333 Comments

I have an anecdotal support for your point: I had an event that resulted in intense lumbar pain and I was duly referred to a well-known specialist at a very large hospital. While waiting for the specialist to come into the examining room, I was able to overhear the employee at the front desk making phone calls. She made the same call over and over: “The MRI shows you have a stenosis, for which the only treatment is surgery.” I thought that was a little curious and filed that information away. Finally, the specialist came in and, after perfunctorily taking my “history”, recommended an MRI. I think even he felt a little awkward that he never even really looked at me, and so had me briefly pull up my shirt and point to where it hurt. Sure enough, a couple of days after the MRI, I got the “stenosis” phone call. My intuition told me not to go, and I didn’t.

The pain subsided and was manageable for a few years, but again I went to a (different) specialist who duly ordered another MRI, after which he informed me that I was not a candidate for surgery (his words were essentially that I could go to someone else and get surgery, but he was confident that I would come back to him to fix their mess) and suggested physical therapy. When he asked me what I did for pain, I told him OTC analgesics. He gave me a peculiar look and said “I can prescribe something stronger if you want”. I didn’t want, but got benefit from the physical therapy and have taught myself how to manage the problem, within the bounds of the underlying condition, through proper stretching.

Now, of course I have no idea whether the surgery would have helped or harmed (I suspect the second specialist may have been right), but I’m done with doctors, and will just live within the limitations of my minor disability.

Expand full comment

Thank you for sharing. This is a great comment to go with part 2. It's really sad how assembly lined the whole business model is. I'm pinning this one too.

Expand full comment

I herniated a disc which was very painful. Spine surgeon told me I would be far better off with physical therapy and massage than surgery. Grateful for his advice. I followed his advice and added acupuncture and eventually resistance training with a trainer/physical therapist to strengthen my muscles. I have had no pain for years now.

Expand full comment

I've never had a surgeon tell me I'd be better off without him!!!!

Expand full comment

Well this one did! Most unusual I am sure.

Expand full comment

Beautiful testimony.

Expand full comment

You made the right choice NEVER to have the surgery. It would not have helped you. I had two uncles who dies from bad back surgeries. That’s all they know because therapy and exercise is cheap and they don’t make money on it.

Expand full comment

I am very sorry for the deaths in your family. People still die under anesthesia from any and every type of surgery. 🤗 ❤️

My opinion agrees with A Midwestern Doctor and I feel everyone should avoid surgery unless and until every other option has been ruled out. At least this way, if anything bad happens, you could say you tried everything else to avoid it.

Expand full comment

I had a similar diagnosis but I had the surgery. It is a horror story; The surgery went bad. The fusion device got lodged in my abdomen somehow and hhad to have abdominal surgery the next day to rmove it but the ennd result was paralyization of my left foot from the middle of my calf down to including my toes. Then a following nerve test revealed a pinched nerve followed by another surgery to release the nerve which did absolutely nothing to give motion to my foot. Ended up in rehab with PT for 2 months which resulted in me learning how to walk with a dead leg. That was in 2015. I have pain in my back still but I take no meds except a ibuprofin in very rare instances where I may have irritated the nerves or muscles. I

too am done with the medical profession. I turn down my primary care doctor';s offer of pain

meds. I have learned to accept the pain and move on. I will never have surgery again on anything. I just live with the pain but I do not have the use of my left leg and foot so I am somewhat disabled for life. I cannot do my housework or garden and can only walk short distances because my back seems to give out on me. I am glad you didn't have the surgery.

meds

Expand full comment

I, like you am DONE with doctors and this so called healthcare cabal! It is corrupt and like our government and schools, cannot be fixed but needs dismantled and rebuilt, with God at the helm!!!

Expand full comment

I had a similar experience. The doctor would not have me take an x-ray, but insisted I get an MRI, which it turns out I had to wait days in excruciating pain to get it, and it was his friend's new MRI business. Then he told me he couldn't see anything on the MRI and did an x-ray, and said you must be in a lot of pain and sent me to a pain specialist for a herniated disc. (In fairness, I think a lot of doctors see people who are angling for drugs, but that was also to help his friend's new business, IMO.)

The pain specialist gave me an injection, which really helped, and a prescription for massive amounts of pain killer. I hated the pain killer, and after several days, stopped using it, though I would take a half pill occasionally if the pain got too bad to sleep. She recommended physical therapy which allowed me to avoid surgery and an Ab Lounger keeps my core strong.

Expand full comment

I'd like to see more about efficacy rates of "pain specialists." I think they came about with the "opioid crisis," so that GP's can pass the buck. I require small amounts of codeine (something like 1-2 tablets a week, tops) for breakthrough pain, but no GP will touch even that - and constantly want to refer me to pain specialists (the algorithm tells them to). I looked through the list I was given of pain specialists - one loves the implants (where you gonna implant for fibromyalgia?), another loves burning the nerves (again, which nerve?) and the others were equally invasive.

