Episode #18: The One Thing That Can Dramatically Increase Or Decrease Your Odds of Back Surgery

June 21, 2019

Show Notes:

Speaker 1: (00:00)
Hey everybody, what's going on in Doctor Chad Woolner here and Dr. Buddy Alan. And this is episode 18 of the health fundamentals podcast. On today's episode, we're going to be talking about new research that shows that just one thing can dramatically increase or decrease your likelihood of back surgery. So let's get started.

Speaker 2: (00:19)
You're listening to the health fundamentals podcast. I'm Dr. Chad Woolner and I'm Dr. Buddy Alan. And this show was about giving you the simple but powerful cutting edge tools you need to change your health and your life. So sit back and enjoy the show as we show you the path to your best life down to a science.

Speaker 1: (00:39)
So here everybody on today's episode, we want to share with you a relatively new study that came out that shares something pretty powerful when you crazy. When you, when you first heard the, the statistics of this study, what were your thoughts? What were your impressions? Well, first it didn't surprise me, um, just because it didn't, but it did it. Yeah. Well, it didn't because just from practical experience throughout the years with patients on a, and I kind of suspected this to be the case, but it did surprise me in that it was coming from a journal. Well, the general dedication from medical journal. Yeah. Yeah. Well we'll that and I would see too, the thing that surprised me was, uh, the actual numbers, the statistics, the odds, you know, that the difference is, is crazy. So it's not just a little bit, no, it's huge. It's huge.

Speaker 1: (01:29)
So, so what we're talking about is a study that was actually published back in 2013, uh, in the spine journal. A spine is a very well known reputable medical journal. Um, and over the years actually spine has, has had some really incredible research supporting chiropractic care and other conservative approaches for dealing with problems like back pain. Right. Um, but what they did, the study was, it was titled Early predictors of Lumbar Spine surgery after occupational back surgery results from a perspective study of workers in Washington state. And so basically what they did was they looked at a variety of different factors. And One specifically, one factor that they really honed in on was what was your likelihood of having back surgery if you sustained a back injury at work. And the one factor they looked at was did you first see a surgeon for your consultation after, you know, w per to, uh, as, as your doctor, as the, as the portal of entry doctor that you saw or did you see a chiropractor?

Speaker 1: (02:32)
And here are the, here are the statistics. I'll read it straight from the, from the results of the study here. Uh, they said 42.7% of workers who first saw a surgeon had surgery in contrast to only 1.5% of those who saw a chiropractor. That's insane. That's crazy. So basically saying roughly almost 50% mean 42 we'll, we'll round up, you know, nearly 50%, uh, had surgery but saw a surgeon first. So I mean, that's like flipping a coin and basically saying, will you have surgery or not? You know, you've got a 50, 50 chance versus if you were to see a chiropractor, hardly anybody 1.5%. You know, in the past we've talked about the system being broken. And again, and I don't necessarily blame doctors, I blamed the system that they're set up in there. There are certain protocols that have been established and they have to do things within kind of the accepted, um, care that is going on at the time.

Speaker 1: (03:40)
And so, you know, docs do what is kind of expected of you, Ben. So, so again, it's not necessarily all of their faults, it's the system that, that were kind of set up in. Yeah. And you actually said it before we even started. You know, there's this funny little saying that we heard, I think the first time I ever heard it was in chiropractic college was, um, when you're a hammer, everything starts to look like a nail. Yeah. All right. So if you're a surgeon, his, his tools of, of curing people are knifes. Yeah. So if there's knives that are, what, that's what he uses. So everything that the, the lens through which he sees, he looks at everything as, I could fix this by cutting this and fixing this paradigm. That's just, that's all they understand. Yup. Uh, here's an interesting quote. It kind of along these same lines.

