The Medical Approach to Back Pain is a Killer

I don't take any joy in writing this article.  It actually makes me pretty angry.  I recently wrote an article about why your medical doctor should not be your first choice for dealing with back pain.  It mostly dealt with the lack of training most MDs have dealing with back pain and musculoskeletal conditions in general.  Unfortunately, now I have to add another reason to steer clear of your MD for these types of problems: it's dangerous.

You may have heard about the recent debacle involving Epidural Steroid Injections (ESIs).  This is a procedure where cortisone, a synthetic antiinflammatory drug, is injected into the space around the spinal cord to ease low back and sciatic pain.  The only problem is that the procedure has recently proven to be deadly as well.  The Center for Disease Control (CDC) estimates that 13,000 people in 23 states may potentially be at risk for contracting a fungal strain of spinal meningitis.  As of this writing there have been 214 cases in 15 states and 15 deaths from these infections. 

The ironic thing about this is that ESIs are medicine's version of a "conservative" intervention for low back pain.  The rhetoric coming from the medical profession is that this is an unfortunate but rare incident.  But this isn't the first time devestating results have been linked to this treatment.  According to a 2007 issue of the journal Spine a survey of physicians revealed that there were 78 reports of complications related to ESI in the neck.  These included 30 strokes and 13 deaths. 

This isn't even a necessary or very effective procedure.  It provides short term benefits and in most cases does not resolve the cause of the back or neck complaint.  Cortisone damages connective tissues such as tendons and ligaments, a fact well known by physicians.  For this reason responsible physicians won't do more that about three cortisone injections to the same joint.  Studies that show ESI as an effective technique typically combine the procedure with rehabilitation which would lead you to believe that it was actually the rehab that had long term benefits, not the injection.

So how often is this risky, invasive procedure with temporary benefits and acknowledged deadly risks performed?  Only 8.9 million times per year!  Why $o many time$ $ince it i$ ri$ky and not $uper effective?  Nobody know$ unfortunately. 

Now… Imagine if Chiropractors killed 15 people this year or on average 6 per year like these injections are.  People would be outside of Chiropractic clinics around the country with pitchforks and torches.  They would call for immediate reform or even the elimination of the profession.  Why don't we hold medicine to the same standard?  It may be because of the firm grip they have over the media.  Doctors are constantly portrayed as saviors in white coats and never villans in black hats.  Or maybe it's just because we are used to it.  Medicine is afterall one of the leading causes of death in America.  30,000 deaths from unnecessary procedures like ESI occur every year.  16,500 people die every year from use of over-the-counter drugs like Advil, Aleve, and Ibuprofen.  Over 100,000 die every year from "properly" prescribed drugs.  We have been trained to overlook the fact that medicine kills more Americans every year than terrorists, drunk driving and drugs combined.  We have launched wars on terrorism, a war on drugs and drunk driving but for some reason we seem very comfortable and forgiving when medicine kills people.

I'm always amused at the audacity of medical doctors who try to tell patients they shouldn't get a Chiropractic adjustment.  A series of articles by Kevin B. Friedman, MD exposed that 82% of orthopedic residents (doctors who had graduated from medical school and practiced for a few years) couldn't pass a basic musculoskeletal medicine exam designed by several department chairs of hospital-based orthopedic residency programs.  The test was repeated 4 years later and 78% failed.  Of Chiropractic student in their final quarter of training who were given the exact same test 70% passed.  So who do you trust when it comes to your back pain?

We need to start holding medicine accountable for the death toll.  These are unnecessary, totally preventable deaths.  We can't afford to keep writing them a pass.  How can we do this?  Stop making Medicine your first stop for problems like back and neck pain.  When your MD tells you that you don't need Chiropractic, or Chiropractic doesn't work, or Chiropractic is dangerous, or your problem is too serious for a Chiropractor to manage recognize this simple fact: They aren't qualified to make those judgements.  We aren't Medicine's kid brother.  I don't have to ask their permission to do my job.  I'm better trained and more qualified to make decisions on the management of musculoskeletal conditions.  Looking at Medical education versus Chiropractic education no reasonable person would dispute that.  Chiropractic is safe and proven as a potent treatment for neck and back conditions.  The reality is that when it comes to musculoskeletal conditions Medicine should be considered the "alternative".


This Post Has 3 Comments

  1. Bonnie Sanders

    I am in your corner and have been for my entire life. I have had more help for anything I am having problems with from a chiropractor than ever from medical person. Thanks for posting your opinion.

  2. Sara Davis

    With all due respect, it would be valuable to your readers to elaborate on the difference between allopathic and osteopathic medical education. My husband is an osteopathic orthopedic surgeon specializing in total joint replacement and revisions. He also practices general orthopedics. He has extensive knowledge of musculoskeletal issues. He knows when patients require non-surgical treatment and refers them to other trusted osteopathic physicians who specialize in and provide excellent musculoskeletal manual treatment. The fact that he can recognize and diagnose patients who can benefit from OMT is amazing and we credit his preceptors for teaching him how to properly care for those who come into his office. My family personally has benefited from the therapies available from those who are trained and gifted in OMT. It is also my understanding that chiropractic philosophies have their root in the teachings of A. T. Still, the founder of osteopathic medicine. The history of this type of medicine is rich and has much to offer as an alternative to medication, as it predates the pharmaceutical industry by about a century! I understand your frustration with the statistics and recent events. I believe that the differentiation should be made between allopathic MDs and osteopathic DOs who took time to learn from those talented OMT preceptors in their respective DO schools. Musculoskeletal medicine is a major component of their holistic approach to wellness and their emphasis on using the hands and mind to achieve an accurate diagnosis is an advantage that osteopathic physicians can gain at any osteopathic medical institution. I and my entire family have been blessed by several amazing OMT physicians over the past 2 decades. I would be disabled without the gifted hands of my husband and my other OMT physician who has been practicing OMT exclusively for 20 years. Thanks for hearing me and my opinion!

  3. Jason Young, DC

    You’re right that DOs are different than MDs. One thing that is sad about DOs is that more and more of them are not practicing OMT. I don’t like how the AMA is trying to consume that profession. They want total control over a homogenized health care system. Your husband sounds like the exception and I think that’s fantastic.

    The problem is that Osteopaths need to do more to differentiate themselves. The average healthcare consumer has no concept of what an Osteopath is. They don’t know that it is synonymous with a DO. They all assume that their surgeons and general practitioners are MDs.

    Thanks for calling attention to the distinction!

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