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Personal Injury

6/11/2008
James R. Carroll, Jr., Esquire
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Here is an interesting Interactive Guide to Your Body from the New York times.

What caught my eye is the section on back pain. You can find it here. Probably the most common injury that we face in our personal injury and workers' compensation cases involve the spine. Therefore, I'm always reading articles and journals on the most updated treatments and studies on the spine and traumatic back spinal injuries in particular. The following passage really stood out for me.

The effectiveness of virtually every pharmaceutical or surgical remedy, however, has been questioned. And for all the money sufferers spend on doctor visits, hospital stays, procedures and drugs, backs are not improving. The Journal of the American Medical Association reported that spending on back treatments jumped 65 percent to nearly $86 billion from 1997 to 2005, after adjusting for inflation. But during the same period, the proportion of people with reduced function because of spine problems increased, even after controlling for an aging population.

The exact cause of back pain is never found in 85 percent of patients, said Dr. Dennis C. Turk, professor of anesthesiology and pain research at the University of Washington and a past president of the American Pain Society. Even magnetic resonance imaging seldom sheds light; in many studies the scans have picked up spinal abnormalities in many people who have never reported back pain.

While the quest for a safe and effective pain pill continues, Americans undergo more than 300,000 spinal fusion surgeries a year, at an average cost of $59,000 each, according to the National Center for Health Statistics. Almost as many undergo laminectomies or diskectomies to remove damaged vertebrae and disks.

For some, back surgery can be life-changing, eliminating pain and disability. But for others, it can have serious consequences. One study found that 11.6 percent of patients in the 78 spinal surgeries that were analyzed developed infections and other complications.

Here's an article from the National Institute of Health on alternative remedies for low back pain (LBP).

Here's an article from Back.com demonstrating, with pictures, exercises and stretching maneuvers that will help with back pain as well as prevent it.

Last, here's an article from a orthopedic surgeon answering questions about his own experience with back pain and how he's dealt with it over the years without surgery. The following caught my eye from the interview:

Q. What kind of patients find their way to a specialist like you?

A. Usually they're at the end of a long road. They may have gone to their local primary care doctor, a physical therapist, another surgeon, various specialists. They may have had surgery, and it hasn't worked. We, the health care system, make it complicated. When your back hurts, it's bad. It can take your breath away and make you totally immobile, and it's scary. In many cases, these are people who've been so taken aback by it. They are seriously looking for help, and they don't want to experience the pain again. And that's understandable, having had the problem myself.

Usually, 95 to 98 percent of the time, it will get better by itself without any intervention. But that's not the American way. We've built an incredible medical structure. People think, "I shouldn't have to suffer for one day -- there must be a pill or surgery that can help me." I agree with how they feel, but certainly there's over a 90 percent chance most people will get better with no intervention. That's an important message. People will say, "Well, what am I supposed to do when I can't walk or go to work?" Well, having surgery is going to keep you out of work. For the common cold, do you expect to see a doctor every time or expect surgery to make you better? Most people know it will take a week to 10 days to feel better.

Why don't we have that same approach to backaches? Stay active. Take aspirin or other over-the-counter drugs.

I try to tell my clients that spine surgery should be the last option. I would say about half of my clients have truly successful outcome from spine surgery. Another quarter have a good outcome but still suffer symptoms. The last quarter have no change in their symptoms or become worse.

Labels: back injury fusion surgery spine injury work injury workers' compensation

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