Regular chiropractic care stretches, and maintenance exercises can often prevent further degeneration and the need for back surgery. Some patients, however, end up with back surgery as a result of serious injury, or from having sought only traditional medical treatments for their pain. Even after surgery, patients can remain in pain. While back surgery can limit future alternative treatments, there are some options left in chiropractic care.
Reasons for Back Surgery
Spines suffer as a result of injury, normal wear and tear, and aging. Back surgery is actually rarely needed, according to the Mayo Clinic. Patients need to explore other options, such as “anti-inflammatory medication, ice, heat, gentle massage and physical therapy.” If those don’t work, and if patients don’t see alternative care, they may desire back surgery; however, it “doesn’t help every type of back pain.” Back surgery may be necessary for conditions where the spinal nerves are compressed (causing “debilitating back pain or numbness”), for ruptured disks, for an unstable spine (from broken bones), or osteoporosis. There are certain medical situations where patients may also need surgery, such as severe scoliosis (spine curvature), humpback, spinal stenosis (from arthritis), or other degenerative diseases. Types of back surgery include discectomy, which is “removal of the herniated portion of a disk”, laminectomy, or “removal of the bone overlying the spinal canal”, spinal fusion of “two or more bones”, vertebroplasty, in which the “surgeon injects bone cement into compressed vertebrae”, or the implantation of artificial disks.1
Complications of Surgery
Typical back surgery complications include “surgical wound problems” and an “increased risk of death”, according to a study in the Journal of Bone and Joint Surgery. Some patients have also had deep vein thrombosis (blood clots), sepsis and other infections, and pneumonia. Those most at risk of complications were older patients, those with heart disease, corticosteroid users, those with neurological problems, and patients with longer surgery times.2
Chiropractic Post-Surgery Care
Many patients who have had back surgery experience pre-surgery symptoms and pain months or years post-surgery. This situation is called “Failed Back Surgery Syndrome.” Chiropractors who could have helped patients avoid surgery in the first place may be called upon to help prevent future surgeries.3 “Post-surgery patients are more technically difficult to treat,” according to Paul Kramer DC. Treatment will require a chiropractor who is specially trained in post-surgical therapies. Some patients will only get symptom relief (such as those who had spinal fusion). Some types of fusion will not respond to treatment. Those with laminectomies (who had bones removed) will need to be treated on different contact points. Discectomies should be less problematic to treat. Treatment should not commence until at least six months after surgery, to give the bones and tissues time to heal. Physical therapy may be required first, to “strengthen up the area” before spinal manipulation is undertaken. Chiropractors may also provide “lifestyle counseling and exercise”, as well as diet changes (to reduce inflammation), and ergonomic advice.4