I have been told I have a slipped disc in my lower back. My doctor says I need surgery. I am 44 year old and have mild to moderate pain but can work. Should I go for it?

Prolapsed discs are very common in our society; at least 5% of the population has prolapsed disc but not all of these people have symptoms. In some cases , prolapsed disc may cause pain which runs down the buttocks. In the majority of cases, this pain will settle down with non-surgical treatments. Surgery is only recommended in people who are in a hurry to recover and do not want to be bothered with exercise and/or a weight loss program. However, you should know that the results of surgery are not great. The majority of patients turn out to be worse. My advice is that you should exercise, lose weight and keep away from back surgeons- unless you want a life of intense pain and remain disabled for the rest of your life.

I was recently referred to a chiropractor who suggested that I undergo spinal manipulation to get rid of my low back pain? Do these therapies work?

Low back pain is a big money maker and thus, many health care professionals have opened up back and pain clinics all over the country. Now the chiropractors have come up with their own treatments because they can’t not prescribe medications. Chiropractors offer spinal manipulations for treat almost every medical disorder under the sun. Cochrane reviews has looked at many of these therapies and found that spinal manipulations is no better than physical therapy, medication or exercise. Moreover, chiropractic spinal manipulations have to be undertaken for many weeks and each session can cost anywhere from $75-$200. Best advice- start your own exercise program, swim, walk, lose weight and stop smoking. This is still the cheapest, safest and most effective way to treat back pain- no gimmicks and no scams.

My surgeon says I should try out chemonucleolysis for my lower back pain. Should i go for it?

Run, away from this bum of a surgeon. Chemonucleolysis has never been proven to be an effective therapy for prolapsed disc It is a waste of money, can cause more problems and the surgeon can even mess up your back. After chemonucleolysis, the majority of people have recurrence of back pain within weeks. The procedure has only one benefit- it only enriches surgeons and is at best considered to be bogus treatment. So far there are no solid data that the treatment works. In fact, the treatment is so bad that it is not even performed today. So if your surgeon is still doing it, he/she must be full of S..T.

I have had low back pain for many years. Recently my doctor told me I had Foraminal Stenosis. Can you tell me exactly what that is?

There are some people who do not have spinal stenosis but have foraminal stenosis. This is a condition, which may affect more than one vertebra. Normally nerves in the spinal cord exit along the gaps in-between the vertebrae called foramen (openings). Sometimes this foramen can become narrow and impinge on the nerve. Aging and arthritis are two most common causes of foraminal stenosis. The symptoms of foraminal stenosis are similar to spinal stenosis. However, not all foraminal stenosis requires surgery. When the stenosis is ignored, some individuals can develop wasting of muscle and weakness- in such cases surgery is required.

When surgery is performed to enlarge the opening in the foramen, it is called a Foraminotomy. Foraminotomy is often combined with laminectomy to provide the maximal benefit. If you have no symptoms or mild symptoms, surgery is best avoided. Surgeons can make a bigger mess of your back.

My doctor says I should use heat treatment for my low back pain. Is this useful?

There is some evidence that heat therapy may help reduce low back pain and disability. However, this is true  only in people who have back pain that is of less than 3 months in duration. Moreover, the heat packs only causes a mild reduction in pain that is only of a short duration. For people who have back pain for more than 3 months, both heat and ice are a waste of money.

The type of heat therapies that one can use include hot water bottles, soft heat packs, hot towels, saunas, steam, heat wraps, electrical heating pads and infra red lamps.

I have had back pain for many years and would like to try out spinal manipulation therapy. Does it have any benefits?

Low back pain is a very common and disabling disorder. There are hundreds of treatments for back pain but none is ideal. Over the past few years, many doctors and alternative health care workers have been offering spinal manipulation therapies or “hands-on treatments” for the spine. This basically consists of manipulation and mobilization of the back joints. The manipulations are carried in certain directions and the often the joints are “cracked.”  These treatments are undertaken for many weeks and months and are quite expensive. By the end of 3-6 months, you will most likely have spent anywhere from $3,000-$8,000 for the treatments. So does the therapy work?

Analysis of data done by Cochrane reviews revealed that spinal manipulation therapy was no better than physical therapy or regular exercise. So what does this mean to the consumer?

If you have money to spend, then perhaps you may want to start with a physical therapy program. If you have no money, then you can obtain the same benefit by doing exercise at home or at the gym. The type of exercises to help increase muscle strength and mobility can be obtained from cyberspace for free.  If you do not have internet, swimming and walking will do the trick.

Does traction therapy help relieve back pain? My doctor says I should try it out. What do you think?

All over the country, back doctors are offering traction therapy for low back pain. The concept is simple. You sit or stand and a device gently pulls on either end of your body. This will supposedly relieve the pressure on the joint and you will be free of back pain. Like the plastic surgeons, the therapy involves multiple sessions for many weeks or months. Each session can cost anywhere from $175-$300 and on average one needs 20-30 sessions.  Low back pain is a major health problem and accounts for large number of people being absent from work, being disabled and depressed. So far, no one therapy seems to work for all people with back pain and now we have traction.

Evaluation of current literature indicates that traction is just another scam. It does not work; it provides little or no pain relief and does not reverse your disability. The only people who benefit from traction therapy are the people who sell it- these health care providers are the ones who drive the fancy cars with your hard-earned money. There is not a single well-controlled randomized study that shows that traction is effective for low back pain. Of course, there are some bogus studies from the Orient or those published by the manufacturers, but the results are fraudulent. 

If you have back pain and do not want to end up more depressed than what you already are, avoid traction. At least you have money for food now; after traction therapy not only will you still have back pain but you will also go hungry.