Not so sure about this article (see below) - there are holes in the logic... what do you all think?
My thoughts: So they suggest getting rid of MRI's and x-rays within the first 6 weeks of a patient experiencing back pain. Okay, I think that's ok as long as the dr. is smart about it and has reason to think that it's NOT a fracture or life-threatening.
Most of us wait more than 6 weeks before going to the dr. anyway. I know I waited 6 mo. after my accident and only went to my primary care dr. after trying months of PT - it was the PT that told me I should have someone look at my back.
But - I personally do not have a feeling that neurosurgeons or ortho's are surgery-happy! I was terribly reluctant to even see a neuro - I figured they are surgeons, of course the answer will be to have surgery. But, once I finally saw one, I found that he was NOT cut-happy. I had to have some serious problems (the CES) to be considered for surgery.
Maybe my surgeon just picked up on my reluctance to have surgery. But honestly, with all the denials and the waits and the 'lets do conservative treatments for at least 6 months' that I see here... well, I do not see this article's claim that unnecessary surgeries are as prevalent as they make it sound.
oh - and the ONLY do surgery if there is a fracture or tumor???!! What!! WHAT!!!???
Okay, so YES, I think surgery is a HUGE thing and that it is NOT to be done willy-nilly. You have to really really be in a bad position to go forward with it. I personally was willing to accept almost anything else (death, wheelchair, permanent disability) besides what I was currently living with.
I KNOW my surgery saved me. I did not have a fracture, not unless herniations are really fractures. I know that at the rate I was going the CES would have had me homebound, out of work and possibly suicidal.
It makes me really worry about the future.
Newsweek article / link at bottom of post
Smith's group is also considering nixing X-rays and MRIs for lower-back pain:
scans often spot something that is unrelated to the pain. About 80 percent of adults over 40 have a bulge or other deformation in their lower back that makes surgeons think "operate"—but no pain. So when such an "abnormality" shows up on a CT or MRI, attributing a patient's pain to it is probably nonsense. In fact, the vast majority of lower-back pain is caused by muscle sprains and strains that don't show up on scans, and for which surgery is no more effective (and is more dangerous) than over-the-counter pain meds, time, rest, and exercise. although lower-back pain typically resolves within six weeks,
many patients refuse to wait, and surgeons and radiologists have financial incentives to see that they don't. A 2009 study found that Americans spent $85.9 billion for imaging, surgery, drugs, and doctors' visits for lower-back pain—most of it for no benefit. "The use of MRI within six weeks of the start of lower-back pain is not only not useful, but it increases the number of surgeries, treatments, and costs," says anesthesiologist Ray Baker, president of the North American Spine Society, whose members do those very things.
Baker, who "applauds" Brody's call to arms, believes there are enough data to "draw a circle around" other procedures that are his members' bread and butter. For instance, at least 351,000 spinal fusions were performed in 2007, reports the Agency for Healthcare Research and Quality, at a cost of $26.2 billion. Yet except in the tiny fraction of cases in which the pain is caused by fracture or tumor,
they're useless—but financially irresistible, points out Shannon Brownlee in her 2007 book Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer. At $75,000 per spinal-fusion procedure, medical-device makers, hospitals, and surgeons have every reason to keep the gravy train rolling. "We doctors are extremely good at rationalizing," says Brody. "Somehow we manage to figure out how the very best care just happens to be the care that brings us the most money."http://www.newsweek.com/id/234514