Speaker 1: (04:26)
Uh, and again, that's the thing. Hopefully that people who, whether you've been listening to our podcast for quite some time, or just kind of getting to know us and our approach, understand we're, we're pretty moderate in the way we look at things. And the reason being is because we find that most extremes lead people astray. Um, you know, there's a place for medicine. There's a place for Chiropractic, there's a place for acupuncture and massage, and there's a place for, um, just about every proven type of, of treatment, modality and approach out there. You know, there's a time for conservative care, you know, and that should always be first. We should always exhaust conservative options first, but um, understand we're not anti-medicine, but we do have to acknowledge the truth, the, the painful truth that right now the system is broken and that there are a lot of, um, powers that be right now that want to maintain a broken system because there's a lot of money to be made in a broken system.

Speaker 1: (05:23)
Here's an interesting quote by a Dr Marsha Angle and I think I'm pronouncing that right. Angel Ange Angle. Uh, she used to be the former editor of the New England Journal of Medicine. So somebody who, who knows why the Pequot yeah, she said it is simply no longer possible to believe much of the clinical research that is published or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine. And so the problem that we're seeing here is that what so many in that realm take as authoritative, you know, this is the standard, this is the protocol. This is the, you know, bet these are the best practices. Um, what we're finding is that in many instances, not always, but in many instances, that's not really the case. You know, and I would say especially what the overwhelming research has, has shown time and time again, is that the best approach for back pain is to always start conservative.

Speaker 1: (06:30)
And that's not, this is not some sort of a propaganda piece for us to say, heck, Rah chiropractic. And that's the only thing, um, because, because at our clinic, we utilize a lot of different tools. You Bet. Physio therapy, we use exercise, stretching and massage there. Yeah. But what we are saying is the research has shown loud and clear that you should always start conservative and then move forward from there. And the problem is that I think sometimes, uh, in, in with certain doctors is that they, they look at, like if we are to ratchet the system, right? If we were looking at a ratcheting system one through 10 in terms of conservative, most conservative, all the way up to like most invasive, right? Uh, the, the problem that happens, I think, uh, and you tell me your experience, Dr. Allen, is that many medical doctors will start at one and two and then they'll skip three, four, five, six, seven, eight and go, you know, and nine and go straight to 10.

Speaker 1: (07:26)
And what I mean by that is, is they'll look at the patient, they'll say, well, have you tried Advil? Well, yeah, we try to Advil. And have you tried some home stretching? Yeah, I've tried that. Okay. Those didn't work. So now it's time for us to go straight to cortisone injections and, or surgery. Right. When in reality it's like, there were tons of other options in there. There you could've tried massage, you could have tried acupuncture, huge, could've tried chiropractic. You as a could of tried physical therapy. You could have tried some sort of nutrition or better yet, what you could have and should have done is an integrated approach. Well, and honestly, even when it comes to the, uh, whether it be physical therapy or Chiropractic, you know, frequently I've seen a recommendations and I don't, and I don't blame the doctors per se.

Speaker 1: (08:06)
They just don't understand. There'll be like, I'm here, we want to send you to the physical therapist or the chiropractor for a four visits over the next two weeks, two weeks, you know, to fix this, to, to fix your back problem that's been going on for 10 years. Oh, you met. Or maybe one that you just destroyed right at the, on the job. You know, and it's like they don't, they don't have a true understanding of how, what kind of time it takes to actually, in most cases, even with a terrible things like disc herniations, the research indicates that given time with very few exceptions, right? Um, those will heal and you will not have to go under the knife and you will not have to do super invasive things. There are other alternatives. You, you may have to undergo some pain for a little bit longer or you know, and, and really kind of just again, be patient and, and not only have to undergo pain and be patient, but also have to work, you bet.

