When the DOC project began to evolve in 1999 it was my feeling that if there was a structural problem that it first needed to be dealt with surgically and then we could move ahead with the rest of the protocols. I define a structural problem as one that can be identified … Read More
Mainstream medicine is frequently not offering you effective care. Many procedures performed for spinal problems have been documented to be ineffective. Much of the problem stems from the corporatization of medicine where the interventions that have been proven to be effective, such as ACT (acceptance commitment therapy) (1), mindfulness-based stress … Read More
I received this email from a physical therapist on the East Coast, who I’ve never met. He’d heard about my work on a podcast. Before you read this letter, I’d like to emphasize that research has documented for decades that arthritis, bone spurs, disc degeneration, disc bulges and herniations are … Read More
“Prehab” is refers to a patient engaging in a rehabilitation process before surgery. There are well-documented factors that affect pain and surgical outcomes. It’s important to implement treatments to address all of them prior to undergoing a procedure with significant risks. Chronic pain infiltrates every aspect of life. You have … Read More
Deciding whether to undergo spine surgery is one of the most important choices you will ever make. Currently, failed spine surgery is so common there is even a separate diagnosis for it – “Failed Back Surgery Syndrome.” You do not want to become one of these people, as it usually … Read More
A seventy-three-year-old woman—let’s call her Dorothy for the sake of this story—was understandably apprehensive. She had just been told that she needed an eight-level spine fusion from her tenth thoracic vertebra to her pelvis, so she came to me for a second opinion. Dorothy was a retired National Guard armed … Read More
Ernie presented to me a few years ago with severe back and leg pain. He had undergone two spine fusions for LBP about 10 years earlier that had not been helpful. His three lowest vertebra had been fused from L4 to the sacrum. Additionally, he now had severe leg pain … Read More
Mike is a local physical therapist who is a friend of mine. He has been interested in the DOC project and, like me, has struggled with severe chronic pain. I have been helping him work through different strategies to pull out of it and he is slowly coming out of … Read More
Patients and physicians are frequently making illogical decisions regarding spine surgery. I have watched this phenomenon steadily worsen for over 30 years. One of the core problems is that there is little accountability. You would expect your surgeon to do everything he or she could do to optimize your chances … Read More
When I published the first edition of my book, Back in Control: A Spine Surgeon’s Surgeon’s Roadmap Out of Chronic Pain in 2012, I was still of the mind set that if the correct pathology could be identified as the source of the pain, surgery was the best option and the sooner the better. Then … Read More