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canstockphoto10599353I am chiropractor.  But not just any chiropractor.  A primary spine care physician.  The difference is more than semantics.  Balance plays a key role in the latter.  Most back pain can be effectively treated early on with conservative care, chiropractic care representing one option. However, there are cases when surgery is the best option.  A good doctor can help you decide.  As a primary spine care physician, my goal is to get you the best treatment for back pain as quickly as possible and steer you in the direction that helps you achieve your goals.  That said, I came across some good information that addresses the very question that people want to know.

Back pain is engulfed by so much bad publicity that heightens the fear associated with back injury. Think of Public Enemy, “Don’t Believe the Hype.”  I like general rules because they help clear the air. Generally speaking, most back pain is self limiting.  This means it will resolve on its own without any intervention.  When it does NOT resolve after three days or at most a week, a professional opinion is a good idea.

Red flags rule out potentially serious causes of back pain–masqueraders–that need immediate medical attention and NOT conservative care. Some of these include bladder or bowel loss, rapid onset of muscle loss or weakness, complete losses of sensation, infection, cancer, aneurysms, fractures.  Pain alone is not a factor but intense, intransigent pain non-responsive to short term interventions should raise suspicions.  Next, identifying the pain generating structure will help guide treatment decisions.  When symptoms arise from gross instability or a well defined anatomical structure surgery has a higher likelihood of success. Remember though, that in terms of surgery, success is relative.

General health factors the most common of which include diabetes, hypertension and vascular disease also play key roles in surgical success. Additionally,  research shows that high psych factors are poorly associated with positive outcomes for any type of intervention but more so for surgery. Psychological factors play a pivotal role in treatment success because they significantly increase the pain experience, confound the clinical picture and distract from the anatomical pain generators that surgery hopes to correct.

These links provide an excellent review of the conversation surgery vs conservative care for back pain and chiropractors role in the medical model.

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