Soft Tissue Problems

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A non-structural lesion is generally an injury to the soft tissues–muscles or ligaments supporting the spine. With the soft tissues, the source of the pain is not distinctly identifiable on a diagnostic test.

If the problem is NOT structural, then the only other possible source of the pain is an injury to the soft tissues around the spine. This is the most important distinction I make as an orthopedic surgeon. With non-structural issues, I do not recommend surgery under any circumstances.  I spend a significant percent of my practice not only telling my patients that they don’t need surgery, but also explaining why they don’t need it.  This is a critical part of my job.  It also clarifies the situation for the rehab doctors I work with, so the whole team can move forward.

If one of my patients needs to hear this message from someone else, I strongly encourage that he or she get a second opinion.  If I feel the second opinion is way off, I don’t hesitate to call the other surgeon and ask for clarification. If a case is controversial, I’ll also present it to colleagues for feedback. Remember that clarity of the problem is an important part of decreasing your anxiety.

In virtue of having lived in misery with pain for so long, you’ll be vulnerable to a surgeon walking into a room and saying, “I can take care of you with surgery.”  Additionally, surgery is viewed by almost everyone as a “definitive” solution. How can you turn that down? However, you may be undergoing an operation that is not only unnecessary but potentially damaging. It can negatively affect your quality of life, permanently.  Do not trust anyone, including me, to tell you what to do. Research your problem with a vengeance so that you fully understand your situation.