By Linda Thames, DNP
Here is a common scenario:
I hurt my back lifting a heavy box, my back pain is a 10/10, and my MRI shows I have a herniated disc. I need surgery. Where do I start?
Research indicates that 42 million people go to their primary care provider with back pain each year. The pain may range from mild to severe. It might simply require Ibuprofen for relief or it might be severe enough to cause a visit to the emergency room. If you find yourself in a situation such as this, it is important to understand that an MRI is not a diagnosis.
A herniated, bulging, or protruding disc may not require surgery. The MRI is only a picture. Your history, symptoms, and exam are very important. A study in the New England Journal of Medicine found that more than 57 out of 98 of the test subjects who had an MRI done on their lumbar spine DID have disc herniations or bulging discs but DID NOT have back pain or leg pain. There are far too many causes of back and leg pain to discuss in a brief article like this. However, please ask yourself if one of those 57 test subjects were to begin having back or leg pain 6 months later and the MRI remained the same, is the disc the absolute cause of that pain? I hope you understand the answer is a resounding NO! Therefore, will surgery to remove the disc or decompress the space improve my symptoms? Again, the answer may be NO! You may indeed have a herniated disc and your pain is instead coming from a muscle strain, facet joint, bone spur or something more serious, including cancer. You need a diagnosis first!
Where do you start?
- Step 1: Finding the diagnosis. Tell me what is causing my pain.
- Step 2: What are ALL of the options for treatment?-write them down for me please. I need to know non-surgical options too.
- Step 3: What do you expect the success rate is of the options you tell me about?
- Step 4: Can I get a second opinion?-the answer needs to be "yes" without hesitation
For more information and to visit one of our locations in Stockbridge, Newnan, Fayetteville and Buckhead, Georgia or call (770) 997-0600