placidfox55 said:Surgery is usually recommended for serious spinal issues, like losing bladder or bowel control.
If we're just talking about standard chronic back pain, surgery doesn't actually perform any better than conservative therapy.
To be classified as a "chronic pain patient," there are certain criteria you have to meet—it’s not just something you decide for yourself. You have to go through a specialized pain management clinic.
Basically, if someone deals with continuous, unbearable pain for more than three months without relief, they are designated as a "chronic pain patient." This usually applies when there is clear neurological damage, or when dealing with patients who have already had unsuccessful surgeries, or those whose issues resurface years later.
At the clinic, these cases are often referred to as "failed back surgery syndrome." A specialist from the clinic handles things after the patient goes through evaluations by nurses, physical therapists,
psychologists or psychiatrists, and the pain management specialist overseeing the case. The whole team meets with the patient to discuss the next steps, and you usually get a plan within 6 to 8 hours.
They might use 4 or 5 different medications, one of which is a placebo. These are administered every hour with short breaks. The injections used are much stronger than what you'd get normally, so you can see pretty quickly—within 10 to 15 minutes—if they actually help manage the pain.
They also use various antidepressants, which can work effectively for pain as well. Even then, about 30% of patients can't be helped.
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Standard pain crises, if they aren't neurological in nature, mostly improve on their own within 4 to 6 weeks—though it varies depending on the person.
Out of everyone seeing neurologists or orthopedic specialists, only about 5% actually end up having surgery. Some of those undergo a discectomy, which is a lighter procedure. But all surgeries carry the risk of neurological consequences, similar to the
patient's original symptoms, so you always have to weigh the risks against the potential success and necessity.
It's normal to go through an acute pain phase that lasts up to 3 months.
We don't jump into surgery until every conservative treatment option has been exhausted. I mean, what exactly would you operate on if someone only has chronic pain?
That's why you start with an X-ray, move to a CT scan, and eventually get an MRI. In my case, I needed an MRI with contrast because it provides a much clearer view of the nerves, especially when dealing with multiple injuries, previous surgeries, or other complications.
In my experience, we shouldn't just take a specialist's word that everything will be perfect. Success rates hover around 85%. For some procedures, like my second surgery, the guarantee was much lower—maybe only a 40-50% improvement. When you're someone who can barely walk 150 to 250 feet, you'll take whatever chance you can get.
Best,
🙂 😉 😎
