Alternative Treatments For Neck And Back Pain

For more than twenty-five years, I have personally represented thousands of people who have been injured due to motor vehicle accidents and other causes, and have seen a variety of types of medical care and treatment available to accident victims. Some types of treatment you may be familiar with, but today there are many new alternative procedures, particularly with respect to neck and back injuries that are worth noting.

Often times the injuries from a serious accident are severe and immediate, and result in fractures of bones which require operations involving the implementation of plates, rods, screws or other surgical hardware. Other times, badly herniated discs in one’s spine necessitate major neck or back surgery such as a laminectomy, discectomy and spinal fusion. In the most extreme instances, an individual’s injuries can cause paralysis or death.

Yet many people who have been involved in an auto accident have significant injuries that affect every aspect of their life, but are reluctant to have surgery, especially spinal surgery. Instead they rely on what we call ‘conservative care,’ such as physical therapy, massage therapy, or chiropractic. However, they often reach a point where their treatment, while initially quite helpful, causes little improvement in their pain.

In the past, when patients did not want to opt for spinal surgery and were no longer improving with conservative care, doctors would rely on pain medications for pain management. Of course, the current opioid epidemic has demonstrated that reliance on prescription pain medications can have disastrous consequences, as today more Americans die from drug overdoses than from auto accidents.

There are some promising alternative medical procedures for neck and back injuries. Increasingly popular are various minimally invasive surgeries as a substitute to traditional spinal surgery (i.e. laminectomy, discectomy, and/or fusion). One type of surgery is sometimes referred to as “robotic spine surgery” or “robotic-assisted surgery.” These robotic-assisted procedures provide surgeons with a precision tool that makes the same small incision as a conventional laparoscopy which are usually an inch or less in size. In fact, you may even have seen television commercials or news articles advertising this aspect of the procedure.

Instead of cutting through muscle, special instruments are used to separate the muscle and keep it intact while removing the disc or bone that is compressing a nerve in the spinal cord. Consequently, there is a considerably shorter recovery time and the procedure can often be done on an outpatient basis. Nevertheless, unlike traditional spinal surgery, these robotic assisted procedures are relatively new so there are fewer long-term follow up studies on post-surgical patients to determine their effectiveness.

Another alternative to traditional spinal surgery is "endoscopic spine surgery," which utilizes an endoscope, a small illuminated optical tubular instrument used to look deep into the body. Endoscopic surgery can also be performed to many other areas of the body besides the spine and is well-established. With respect to the spine, the endoscope allows the surgeon to make a very small incision to access the herniated disc. Muscle and tissue are dilated rather than being cut when accessing the disc. As with other minimally invasive procedures such as robotic assisted surgery, endoscopic spine surgery may not be effective if the spinal injuries involve several discs, or if a larger incision is required.

Another alternative to traditional spine surgery is a “facet rhizotomy” which takes a different approach by attempting to shut off pain signals that are sent to the brain. Using a local anesthetic and x-ray guidance, a needle with an electrode at the tip is placed alongside the small nerves to the facet joint. The electrode is then heated, with a technology called radiofrequency, to deaden these nerves that carry pain signals to the brain. This can be beneficial as sometimes the pain a patient is experiencing is not necessarily related to a problem with a disc in their spine. The facet rhizotomy procedure involves very little down time, and it is almost always done on an outpatient basis. However, there is always a chance that the nerve can regenerate and the symptoms may return.

Of course, the purpose of this short article is only to introduce a few alternatives to traditional spinal surgery or prescription pain medications when conservative care is no longer helpful. Yet as any experienced attorney knows, it is our job to practice law and not medicine. In the end, all medical decisions need to be made by the patient and their doctor. Nevertheless, as a lawyer who has represented accident victims for nearly three decades, it is important to keep up with the latest medical advances so that we can be of greater service to our clients.


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