Dear Dr. Matt

Dear Dr. Matt,

A couple of orthopedic specialists have told me more or less that even though the human back is simple mechanically, there’s still so much they don’t understand about why people have certain kinds of chronic pain. So in the 3 years since I herniated a disc and was recommended for a lower-lumbar spinal fusion, I’ve pretty much worked constantly to figure out what’s actually causing most of my pain and find non-surgical ways to relieve it. When I started talking to other people whose pain was bad enough that they’d gone to an orthopedic doctor (I’ve been to 4) and gotten an MRI, I noticed something in common that’s probably true of most medical consultations: The initial diagnosis was terrifying, because you don’t get plain-talk. You get specific medical terms that doctors consider to be descriptive – which the doctors seem to have forgotten are not familiar to anyone else. I heard things like, “degeneration,” “protrusion,” “herniation,” “disc narrowing,” “dessication,” “endplate signal abnormality,” “spinal stenosis.” When those terms are all new to you and you’re in a great deal of pain, it can be very overwhelming. And when three different doctors wrapped it all up for me by recommending spinal surgery, it sounded like the only option. I actually had to press the doctors to explain all this terminology – really insist. One finally said, “It means, You have a bad back.” I say all this because I know a lot of people start getting back pain when they’re still young enough not to have had any other kind of serious medical problem. So when it’s the first time in your life that you’re working with a group of doctors and you’re terrified by what you hear, you’re in crippling pain and you’re given a recommendation of surgery — you don’t necessarily have a lot of patience or the best mindset to work through the facts and the decisions methodically.

I had good spinal strength and flexibility from years of yoga and no nerve damage or sciatica, but there was a constant and excruciating belt of pain around my lower back. In all the research I did as I was considering the surgery, I found a very good article online from The New Yorker by Dr. Jerome Groopman about the gross misuse of spinal fusion, and it echoed my suspicion that, in my case, when I wasn’t even 40 years old, the downside of permanently fusing three levels of my lower spine together, as recommended, might outweigh the benefits. One week before my surgery was scheduled, I again pressed the neurosurgeon with all the things I’d read, and he admitted that this serious, irreversible procedure might well do nothing at all to alleviate my pain. The hospital’s “pain management” attempts – including an epidural shot where the needle going in repeatedly hit major nerves to my legs – were more horrifying and traumatic than the severe amount of day-to-day pain I was already dealing with.

Obviously, surgery is critical for certain types of spinal injuries and problems. That’s what everyone has to determine. But I also realized that all three of the specialists I’d spoken to at that point were surgeons. Not exactly a balanced set of opinions. I finally consulted an osteopath (non-surgical), who in turn brought in a 4th surgeon. Getting a very different opinion and much more information from them, I again pressed the surgeons I’d originally consulted, and they all admitted the fusion was “not necessary” in my case – it was just the only thing they could offer. I give the neurosurgeon credit for being honest, but after I decided to cancel his $35,000 procedure, he walked me out the door this this uplifting thought: “It might not get worse. But it will never get better.”

…He was wrong. It has gotten better, without any steroids or anti-inflammatory drugs. I’ve continued yoga practice and tried acupuncture, physical therapy, massage, rolfing, different exercise routines, a new bed, better sneakers, a zero-gravity chair, chiropractic and more. It sounds like a lot, but since the back is such a mystery, different things help different people. Some things didn’t help me at all. But I learned which things did reduce some of my back pain and let me keep moving and exercising. After getting that far, I’ve had the most progress since I came to Back to Balance six months ago. Continuing my chiropractic work to keep my hips aligned and help the joint was part of why I came, but I was also referred to you by my original chiropractor because he knew you could do disc decompression to try to help rehabilitate my collapsed disc. (The only form of IDD I’d heard of used a computerized machine, and the only facilities I could find were extremely expensive and not anywhere nearby.)

I’ve been more encouraged and felt better in the few months I’ve worked with you than I have felt in three years. And it’s given me a lot of good energy. Because your practice is warm and human. You have patience. You try different things. You care. You listen. You have great experience, ideas and equipment. You are the first doctor who has thought of the two things that have helped me reduce my pain even more, to the smallest amount yet: loosening the facea on my lower back that has been restricting my muscular movement there, and using a portable Tens unit to keep the muscles loose. Along the way, a few doctors suggested to me that the majority of my pain sounded like it was more from the surrounding tissues and muscles than from the actual joint, but no one offered me a sustainable way to calm it down and stop the pain cycle. You did. And I understand even more about to keep the pain low now because you are great about sharing information and explaining things. I feel almost no pain most days, and I can’t tell you how much I appreciate your help. Obviously, everyone has their own level of tolerance and patience for working through injuries. But for so long, I felt like I was much more open to trying options than my orthopedic doctors were. At Back to Balance, it was the opposite. Your willingness to keep trying has ultimately given me a lot of support and real progress, and made my earlier attempts worth the effort. I am very grateful.

Sincerely, P.C.