Speaker 1: (09:00)
Have to be actively engaged in and be a part of a process that may not necessarily be as convenient as popping a few pills or you know, being put under general sedation and sleeping through a procedure that that doesn't require any effort on your part whatsoever. The problem though is people that wind up going down those roads pay the price in the long run. Unfortunately, you know, um, back surgery has such a lousy track record. Tara, you know, and again, we're not talking about some sort of a personal bias here. We're talking about just looking at the research. What the research shows loud and clear is that back surgeries, the vast majority of them out there don't have good outcomes. They just don't. And when they do, it's very short lived. Right, right. Yeah, exactly. Which I long term, again, we're looking at longterm. You know, that's the sad part with and, and, and I've heard patients, um, share the exact words that, that their surgeon said, you know, do you want to be in pain every day for the rest of your life using fear attack?

Speaker 1: (09:58)
Yeah. Using fear tactics. And it's like, you know, I can certainly, you know, if someone had a disc herniation and you did surgery, the likelihood of getting them out of that nerve pain very quickly is, is really, really good. But the, the long term of that is, guess what? Now you are going to have a chronic back pain forever and it's going to get worse and many of those symptoms will come back. Right. So, yeah. So I think the big take home that we want people to understand about this is I think it's fairly safe for us to kind of extrapolate the meaning of this to a much broader, uh, group. And that is most people, whether you're cause for those listening or watching this podcast right now, they might be thinking, you know what? I don't, I don't work at a job where I experienced back issues or if I'm at risk for uh, developing on the job injuries or whatever.

Speaker 1: (10:49)
I don't think that's really a point of, of the emphasis of what we're trying to say here. I think what we're trying to really say here, um, the real take home is regardless of what type of work you do, if you're dealing with the back issue, if you've just come, if you've just started to develop back issues, understand that these statistics I think are pretty telling number one and I think could to some degree be broadly applied that look, if you first go to a medical doctor and or a surgeon, the likelihood of surgery is going to be dramatically higher. Absolutely. Or, or even medications. You know, right now we're, we're battling a huge epidemic with the opiate opioid, um, you know, crisis that we have with people overdosing. You know, the, the, the statistics are in sounding yas, downing and again, if you, if you go to somebody who that's their tools, again, I don't fault them per se in the fact that that's all they know.

Speaker 1: (11:44)
Yeah. They're doing what they know how to do. Exactly. So, yeah, and, and what we're talking about really in terms of really addressing the root cause, there is something far deeper than this podcast episode. You know, we're talking about an overhaul of the system. Again in terms of education, in terms of, you know, training in terms of, you know, uh, integration, you know, ideally what we should see. If we could wave a magic wand, um, and, and have a as near perfect as possible system in place. What it would look like is an integrated system. You'd see a lot more doctors collaborating together. But the challenge and problem there isn't just the powers that be, it's also the egos that be sure you know, that, uh, you know about this. I mean really looked at these numbers again, 42.7%, you know, seeing the surgeon more likely more likely than if you were to see a Cairo, a chiropractor in this particular study that is 41 times greater chance that you have of going under the knife at least if you had just started at a different starting point, right, of the a better starting point.

Speaker 1: (12:50)
Right? So, you know, those are just, um, I would say think about the tools that the of the doctor that you're going to see and you know, that gives you a pretty good indication of the path that you're probably going down. We, Elena and I would say this, you know, there's, there's one of the things that we try and help patients understand in terms of helping kindle a certain level of hope within them is that it's never too late. It's never too late to make the right decision. That being said though, one other thing that we tell patients is that you're never going to arrive in the right destination if you get on the wrong path. The wrong, the wrong path can never lead to the right outcome. And so that's the thing is just understand this, that, that starting with the right path in the first place dramatically increases the likelihood that you're going to end up in the right place.

