Back and neck pain is one of the most common ailments that North siders, and all Americans, face due to injury, aging and normal wear and tear. It affects 8 of every 10 people and often becomes more prevalent and more intense as they age, according to the Department of Health and Human Services.
It should come as no surprise that the surgical treatments available for back pain are more advanced than ever before.
So why is it that The Chicago Back Institute at Swedish Covenant Hospital, Chicago’s newest back pain treatment practice — equipped with the latest surgical technology and a staff of internationally recognized neurological surgeons — views surgery as a last resort?
The answer is multi-faceted, but related to the larger issue of people being “over treated” for conditions that could be treated equally or more effectively using less aggressive or complementary measures, according to Dr. Daniel Laich, a neurological surgeon at the Chicago Back Institute.
In fact, a recent study released by the Journal of the American Medical Associates (JAMA) found that costlier, riskier and more complex spinal fusion surgeries are on the rise, despite less aggressive alternatives.
“Surgery is not the answer for most patients with back pain and it often comes with more complications,” Dr. Laich explained. “There are numerous, highly effective non-surgical treatments that should be fully explored before surgery. Our practice favors less aggressive, complementary and rehabilitation-focused treatments as appropriate.”
Conservative approaches and patient involvement
Less aggressive treatments — known as conservative options — encompass a variety of therapies and non-surgical procedures that address the patient’s needs, which are often to relieve pain, build strength and regain mobility.
Treatments employed by the Chicago Back Institute include nutrition counseling, osteopathic and chiropractic techniques, massage therapy, physical therapy, medical fitness, pain management and acupuncture.
Dr. Laich and his partners, Drs. Jerrel Boyer and Fred Geisler, share a policy and belief that treating back pain and injuries starts with appropriately matching a patient with a treatment which suits their situation.
“For each patient we consider their age, what is going on in that person’s life, what are their symptoms and if they have an active lifestyle,” Dr. Laich said. “Once those priorities are established, then the best treatment options are explained to the patient.”
This gives the patient the opportunity to carefully consider their options and have an active say in their own care.
Diane Bell of Yorkville, Ill., has experienced this first hand. The 47-year old human resources director collapsed with a herniated disk seven years ago. For six years, she saw chiropractors to treat her pain.
But in October 2009, her pain reached new heights, so she sought out Dr. Laich, and now commutes for an hour and a half to the Chicago Back Institute for her care.
“At my first appointment, Dr. Laich asked me what I wanted to achieve with treatment and put all the options out in front of me,” Diane said.
When the last resort is the best option
After exploring several different treatment options, including cortisone shots and physical therapy, Diane felt her pain was unbearable and ultimately decided with Dr. Laich that surgery was the best option. He explained to Diane that the least invasive surgical options which preserved the greatest amount of motion possible would be the best options to treat her pain.
Three weeks later, he performed a newly developed anterior procedure — which means he performed the surgery through her abdomen, rather than through her back — in order to keep her spine and supporting back muscles intact, while addressing the damaged disks.
The surgery was a success, and two weeks later Diane did something she hadn’t done in months — she took a walk around the block. Three month after surgery, Diane no longer wears a brace and is quickly recovering in physical therapy.
Dr. Laich explained that Diane’s case is an example of when it is truly appropriate to treat with surgery and his response to the trend towards “over-treating” patients by considering surgery too early in the treatment plan.
His approach requires a precise combination of a conservative treatment plan, patient involvement and surgical expertise, which is not easy to achieve — but one that has benefitted his patients throughout the past 19 years.
“We understand that no ‘silver bullet’ exists for back pain, which is why we take into consideration all treatment modalities and develop new techniques to further improve spine care and help people return to their desired lives,” Dr. Laich said. “Our end goal is to help patients regain stability while preserving as much natural motion as possible.”