disc bulges were completely clinically silent: we could not even elicit leg pain related to those bulges in the lumbar spine. The fact is that many of us, perhaps most of us, have asymptomatic disc bulges. What he did have was a fracture of his L5 vertebra. It was not the kind of fracture that requires surgery, but the kind that responds well to conservative care. It causes pain, pain is not a reason to debilitate someone with unnecessary surgery.
This article shows another frequent "go-to" strategy for people who have musculoskeletal pain. The opiate crisis has been fueled by prescription medications. If you have an acute injury involving joints, ligaments, muscles, or tendons, find a conservative practitioner that you trust as a first resort. Very few back injuries require surgery. Opiates will not address the problem, but can cover it and create new ones. If someone encourages you toward immediate surgery or toward opiates, as Mrs. Reagan used to say, "Just say no." You have heard me talk are seen me right about our new Academy of Georgia Chiropractors. We are a multidisciplinary group of chiropractors, orthopedists, neurosurgeons, and physiatrists. A common thread among us is that we are a network of research driven, evidence-based practitioners. The story above is one of the reasons we created the group.