Have you been told that surgery is imminent? I'm not against surgery. However, I think it should be the last option. Surgery is non-reversible, and I have treated countless post-surgery clients who have found no change in symptoms, increased symptoms, or new symptoms.
I have also had clients who ended up canceling the upcoming surgery appointment as it was no longer required due to decreased or resolved symptoms.
"How can this be?" I hear you say. "I have lower back pain, my MRI shows I have a bulging disk." Let's look at some telling research:
- In a study of 71 PAIN-FREE adults, 52% had at least one bulging disk or other similar MRI abnormality. The study's authors stated that: "the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental."
- In 2002, a controlled trial of arthroscopic knee surgery for osteoarthritis involving 180 participants found NO difference in outcome over two years between the participants who had knee surgery and those that had a sham (fake) surgery.
- A four-year follow-up of 124 patients with lower back pain published in 2010 found that long-term improvement was NO better after spinal fusion than cognitive intervention and exercises.
- A 2018 summarization of systemic reviews concluded, "The available evidence does not support the hypothesis that spine fusion confers a clinical benefit compared to non-operative alternatives for low back pain associated with degeneration."
- Check out the article linked here written by a top orthopedic surgeon who walked away from his career. He thought his (hard to recover from) lumbar fusion surgeries had a 90% success rate; then, a study showed the success rate was 15 - 25%...
I think of body dysfunction as either "hardware" or "software." "Hardware" is wear and tear on joints, ligaments, cartilage, strained muscles, adhesions between fascial layers, etc.
"Software" is how the nervous system tells the musculoskeletal system to move in any given situation. If you want to move your leg, but your nervous system is firing your glutes instead of your hip flexors, that's a dysfunctional movement pattern.
When I meet a new client, I have a few questions that run through my head:
1. Is this a Hardware or Software issue? (I only fix software)
2. If this is a Hardware issue, was it caused by a software issue, and can correcting the nervous system's dysfunctional movement patterns reduce or remove the symptoms?
An example of a "software" issue causing a hardware issue might be incorrect centration of a joint... Joint centration is the ability of muscles surrounding the joint to fire at the correct time in any movement, thereby allowing optimal joint position. The optimal position of the joint facilitates maximum loading with minimum strain/degeneration.
If a joint is not in an optimal position, inflammation will occur, and pain will be communicated. Yes, you might have damaged cartilage (hardware issue), but what if we get that joint into optimal position (software)? Perhaps the signal of pain will be removed.
I'll state it again...
I'm not against surgery. I just think it should be a last resort and that people should realize that when you ask a surgeon how to fix knee, hip, shoulder, wrist pain etc, they are likely to think of a surgery option.
Here are four questions I think all clients should ask before surgery is agreed to:
1. What is the success rate of the surgery?
2. What are the risks, benefits, and possible complications of this operation?
3. Are there any alternative therapies worth trying before surgery?
4. How many times have you successfully performed this surgery?
The answer to question three should often be a referral to a neurological movement repatterning therapy. Unfortunately, it may take years before the surgery community cues into this.
My approach to joint pain is simple, ensure all the muscles are firing correctly at any given time, in any given functional movement. If we can achieve this, and there is still significant pain present, then, unfortunately, we got to the source of the problem too late. The software issue has caused considerable joint deterioration, and surgery may be the only option.
But often, correcting the dysfunctional movement patterns completely resolves pain or reduces it enough to push surgery further down the road. Three sessions of SMR are enough to stabilize muscles around a joint for most clients.
Bookings can be made here... online bookings page
References:
Jensen MC1, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. 1994 :Magnetic resonance imaging of the lumbar spine in people without back pain
Lubowitz, James H. 2002. "A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee." Arthroscopy 18 (8): 950–51.
Harris, I.A., Traeger, A., Stanford, R., Maher, C.G. and Buchbinder, R. (2018), Lumbar spine fusion: what is the evidence?. Intern Med J, 48: 1430-1434. https://doi.org/10.1111/imj.14120
Brox JI, Nygaard ØP, Holm I, Keller A, Ingebrigtsen T, Reikerås O. Four-year followup of surgical versus non-surgical therapy for chronic low back pain. Ann Rheum Dis. 2010 Sep;69(9):1643-8. doi: 10.1136/ard.2009.108902. Epub 2009 Jul 26. PMID: 19635718; PMCID: PMC2938881.