Low back pain is the second leading reason for patient visits to their primary care physician; up to 90% of people suffer from it at least once in their adult lives. A recent review of related studies in the Journal of Back and Musculoskeletal Rehabilitation showed that the highest rate of back surgery in the developed world is in the U.S., with the most common surgical procedure of the lower spine being removal of disc herniation. Despite these statistics, the cause of low back pain remains elusive and there is conflicting evidence over the best form of treatment.
The authors of this literature review evaluated studies on current surgical and nonsurgical treatments for lumbar (low back) disc herniations, to determine the short- and long-term results of each. Several different approaches were discussed.
No statistical difference was noted in long-term outcomes between surgical and nonsurgical options for low back pain treatment. Only short-term relief of hip pain was shown as more successful through surgical intervention. (Note: Recent studies in the literature have shown comparable results between nonsurgical and surgical approaches to hip pain.) The authors recommend that aggressive rehabilitation combined with pain control may be the best treatment option for low back pain.
Surgery remains a controversial treatment option for low back pain. When you consider the costs and complications associated with surgery, almost any option may be better.
Memmo PA, Nadler S, Malanga G. Lumbar disc herniations: A review of surgical and non-surgical indications and outcomes. Journal of Back and Musculoskeletal Rehabilitation 200: 14(3), pp 79-88.www.optimalwellnesstx.com
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