TREATMENT of PAIN: Part 2: Surgery

A recent report by the Agency for Healthcare Research and Quality, a federal organization, found that in 2007, 27 million adults reported back problems with $30.3 billion spent on treatments to ease the pain. While some of that money was spent on physical therapy, chiropractic visits, injections, and other less invasive procedures (the study did not cite acupuncture costs), the majority of the money paid for spine surgeries.

Complicated spine surgeries that involve fusing 2 or more vertebrae are on the rise. In just 15 years, there was an eight-fold increase in this type of surgery, according to Spine in July 2013.

For some patients there is a legitimate need for spine surgery, but clearly many surgeries are not necessary and, in some cases, can be damaging. Experts estimate that nearly 600,000 Americans opt for back surgeries each year. A new study in the journal Spine states that in many cases surgery can even backfire, leaving patients in more pain.

Researchers reviewed records from 1,450 patients in the Ohio Bureau of Workers’ Compensation database who had diagnoses of disc degeneration, disc herniation or radiculopathy, a nerve condition that causes tingling, pain, and weakness in the arms or legs.

Half of the patients had surgery to fuse 2 or more vertebrae in hopes of curing low back pain. The other half had no surgery, even though they had the same diagnoses. After 2 years, just 26% of those who had surgery returned to work. That’s compared to 67% of patients who did not have surgery and used non-invasive methods to treat their backs.

In perhaps what was the most troubling finding in this study, researchers found there was a 41% increase in the use of prescription opioids in those that had surgery.

Acupuncture studies often include a control group that receives “sham”acupuncture, where non-traditional acupuncture points are needled and compared to needling of traditional acupuncture points. In a 2016 review a comparative analysis of surgery versus sham surgery revealed that “sham surgery has shown to be just as effective as actual surgery in reducing pain and disability”. Sham surgery consisted of making an incision and closing the incision without any further surgery. The 2016 review was admittedly based on a small sample size, but it is it’s conclusion gives one food for thought.

Chronic pain can be tricky to diagnose and treat, and I’m not saying acupuncture can and will help everyone. Often a combination of modalities is what works best. But acupuncture is not utilized nearly enough, nor to its capabilities, especially when considering how once surgery is done there is no reversing it. It makes far more sense to first try a treatment that is far less invasive, is cost effective,and is extremely effective in many cases.

(Part 3 of this series will discuss mechanisms of pain relief with acupuncture.)