Do doctors reach for a scalpel too quickly for back pain?
The number of spine operations is increasing steadily. Other procedures, such as orthopedic pain therapy, physiotherapy or osteopathy, often help better with back pain than surgical interventions. The fact that doctors still resort to scalpels more and more could be due to the advanced diagnostic procedures and better remuneration.
Eight out of ten Germans suffer from spinal problems According to the AOK, the number of spine surgeries has doubled in recent years. "From a medical point of view, the increase in back operations to this extent to over 280,000 operations last year is not understandable," explains Professor Joachim Grifka, founding president of the German Society for Orthopedics and Orthopedic Surgery and director of the orthopedic clinic at the University of Regensburg.
In the meantime, eight out of ten Germans suffer from back pain that requires treatment. 25.8 percent of sick leave is due to pain in the spine. In total, back problems cause 50 million days off work and 18 percent of early retirement in Germany. According to experts, the main cause of back problems is a lack of movement and one-sided stress like sitting for long and constant periods in the workplace. The result is overloading and signs of wear. It is therefore not surprising that herniated discs are among the 20 most common diagnoses in medical practices.
Orthopedic pain therapy instead of spinal surgery Grifka is critical of the increase in spinal surgery: "Apart from acute paralysis or cross-sectional symptoms, advanced orthopedic pain therapy without surgery can help with back problems, even with massive pain," by means of targeted injections of the emerging ones Good treatment results could be achieved for nerves in the area of the small vertebral joints or directly into the vertebral canal. "The success rate of this minimally invasive treatment method is more than 80 percent, even with changes that would otherwise require surgery," reports the physician to the online reporting service "OBX Medical Direct". If an intervertebral disc surgery was nevertheless necessary, microscope procedures could be used that left no scarring.
"If you search, you find" is the old saying. The increase in operations could also be related to this. Because, according to the holder of the chair for orthopedics at the University of Regensburg, diagnostics has improved a lot in recent years. "Today it enables us to recognize early changes in back diseases early on. But that is both a blessing and a curse at the same time. An examination with a magnetic resonance imaging scanner often reveals, for example, changes in the back that are not the cause of existing back pain and therefore do not require surgery would have to be, "says Grifka. Only about 33 percent of the findings diagnosed with magnetic resonance imaging would actually have to be treated. All other findings would have little medical significance.
Rather, getting a second opinion before surgery The fact is that today the scalpel is used far too often and too quickly. Proven conservative methods could help the patient without invasive therapy. "In some disciplines, such as neurosurgery, the option of treatment without surgery is often no longer considered at all." The expert therefore advises patients not to leave the decision of an operation to the surgeon alone. It is better to get a second opinion and to discuss with the orthopedist the chances of an invasive, alternative or conservative treatment method. (sb)
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