Ernie presented to me a few years ago with severe back and leg pain. He had undergone two spine fusions for LBP about 10 years earlier that had not been helpful. His three lowest vertebra had been fused from L4 to the sacrum. Additionally, he now had severe leg pain … Read More
Mike is a local physical therapist who is a friend of mine. He has been interested in the DOC project and, like me, has struggled with severe chronic pain. I have been helping him work through different strategies to pull out of it and he is slowly coming out of … Read More
Patients and physicians are frequently making illogical decisions regarding spine surgery. I have watched this phenomenon steadily worsen for over 30 years. One of the core problems is that there is little accountability. You would expect your surgeon to do everything he or she could do to optimize your chances … Read More
When I published the first edition of my book, Back in Control: A Spine Surgeon’s Surgeon’s Roadmap Out of Chronic Pain in 2012, I was still of the mind set that if the correct pathology could be identified as the source of the pain, surgery was the best option and the sooner the better. Then … Read More
My surgical decision-making dramatically changed over the last five years of my practice. In spite of watching so many successes of people healing from chronic pain without surgery, I still had a surgical mindset and was always looking for a surgical lesion that I could “fix”. In the first edition … Read More
A friend of mine asked me for an opinion a couple of years ago about his back. I was giving him advice as a friend, not as a surgeon. He was having some pain and numbness down the side of his leg. It was down the distribution of his 5th … Read More
Roy Carey, a well respected spinal surgeon in Melbourne created this video highlighting the decision-making about undergoing spine surgery. It helped reduce the frequency of spinal surgery in Victoria, New Zealand.
I discuss the cultural belief system about spine surgery and it’s impact on the treatment for chronic pain. It took me years to understand that performing fusions for LBP is based on unsubstantiated belief rather than hard data. I thought that surgery could always alleviate pain and felt I had an … Read More
I discuss the lack of awareness to the alternative approaches in the spine surgeon world and the treatment of chronic pain. We are both not being trained in the correct and effective approach, but also ignoring well-established data. (1) Young AK, et al. “Assessment of presurgical psychological screening in … Read More
Imagine your life before the pain. Stop and visualize a day or period back then when you were just plain angry. What kind of a day was it? It wasn’t great. Now add the pain back into the picture and what you have – living hell. One of the byproducts … Read More