Should I have an operation on my herniated discs?

Dr. Lumbago,

Here’s my story. I hope you can tell me what I should do.

Last year, almost 14 months ago, I had an accident at work on a fork lift truck when another employee hit me with his fork lift truck that was going at a high rate of speed, and hit me from the side and I was thrown in the air from my seat 20 feet away onto the concrete and landed on my lower back. They sent me to the hospital where I was diagnosed with a minor L4/L5 disc herniation and a major L5/S1 disc herniation. I had unbelievable muscle spasms and leg pain from sciatic nerve pressure, but after a few weeks it eventually cooled down and now I can manage with only moderate pain if I don’t do much of anything. But the pain is always there and it is easy to aggravate like when just standing for more than a couple of minutes or sitting for less than a minute.

I started with the company doctor who is a joke, and later I was sent to an orthopedic specialist who is an even bigger joke. All the PT they did for my low back and herniated discs only aggravated my problem. Everything they were doing just killed me and I always felt worse after each visit.  After a few weeks of PT I started to get leg pain and numbness and now my right thigh is 1½ inch smaller around than the left.  Some days my leg feels like it is on fire. The company doctor was doing nothing for me but trying to dope me up so I would not feel pain, and even that was not working. I asked to go a really good chiropractor in my area, that my wife really got a lot of help from back and neck pain, but they said no. Instead I was sent to a low back orthopedic specialist. He just ordered a different kind of PT that did not help, so he increased my meds so I am dopey when I take them.

After 6 months of slowly getting worse I just went to the chiro on my own without the MDs permission and just paid for the care myself because I was crazy with pain. Within 3 or 4 sessions with the chiropractor I had less pain and I could stand longer without feeling like I was going to pass out. The relief was unbelievable, especially after all the drugs I took without getting any help and after being told nothing could help me but surgery. Man, I am believer.

Now my problem is that the orthopedic doctor insists I should have back surgery on my herniated disc problem even though I am getting better with the chiropractic adjustments. They say if I do not get the surgery they are going to cut off my benefits and demand that I go back to work. There is no way I can get back on that fork lift again with the way I am. I do not want surgery but I do not want to mess up my workers comp claim. What do you think? Should I have an operation on my herniated discs? Or should I go the chiropractor who is helping me and pay for the chiropractic treatments myself?

I hate to get the back surgery but I have a family and I have to keep my job and not build up bills when I am on workers comp. What do you think I should do?

Thanks for your help and advice.

John A.

Greetings John A.,

First of all, sorry to hear of your ongoing problem. You sound like many of the WC cases I handled over the years. People do not realize the poor way so many workers’ compensation cases are handled in this country. People are abused and given marginal care even with problems as significant as a herniated disc, and they are forced to receive care that is not helping them only because of the control and leverage the medical profession has on the process.

Second, I cannot tell you what to do. Sorry. I am not your treating doctor and I am not in a doctor/patient relationship with you. I would be a fool to tell you what to do about your healthcare without having the benefit of examining you, and you would be a bigger fool to do what I say for the same reason. All I can do is to give you ideas and suggestions that I want you to discuss with your treating doctor.

Third, I think you should talk to some people at work to find the names of a few hard-nosed attorneys in your area who handle worker’s compensation claims. It is my opinion, based on what you have told me in this email, that you are being pushed around and that your health care is not being conducted for your good but for the good of the doctor who is managing your case. This doctor wants to do surgery not for your good, but for his good. Find the attorney who seems to make the most sense to you, and do what he says. That is what I would tell you if you were my son.

Lastly, sit down with your medical doctor and briefly outline your case the way you have done here. Be brutally honest with the doctor and tell him again how you are not happy with the results of his care, how the chiropractor is helping you, and how “I do not want to risk low back surgery because you now know that other conservative treatment is documented to be helping me; if something went wrong with me after this surgery you are insisting I receive my attorney said that a big law suit would get started that would involve a lot of people. I do not want to get into any of that, and I doubt that you do, you know what I mean, doc? Do you think you could authorize just one month of care with the chiropractor? After that first month I will come back to you for a complete re-evaluation, is that OK? ”

When you present your situation to your current medical doctor in this way he will see that you are a serious person who might create a problem for him if he does not take better care of you. Do you get what I am saying? Explain the entire situation in this way and I would be surprised if he does not change his mind about letting you go see the chiropractor who is helping your lower back pain. Regardless, work with your doctor, then make up your own mind about what you want to do in your situation.

I think you have a right to the kind of healthcare that you choose to receive, meaning the chiropractic adjustments are related care for your disc herniation problem, especially since it is the only thing that is helping you. All surgery has risks, and there is very little risk in quality chiropractic care. Do not expose yourself to risk if there is a more conservative method of treatment that has proven to be effective for you.

Please keep me informed about how this goes for you, John A.     DL