Buyer Beware – Gimmick vs. Reality

Gimmick – noun
A trick or device intended to attract attention, publicity, or business. “It is not so much a program to improve services as a gimmick to gain votes”
Similar:
publicity device
stunt
contrivance
eye-catching novelty
scheme
trick

Reality –noun
The world or the state of things as they actually exist, as opposed to as idealistic or notional idea of them.
“He refuses to face reality”
Similar:
the real world
real life
actuality
truth
physical existence

Back pain affects a huge population and opens up a big consumer treatment market. Many treatment options are promising, but buyer beware, the predators are out there! Cutting edge treatments seem to bring out the “fake it until you make it” crowd to chime in with their offers, often grasping ahold of the many evolving treatments and promising you a golden path to the end of the rainbow *.

Magnetic buzz words like “minimally invasive”, “laser”, “regenerative”, “stem cell”, and others draw you in to a potentially unsubstantiated, and likely expensive treatment option. These buzz words may come from a valid source, but there is the potential for misrepresentation **.

I see the immense variability in the different back pain treatment options on the different social media feeds, podcasts, reels, advertisements, and blogs. I make it a point to familiarize myself and to learn about all of these treatments out of genuine interest. I follow the user groups to learn what the generally population’s mindset is in regard to diagnosis and treatment. There is a lot of information out there making it confusing to navigate which treatments are valid and right for you as a patient. I want to help you.

Part A. There are many reasons beyond curiosity that I share your interest and that I dove deep into this rabbit hole.

1. I am a Board-Certified Neurosurgeon
2. I am a scientist
3. I am an inventor
4. I treat back pain by a variety of techniques
5. I seek longevity
6. I want to stay active
7. I don’t want back or joint pain
8. I have earned a solid reputation as a sound thinking Board Certified Neurosurgeon.
9. I intend to preserve and enhance this reputation. Learn more.

I want to help you understand back pain, its potential sources, and its treatment options more clearly. 

Part B. Let me break down some of my observations about some of the sources of back pain. This is not intended to be all inclusive.

1. Multifactorial – There are many bones, ligaments, discs, joints, and muscles in the cervical, thoracic, and lumbar spines, and the pelvis and SI joints. Different combinations of these anatomic parts may be involved in back pain.

2. Environmental – How you live plays a huge role. Your body weight, core strength, mobility, smoking and drinking habits, diet, and stress all come into play with back pain.

3. Spine anatomy – The vertebra, discs, and facet joints are often aggravated, injured, or disrupted to the point where they cause debilitating back pain.

Of these 3 possibilities, #1 and #2 should be addressed with proper coaching and personal action. Take this seriously. So many people skip over #1 and #2 and come to me to act on #3. Unless there is neurosurgical emergency, I will generally advise them to address #1 and #2 first. It is generally not a good idea to act on #3 first, as it may result in a procedure to fix a consequence that will remain under stress by #1 and #2. This is a set-up for disappointment and failure.

#3 needs professional attention. Your choices of who you should see are vast here, butthis is a very important choice. Take some time and use your resources. I wish there was a way to consistently determine who is right for you. It’s not easy as there is always the risk of professional misrepresentation. You may also run into a very qualified treater in their own right, but one who may be closed minded and have the hammer and the nail approach. Use whatever resources you have to navigate this path. Most doctors and treaters earned their wings on the merits of patient centric care. Excellent back pain specialists are out there and available, you just have to find them.

Let’s move on to #3 and discuss some back pain treatment options. This is not intended to be an all-inclusive list.

1. Diagnostic injections – The absolute key to a successful treatment is making the right diagnosis first. I so often see patients who have been frustrated by the system and just want to jump to a treatment. I understand this frustration but trust me when I tell you that you need an accurate diagnosis. I perform precise diagnostic spinal injections to facilitate the diagnosis process and have made this injection process so efficient that consulting patients are able to get an injection right then and there at my office, on the day of consultation.

2. Regenerative injections – I sometimes include regenerative options with the diagnostic injection if there is evidence of tissue degeneration because some of these injections add little if any risk since the needle is already being placed for the diagnostic injection. I use steroids very sparingly here, as they do not have positive long-term effects. Read that last sentence again.
   
3. Minimally Invasive Spine Surgery – In my opinion, surgery plays an amazing role for treating many anatomic spine problems. We continue to advance our surgical techniques. “Minimally invasive” refers to the least invasive technique that it takes to get the surgery done properly – It takes training and experience to do this. There are no short cuts. Minimally invasive surgery techniques are favorable to traditional open surgery techniques as they have shorter recovery times, faster rehabilitation time, less blood loss, lower infection rate, less risk, and they are generally performed at an outpatient surgery center instead of in a hospital.
   
4. Ablation or Rhizotomy – Here the specialist is essentially burning, deadening, or otherwise deactivating a painful area. This is generally minimally invasive but note that it “masks” the underlying problem rather than treating it.
   
5. Neuromodulation – Stimulate a part of the nervous system to get an effect.

There are many promising treatments, both noninvasive and invasive alike. I’m open to talk about the different processes with you here, or in person.

Unit next time,

Jeffrey Larson, MD
The Tall Spine

*Protip #1 – if somebody is describing their abilities or their techniques as “proprietary”, “the best”, “only they can do it”, or “superior to everybody else’s”, they are likely false. These treaters may be charismatic, and they may even believe that their claims to you are true. This is nonsense and a opens up a potentially dangerous interaction. Use your intuition.

**Protip #2 – Buzz words might be a gimmick, but they very well might be an honest reality in the right situation. Most doctors and other specialists are committed to earning your trust and helping you with either advice, treatment, or both.