I do have a specialist GP who does trigger point lidocaine (like Midwestern Doc suggests), simple physio (Finch method) and prolotherapy. But he's not a "clinic" and so my GP doesn't always agree with me going to him. But it does get her off my back about "pain specialists."

But the business of "pain specialists" seems like an important topic to explore.

NOTE TO MIDWESTERN DOC: I've since learned of an excellent physiotherapy for the neck, called "Watson Method." It's almost like osteopathic, in that you gently rotate the vertebrae into alignment. It's an American method, but I'm fortunate to have several practitioners here in Australia.

Expand full comment

I often check this site for issues because they keep up to date and cite their references. If you haven't heard of them, this link is for fibromyalgia: https://www.lifeextension.com/protocols/immune-connective-joint/fibromyalgia

Expand full comment

Yar, these people would give me antidepressants for fibro. No sir, thank you.

Expand full comment

Yes. I call it fibromyalgia (no official dx) because that communicates what it *feels* like.

However, I'm pretty certain that it's related to 30 years of psych drugs & those surgeries didn't help, either.

Working on it! It would help to have doctors' cooperation, but now I'm dreaming.

Expand full comment

As always, reading your substack gives me valuable information and teaches me so much.

Thank you for your insight and for sharing so openly with us.

My son is autistic and it is from Tylenol. I hope one day that something might be done to help him and all others who were injured by this drug. I struggle with bitterness every day of my life about what happened to him and I worry about who will care for him after I'm gone. I hate even looking at Tylenol and I avoid it like the plague.

Expand full comment

I'm sorry that happened to you. I am going to pin this comment because a lot of people don't believe me when I say that this happens.

I also want to note that the tylenol doesn't "cause" it. Rather, the tylenol makes it more likely the vaccine will cause autism.

Expand full comment

Americans have an extraordinary talent for industrializing things, including things that they shouldn’t, such as education and medicine.

I have this feeling that the disease that “medicine” has become is going to come to an end, in no small part thanks the efforts of the few like you who are helping illuminate the path out of the madness. Thank you very much for what you do. I think all of your readers appreciate your well-reasoned insights.

Expand full comment

Do you think it is reversible? GAPS diet/gut healing?

Expand full comment

I’ve read that alpha lipoic acid has helped with liver damage from Tylenol. I have no idea if it can help here, but maybe worth a look. Life Extension has a product super r-lipoic which is supposed to be better absorbed.

Expand full comment

A single Tylenol can also result in the need for a liver transplant... Perhaps that's why it over-the-counter...

Expand full comment

IMO I believe Physical Therapy is the best solution! They are highly trained to bring symmetry back to maintain spinal alignment and normal muscle tone!

Expand full comment

I heal my back with yoga and Pilates combination. In one year it was 90% better. “Week core” is what the yoga instructor told me I had.

Expand full comment

I'm sure it is, but I still need to see that. My wife was literally wrecked by a physical therapist after a neck injury in two car accidents (drunk drivers ran into her on two occasions at a traffic light). It took her years to recover from the "treatment" with a good chiropractor's help. My hip injury (MRI showed nothing) was made exponentially worse at first, and made no difference later (I think, the cartilage shattered), and it took me about 10 years to recover. If these were the best things to do, I wish these "medical" specialists hadn't done a thing...

Expand full comment

I think you meant to write you CAN'T "undo" surgery, right? Sorry to be a grammar Nazi. I'm an editor. But boy are you right. I made the terrible decision to have back surgery on l4, l5, s1 (partial discectomy) when I was 23 in 1998 and my life has been a series of unending pain since then. Shortly after the surgery I noticed my spine was curving away from the original source of the sciatic pain, that my sacrum and pelvis were twisting inadvertently, and that all sorts of other muscular and tendon pain were showing up in other parts of the body (shoulder, legs, face, bladder, etc.). Once your spine is messed with in this way all sorts of other things go by the wayside too. Of course I didn't always make the right choices in terms of dealing with this kind of pain and self-medicated with booze and other stuff for years. The spine and sacrum should be thought of as sacred, no pun intended. The ease with which unscrupulous surgeons convinced me I needed to be operated, and my subsequent distrust of them no doubt played a role in my questioning the Covid narrative, though. Perhaps I can be facetiously "grateful" to them for that. Thank you for this post. It is invaluable.

Expand full comment

Thank you for catching that; fixed.

Expand full comment

No problem. Thank you again for your post.

