Back Pain and the Space Between
The difference between temporary relief and permanent solutions
A relatively new study published in the New England Journal of Medicine found that steroid injections for spinal stenosis may not be effective in relieving back pain long-term, and it has the back pain community (patients and physicians alike) all abuzz. The results aren't terribly shocking to us spine surgeons, who are typically the final stop on the road to lasting pain relief after a patient has exhausted every other conservative treatment option. You see, especially when it comes to back pain, not every treatment is right for every person or every condition.
One of my chief concerns when patients come to me scared about the risks of surgery, is the fact that there were multiple other practitioners, healers, "experts" and friends along the way who told them that some (insert name of potion, exercise or supplement here) "easy-fix" was going to solve their back pain - permanently. I'm not discounting alternative therapies, they absolutely have their place in the treatment plan for chronic back pain sufferers, but many of them, including steroid injections, may just be a Band Aid covering the real cause of the problem that actually needs to be addressed.
This study highlights perfectly the experience most patients have with steroid injections. After they receive them, there is a period of some pain relief, typically followed by a return of the symptoms. These aren't permanent fixes and as the study indicates, shouldn't really be done more than twice to achieve pain relief. A few months of relief when you're facing a lifetime of chronic back pain just isn't the best prescription for success. But it is, theoretically, less risky than surgery.
And that's really the point. Permanent relief for some of the most debilitating spine conditions is often achieved via surgery. Yes, surgery has its risks and no, it doesn't always work in achieving complete pain relief. But by and large, for most spinal conditions, surgery has been clinically proven to provide a permanent back pain solution.
However, years upon years of "alternative therapies" have their risks too. The biggest? A chronic spine condition made worse by not having it evaluated by a board-certified spine specialist sooner. I can't tell you how many patients I see who wish they had come to me two, five, even ten years earlier. But they were scared, and I understand that. If you've felt the same way, perhaps it might be comforting to know that plenty of spine surgery practices tell more patients that they don't need surgery than those we actually perform it on.
For the patients who are good surgical candidates and seek our guidance closer to the beginning of their chronic back pain story, we are often able to help them achieve lasting and permanent pain relief using the least invasive surgical methods available. I don't want this to seem like a plug for surgery, it really isn't. I simply want patients to broaden their horizons when it comes to all of the back pain relief options available and to choose a trained spine expert whom they trust to guide them in the right direction, for them.