If I were your spine surgeon...

Pain, it’s a fascinating topic. After 20 years of being a PT and doing a lot of post graduate work my perspectives of it are certainly different than they were a decade ago.

A mechanical treatment such as MDT (ROM exercises specific to a patient’s issue) can be super effective. I am amazed at how rapidly a patients pain can change and function improve when this is implemented by someone with good training, on an appropriate patient. However, what about those that don’t improve? The ones who I treated and several other therapists before me; the ones that just are not getting that much better? Maybe they have had surgery, maybe they haven’t.

There’s another thought, surgery. Why is it that it works for some, and not for others, even after having more than one attempt? Maybe we are missing the “big” picture, or are just seeking that one fell swoop that will fix it with the least work required. Here is an interesting read written by a Spine surgeon.

As a patient (or provider) I implore you to consider these concepts if you are having pain. We can find severe pathology on MRI’s of both people that are having pain, and also people with no history of pain. What makes one person have pain and another not? Or at least one person has pain that affects their life in a negative way and the other manages just fine. The answers are still not clear, but there is a compelling evidence mounting that it is not as simple as fixing something we can see on an MRI. In PT school were taught that a patient is not their diagnosis, they are a PERSON, with that diagnosis. That’s an important concept, two people may have severe degenerative disc disease, but the presentation may be very different even though the MRI’s look nearly the same. Food for thought.

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