Speaker 1: (13:37)
Right? So, um, you know, chiropractic has such a solid track record for being a very safe and very effective approach to helping manage a wide range of different back and, or spine related problems. And so it should make sense, um, to start there. And, and the, the interesting thing is that chiropractic in and of itself can to some degree be fairly polarizing. Um, and it obviously depends on who you're talking to. Um, but if you just, again, if you just look at the research, there is such a solid body of research now that is showing loud and clear just how effective and how safe chiropractic is. And so that would be the big take home here is start conservative first, whether that's a chiropractor or a physical therapist or an acupuncturist or a massage therapist for heaven sake. Um, start conservative and recognize that you always have room to, to kind of advance further, but, but the other take home that I would say kind of along the same lines take into consideration two really important factors.

Speaker 1: (14:48)
If you're in, let's say like you're somebody who's dealing with back pain and you just don't feel like you're getting the results and maybe you're starting to consider resorting to more invasive things like surgery. Understand this number one, what Dr. Allen already kind of hinted at or just straight up said is give it more time. Have you given it enough time and enough time? What would, what would you say in terms of time, enough time would constitute a fair go in your, in your experience depending on the injuries, but I mean, something like a disc, I would say six months to a year, honestly. Like give it enough time. Shoulders, that's not unreasonable shoulders. Um, uh, even tendinitis to, I mean, I've had tennis elbow mysel can be sit, took stubborn year with, with, uh, with therapy and everything to settle down. And you know, it's like I never had to get a steroid injection.

Speaker 1: (15:38)
I never have to do anything invasive. And it finally settled down and I, and I'm great, you know? But I would say just be patient, give it time. So I would say number one, give it time. And then number two, the other question that you want to ask yourself if you're contemplating moving forward into more aggressive approaches is have you done a ace? Has the approach been sufficiently comprehensive? Yes. Meaning, you know, again, going back to one of the, one of the things we say, the helion equation is what the right thing in the right order for the right amount of time, the right things in the right order for the right amount of time. Right? So are we doing the right things together in the right order? Right. And so that's the thing is it may be because we see patients like this all the time, right?

Speaker 1: (16:20)
Where they, I tried this, I tried this, I tried this, I tried this, and none of them worked. And oftentimes we look at some of the things they tried and we know those are things that do help and do work. And so oftentimes, maybe it's just the fact that you were doing the right things together in the right combination, you know, so if you're somebody who's like, I've been trying chiropractic care and it just hasn't been working or I've been trying physical therapy and it just hasn't been working, or I've tried this, whatever you name, whatever that modality is, consider integrating the approach, meaning, okay, I'm going to use chiropractic with active care and rehab as well as massage and you know, make some changes dietarily, you know, increase, incorporate some supplements and this other tool or whatever. But really expanding the, the, um, uh, the, the, the comprehensiveness if that's a word of, of your approach.

Speaker 1: (17:13)
And I think more often than not, what you will find is that that will help you, uh, and, and prevent you from needing to take further steps and, and, uh, and venturing more into the less conservative realm. So anything else you want to add? No, that's pretty, uh, pretty much sums it up. Okay. Yeah. So just remember, man, the, the one, one thing, just one thing, we'll either dramatically increase the odds of surgery or decrease in that is whether you see a surgeon first or a chiropractor first, 42.7% of those people that the surgeon got surgery man, almost half, almost half versus 1.5 nearly hardly, hardly anybody. [inaudible] it's pretty sad. It's astounding. It's very sobering. So anyways, I hope this has been valuable for you guys. Hope you guys learned something and maybe gave you a new kind of way of viewing this and maybe a paradigm shift. Um, if you know others that could benefit, share this with them and we look forward to sharing more with you guys on the next episode. We'll talk to you later.

Speaker 2: (18:20)
Thanks for listening to the health fundamentals podcast. Be sure to subscribe so that you stay in the loop. And in the note with all of the cutting edge health information that we share, if you know other people that could benefit from this information, please share it with them as well. Also be sure to give us a review. These really help us to ultimately help more people. Last but not least, if you have questions that you want answered live on the show, or if you have ideas for topics that you would like us to cover, please shoot us an email and let us know at info@thehealthfundamentals.com.

MJ Manlunas
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