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Every day we see patients with disc bulges or lumbar disc herniation like the patient below who were told to have steroid injections, physical therapy but eventually, they are pointed to surgery. This landmark study in the New England Journal of Medicine proves many discs improve on their own without surgery. What motivates doctors and PAs to not share this type of information with patients allowing truly informed consent? As you can see below, her herniation healed on its own without surgery, likely through time. A true indication for surgery is incontinence and/ or rapidly progressing paralysis of the extremities

Spinal fusion rates continue to increase dramatically in the United States. Oddly enough, this landmark study shows the rise is related financial incentives and other variables not associated with the patient’s well being. This respected journal states that the annual number of spinal fusions rose by 77% within 5 years. This is confirmed in this publication: NEJM Spinal- Fusion Surgery-The Case for Restraint Why do you think so many unnecessary spinal fusions are happening?  

A New York Times article stated, “Spine fusion surgery is no better than alternative non-surgical treatments.” Unlike most operations, spinal fusion was tested in four clinical trials. The conclusion was that “surgery was no better than alternative non-surgical treatments, like supervised exercise and therapy to help patients deal with their fear of back pain”. The studies were completed by the early 2000s and should have been enough to greatly limit or stop spinal fusions, according to Dr. Richard Deyo, professor of evidence-based medicine at the Oregon Health and Sciences University. But that has not happened, according to a recent report printed

It’s no secret that low back pain is a leading cause of “unwanted” lost workdays. Low back pain is not a disease, but instead may be caused by several problems, the most common being degenerative discs.1  Degenerative discs may also lead to facet joint arthritis pain and “sciatica” nerve pain. To help pinpoint pain sources, discography was historically offered because MRIs couldn’t reliably identify pain. Discography was used to plan spine surgery, however, today spine fusions themselves are being questioned because of long-term fusion concerns. Discography was introduced in the 1940s. During discography, x-ray contrast is injected into the center