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Study: Surgery Just One Option for Herniated Disk

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Study: Surgery Just One Option for Herniated Disk

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Study: Surgery Just One Option for Herniated Disk

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ROBERT SIEGEL, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Robert Siegel.

MICHELE NORRIS, host:

And I'm Michele Norris.

If you've had a herniated disk, you know the symptoms all too well - intense pain radiating down your legs or shooting through your back. And while the following news might not bring relief, it may bring answers. A new study looking at treatments for a herniated or slipped disk found that nonoperative remedies such as physical therapy and pain-killing drugs are almost as effective as surgery to remove the disk.

The study appears in the upcoming issue of the Journal of the American Medical Association. Dr. James Weinstein of Dartmouth College is the lead researcher. He says the nearly 500 participants in the trial all suffered severe pain. They were divided into two groups, those that underwent surgery and those that didn't.

Dr. JAMES WEINSTEIN (Dartmouth College): When you compare the patients who had surgery compared to those who didn't have surgery, they both got a lot better. So it's really interesting to see that the nonoperative patients improved dramatically, as well as the operative patients, but the operative patients did a little bit better.

NORRIS: I understand, doctor, that you at one point had back problems, you suffered from back problems yourself. What did you decide to do about it?

Dr. WEINSTEIN: I tried to follow my own advice, and that is keep in action, keep in motion, that hurt doesn't mean harm, that despite having significant pain that you should try to work through that pain. I often think of the high-performance athletes, the basketball players who twist their ankle on the floor in a high college or professional game, who rarely stay out very much now. They sort of get back as fast as they can. They run on it. They may limp a while, but they actually heal faster by getting back to their normal activities as fast as possible.

So if you can in this very painful condition try to stay active and do what you normally do, most people do get better, and we have to realize that as a patient that odds are in my favor to get better rather than not.

NORRIS: You mentioned a phrase, there's no harm in the hurt. For people who are experiencing this extreme back pain, I imagine it's probably difficult to believe that, that they're not doing some sort of physical and long-standing damage to their body by going through this.

Dr. WEINSTEIN: Yes, you're exactly right. It seems totally contradictory, and what I actually say is hurt doesn't mean harm. So while you're in pain, and it's hurting you, to do more isn't going to be harmful to make that even worse, necessarily. My own wife had a herniated disk, and she looked at me. Boy, you're a back expert. You know, can't you help your wife? And I said yes, honey. I would like you to do what you normally do, go running. And of course -

NORRIS: I gather she didn't like that answer.

Dr. WEINSTEIN: Well, it was one of the tougher days in our marriage, but the fact was is that I helped her put a corset on, and she went running, and by the next day she felt almost totally better, and she'd had an MRI, she had a herniated disk, she was in severe pain. And you know, it's hard. When your own wife doesn't want to listen to you, how can I expect my patients to listen to me? But I really think this study shows that patients can get better. And surgery is not a bad procedure for those who can tolerate it.

NORRIS: So if someone's out there listening, and they're experiencing back pain right now, it sounds like your advice to them would be get out and go for a run or at least a brisk walk.

Dr. WEINSTEIN: Yes. I think you should try to do what you normally do every day. Try to avoid sitting more than 20 minutes at a time. Sitting puts a lot of pressure on the disk in the back, so it's better to be up frequently and moving around. But you know, the chances - remember the chances are in your favor.

NORRIS: Dr. Weinstein, thanks so much for talking to us.

Dr. WEINSTEIN: Have a nice day. Thank you.

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