Expand full comment

Go to a surgeon and they'll want to cut. Go to a physical therapist and they'll manipulate the soft stuff. Go to an acupuncturist & they'll poke you. Go to a chiropractor and they'll jump on you & crack your bones. Go to a pain specialist and they'll prescribe you the good stuff, and/or give you epidural injections Go to your GP and they'll send you for an MRI & refer you to one of the above. It's a game of roulette. I've played it many times due to spinal & foraminal stenosis, bulging discs, dessicated discs, bone spurs, sciatica, inflammatory arthritis, and impinged nerves to my bowels & bladder. What worked? Not surgery because I refused it until they get better at it. I walk, use an inversion table, a TENS unit, exercise in a pool, and take NSAIDS, pain meds, physical therapy & muscle relaxers & have had several epidurals. The worst thing to do is nothing, as in lay around.

Although I do get temporary relief from the above, the problem remains because it's a mechanical issue that my body just can't seem to resolve on its own. I fear surgery to fuse L4, L5, S1 will just add insult to injury. But I'm about at the end of my rope.

Expand full comment

Combo of adjustments, exercises, stretching and strengthening, foam roller, hot/cold will help. In particular, the lower crossed syndrome whereby the psoas major muscle is perceived by the brain as contracting when we sit, leads to lumbar paraspinal muscle and hamstring tightness, weakness of the gluteal and stomach muscles. Psoas stretching is a huge miss by most. Also, foot arches drop as we age which has a direct input biomechanically and neurologically into the pelvis and therefore psoas muscle. Semi- rigid orthotics can be a miracle for some. Best!👍❤️

Expand full comment

Orthotics are a crutch too. That was recommended to me but instead I started wearing zero drop, wide toe box shoes (and barefood) and over time my feet have spread out to the natural triangle shape they were meant to be and that helps the biomechanics.

Expand full comment

While it's easy for me, living in Australia where a beach is never more than 20 mins away - sand-walking fixes most orthotic problems. Grass walking is an acceptable (if pale) substitute.

Believe me, I notice this because I'm teaching tai chi to an elderly population - and they want to keep their orthotics on. How are they supposed to feel their feet?

I groan every time they go to the podiatrist and spend $$$$ on new inserts. The inserts here aren't any good either (I've tried them, a life of orthotics, and these are just fluffy foam things). They're so proud of their new shoes & inserts, I'm supposed to be happy for them, but I'm not. How are they gonna feel their feet? I'm supposed to *prevent* falls - and if they can't feel their feet, they're gonna fall.

Another prescription (specifically for plantar fasciitis, but would be good for anyone) is a long, 3" diameter copper pipe. Walk along that pipe like a balance beam, hanging your arches in different directions, forwards and backwards.

Big fan of "barefoot" shoes here, when I have to wear them!

Expand full comment

I understand your point and your position. You don’t mention why orthotics were prescribed and the biomechanics involved? The biomechanics involving excessive foot pronation due to the tissue creep causing elongation of the ligaments of the arch leads to the classic old man posture. The head forward position, shoulders forward, hyperkyphotic thoracic spine, lumbopelvic instability and sacroiliac instability is stabilized by orthotics limiting that overpronation. Adding specific exercises to stretch the psoas and hamstring muscles, strengthen the core abdominal and gluteals, and working cervical spine extension and posterior glide, shoulder retraction and pectoral stretching combines a true global body postural change taking into account global body biomechanics. The arches are 100% a primary driver and consideration whose importance can’t be stressed enough.

Expand full comment

I actually have super high arches and the orthotics were prescribed when I was quite young because the balls of my feet hurt all the time. They said something about my second toes being longer than my first, so the weight wasn't spread out among the toes and instead was all on the big toe joint. And they thought high arches should be supported instead of allowing them to do their job of flexing. This was a while ago, and maybe whomever I saw they didn't really have a clue about biomechanics. I do know from being tested for running shoes that my pronation was perfect. Not over or under. On the other hand, I have scoliosis.

Expand full comment

We’ll, I should have read this comment before posting mine…

Expand full comment

Great minds think alike!!👍

Expand full comment

My buddy’s retort to that is: Two minds too small for two thoughts. 😁

Expand full comment

Brent, has anyone suggested your hip flexors? Psoas major etc.?

Expand full comment

The compartmentalization of "Medicine" even during training makes sure no "doctor" would be able to see the whole picture. It's a military-grade psy-op, forced on patients as well:

https://rayhorvaththesource.substack.com/p/medical-expert-is-an-oxymoron

Expand full comment

This reminds me of the recent interview Tucker Carlson did with two highly trained professionals (brother and sister)- one a surgeon (forgot the other, but he worked for Big Pharma). They gave a two hour interview exposing the psy-op and they both resigned their positions because they no longer wanted to contribute to the harm being done to people. It's a money making racket meant to keep people sick and profit from it.

