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Just a month after back surgery, Nancy Scatena was once again in excruciating pain. The medications her doctor prescribed barely took the edge off the unrelenting back aches and searing jolts down her left leg. The pain just kept intensifying, says the 52-year-old Scottsdale, Ariz., woman who suffers from spinal stenosis, a narrowing of the chanel through which spinal nerves pass. I was suicidal. Return to Neurological Variants of celiac disease

Finally, Scatena made an appointment with another surgeon, one whom friends had called a miracle worker. The new doctor assured her that this second operation would fix everything, and in the pain-free weeks following an operation to fuse two of her vertebrae it seemed that he was right. But then the pain came roaring back.

Experts estimate that nearly 600,000 Americans opt for back operations each year. But for many like Scatena, surgery is just an empty promise, say pain management experts and some surgeons.

A new study in the journal Spine shows that in many cases surgery can even backfire, leaving patients in more pain.

Researchers reviewed records from 1,450 patients in the Ohio Bureau of Workers' Compensation database who had diagnoses of disc degeneration, disc herniation or radiculopathy, a nerve condition that causes tingling and weakness of the limbs. Half of the patients had surgery to fuse two or more vertebrae in hopes of curing low back pain. The other half had no surgery, even though they had comparable diagnoses.

After two years, just 26 percent of those who had surgery returned to work. That's compared to 67 percent of patients who didn't have surgery. In what might be the most troubling study finding, researchers determined that there was a 41 percent increase in the use of painkillers, specifically opiates, in those who had surgery.

The study provides clear evidence that for many patients, fusion surgeries designed to alleviate pain from degenerating discs don't work, says thestudy's lead author Dr. Trang Nguyen, a researcher at the University of Cincinnati College of Medicine.  

Unfortunately, for most patients with bad backs, there is no easy solution, no magic bullet. Pain management experts - and some surgeons -say that patients need to scale back their expectations. With the right treatments, pain can be eased, but a complete cure is unlikely.

In the wake of her operations, Scatena has turned to less invasive therapies. She's learned to baby her back and to find ways to avoid irritating the nerves in her spine. She's working to strengthen muscles in her lower back and abdomen so her spine will get better support. I've been getting some relief from physical therapy, she says. And I hope that's going to be permanent.

27 million adults with back problems
A recent report by the Agency for Healthcare Research and Quality, a federal organization, found that in 2007, 27 million adults reported back problems with $30.3 billion spent on treatments to ease the pain. While some of that money is spent on physical therapy, pain management, chiropractor visits, and other non invasive therapies, a big chunk pays for spine surgery.

Complicated spine surgeries that involve fusing two or more vertebrae are on the rise. In just 15 years, there was an eight-fold jump in this type of operation, according to a study published in Spine in July. That has some surgeons and public health experts concerned.

For some patients, there is a legitimate need for spine surgery and fusion, says Dr. Charles Burton, medical director for The Center for Restorative Spine Surgery in St. Paul, Minn. But the concern is that it's gotten way beyond what is reasonable or necessary. There are some areas of the country where the rate of spine surgery is three or four times the national average.

By Linda Carroll

Majority of  back surgery can be avoided if you considerMyofacial pain

Back pain can be autoimmune including disc inflammation please read the e-book for details.

 More back surgery is done in the United States then any other Country in the World. In a study of Medicare claims

the highest number of back surgeries were done in Pueblo Colorado  ( 1980-1996). Patient's had multiple back surgeries sometimes upto eight procedures in a single patient.

it was concluded that the rate of surgeries in a particular region had to do more with the number of orthopedic surgeon, rather then the pathology in the spine.

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