For Back Pain Sufferers, Surgery Isn’t Always The Answer

Back pain sufferers can wind up desperate for relief. But just because a treatment is new, expensive or elaborate doesn’t mean it will actually make you feel better.

By Amber Dance
The Los Angeles Times

January 9, 2009

An aching back — a dull twinge or a stabbing pain, lasting days or years — is a source of annoyance, misery or even disability for millions of sufferers.

Eighty percent of the population will experience back pain at some point in their lives, and while the majority of cases resolve quickly, 30% recur, according to the North American Spine Society, an association of spinal health professionals based in Burr Ridge, Ill.

Those aching backs, in turn, cost Americans more than $80 billion in healthcare costs, time off from work and other expenses, the spine society says. There is evidence that the suffering is rising slightly — perhaps because people spend more time hunched over computer keyboards. A 2008 study, published in the Journal of the American Medical Assn., found that the percentage of U.S. adults seeking medical help for spine problems rose from 12% in 2000 to 15% in 2005.

Rising significantly, meanwhile, are expensive treatments and surgeries that may not help patients much. The same study found that patients are spending more money on back pain treatment — an average of $6,096 per patient in 2005, up from $4,695 in 1997 — without seeing corresponding improvements in how they feel.

The research implies that expensive treatments with glossy advertising may not be as good as they sound, says study author Brook Martin, a health services researcher at the University of Washington in Seattle.

Surgery rates, in particular, are going up. More professionals now argue that doctors need to think more before they resort to the knife. They note that the U.S. has, by far, the highest frequency of back surgeries among developed nations: There are approximately 1.2 million spinal surgeries in the U.S. each year, double the rate in those other countries. Yet there is no evidence that Americans have a higher rate of back pain or injury.

“I don’t think you want to take the surgical option lightly,” says Dr. Gunnar Andersson, an orthopedic surgeon at the Rush University Medical Center in Chicago.

For the lucky ones who benefit from surgery, it’s certainly worth the risk and costs, he says. Others may not get the results they anticipate. More…