Ask the Spine Surgeon
December, 2015 - Issue #134

Hi Dr. Moza. I'm writing today because I'm worried about my husband. He's 43 and has been pretty active his whole life, but began complaining of back pain a few years ago. At first, he treated it with over-the-counter anti-inflammatories. When that wasn't enough on the "bad" days, he'd have to go to urgent care - once, even the emergency room - for pain relief. They give him a narcotic for "spasms" and he's fine for a bit, but the cycle always starts again. He's spent a small fortune on deep-tissue massages, chiropractor appointments, urgent care visits, prescriptions and more, but the problem doesn't go away - it just gets worse. He says I'm overreacting and that he won't see a specialist. His uncle had back surgery in the '80s and my hubby recalls that that the procedure required a long, painful recovery and that the results weren't "worth it." Help!

Wow. First, let me offer my sympathies to your husband - and you! Chronic pain doesn't just negatively affect the quality of life of the one who has it; loved ones suffer, too.

Unfortunately, your husband's story is not an unusual one. Society offers us many ways to numb symptoms short term, and who can blame a person for wanting the pain to stop now? Couple that with the fear of the unknown ("Do I need surgery?" "What if I have to take time off work?") and you have the recipe for what I like to call "delayed solutions."

Because that's really what's happening here... Patients like your husband kick the can down the road, treating symptoms but not the cause.
In my practice, I encourage patients to stop delaying the solution. It makes sense, too. Popping pills all day can lead to psychological and physiological dependencies, plus all those meds can really wreck your liver if you take them excessively. And, while your husband might feel better temporarily, he's most likely causing further degeneration by avoiding lasting treatment that can make a real difference.

You mentioned that your spouse is avoiding specialists because he has first-hand knowledge of a back surgery gone array. I would encourage you to gently introduce him to today's state-of-the-art surgical procedures. "Yesterday's" large incisions, less-accurate imaging technology and more-crude tools meant that recovery times were lengthy and 100-percent success was unlikely. Today, practices like mine specialize in micro-surgical techniques that are very minimally invasive. In fact, many of my surgical procedures leave an incision so small in size that a standard Bandaid is more than enough to cover the cut. My patients walk out of the hospital on their own volition in less than 24 hours and are back to work - and life - in days or, at the most, a few weeks. Every single patient I've ever operated on has been able to return to their desired activity level.

When you chat with your husband, you might also want to remind him that surgery isn't necessarily necessary! After identifying the problem, we can create a plan to fix it - while also addressing the pain. I'm a conservative specialist; surgery is my choice of last resort. If I feel confident that an exceptional physical therapist or pain management specialist can make a dramatic difference, that's where we'll start.

The key is this: Help him stop the "urgent care" cycle now. There's no reason to waste time and money sitting in the emergency room when you can be seen, evaluated, sent for an MRI and treated in my office - all in the same day. Then we can get him into physical therapy or scheduled for epidural injections asap. If the issue will require surgery, it can be scheduled promptly to avoid more painful wait time and the costly ER and urgent care bills that come with it.
Kapil Moza MD, FACS
Diplomate, American Board of Neurological Surgery
Dr. Moza's Santa Clarita office is conveniently located in Valencia. 805-497-3622
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