Expand full comment

This is why I’ve always been impressed with Dr. Lonnie Hermann in Florida. He started out as a chiropractor and then started learning a dozen other disciplines of medicine and he sees medicine from the point of view of a multidisciplinary approach. He’s fascinating and he is healed people or other doctors were utterly baffled. It is a blessing to have a doctor that has continued his education such that he sees the big picture. Interestingly enough many of the problems start in root canal as it is the only medical procedure that leaves a dead part of the body in the body. And it leaks. There are microtubules throughout your teeth and all dead bacteria and more pathogenic species of bacteria have access to the bloodstream in your gums and travel elsewhere in your body causing all kinds of havoc. He often has patients get their root canals removed and many of their symptoms alleviate. But that’s not all and there are many other more complicated issues he treats.

https://drlonnieherman.com/

I don’t get any kickbacks for mentioning his name I’m just in awe of the way he practices medicine and wish they were more doctors like him. He truly understands from a multifaceted approach.

Expand full comment

The delivery systems and the types of toxins, parasites, and pathogens, along with various sources of radiation, have become so complex that healing has become a heroic enterprise:

https://rayhorvaththesource.substack.com/p/is-healing-a-myth-altogether

Dental Lidocaine contained graphene oxide already in 2021 (and the flu "vaccine" in 2019)...

Your link is also advertised on the MSM, which is strange at best, for several reasons...

"Medical" diagnostics as sophisticated as it is, is still a failure:

https://rayhorvaththesource.substack.com/p/a-few-typical-medical-diagnoses

Many illnesses are simply invented to cover-up common poisonings:

https://rayhorvaththesource.substack.com/p/something-must-give-when-everything

A new medical paradigm is urgently needed:

https://rayhorvaththesource.substack.com/p/what-makes-people-sick-apart-from

Expand full comment

Ha! Your comment wasn't yet up when I asked the same thing. Corroboration! I'm really sad you've had to deal with such a hard lesson, re: surgery; I'm happy you became a skeptic! There is likely so much more pain and misery ahead for so many.

Expand full comment

Very similar story Gibraltar. And like you I have this strange “gratefulness” that I now have distrust for most medical narratives.

Expand full comment

I heal my back with a combination of Chiropractry, Acupuncture, physical therapy, massage with lineaments and hot tub and the only medicines that I use are turmeric with ginger and Boswelia, Ice packs and heating pads.

Never trusted medical doctors with my spine. All the want to do is cut on you and drug you up. The spine needs adjustments just like the body needs bathing. It doesn’t last forever. So I get monthly adjustments. Been doing that since I was 9 years old. Im in my 50’s now. My Dad did the same and it never failed him.

Expand full comment

You can bypass the need for those adjustments if you can do something on your own (eg tai chi) to move the center of the spine.

Expand full comment

While I benefitted from 46 years of yoga - it wasn't until the tai chi and qigong that I was able to open up the joints at will.

I believe that the yoga focuses on stretching the muscles, while the tai chi focuses on opening the joints (which then, releases the muscles).

Expand full comment

That's funny; it looks like when I did yoga as a young man (which taught me to take control over vegetative symptoms), I did it as if I had been doing tai chi: using the fewest possible muscles with the least possible effort.

Expand full comment

The specificity of your adjustment to the hypomobile vertebral segment resets the various malfunctioning proprioceptors (nerves) beyond what general exercises can do and allows reflexive muscle relaxation. This then allow exercises to bring restorative blood to the area that was walled off by the muscle hypertonicity. General exercise, tai chi, etc used in combo have far better outcomes according to well designed studies. Keep up your routine and yes add tai chi and see if it takes you to a better level.

Expand full comment

The major problem, as far as I can see, has been ignored for decades. It's chairs without lumbar support, and sitting too much. Of course, there can be several other causes, but the damages caused by this would be relatively easy to prevent.

Expand full comment

I absolutely love all of your incredibly informative articles! This week, in particular, I couldn't help but wonder how in the world you are able to put out so many highly researched articles.

This one was great, but I noticed that there was only one or two sentences that mentioned "adjustment", but didn't mention that that's what chiropractors do. I'm amazed at how many people I know that have no idea what a chiropractor does or what an adjustment is.

I would always try the least invasive treatment first and then move on to other options if necessary. Not to mention that, as you articulated, pain meds usually won't fix the underlying cause of the pain.

Thank you so much for all of your hard work. You are helping so many people!

Expand full comment

Thank you.

Expand full comment

I will never forget when my Ivy League orthopedic surgeon found out I had read Dr.Sarno’s book (found on my own). He unironically said, “Well you won’t need to see me much anymore.” And he was right! He had studied under Sarno but continued to practice his profession without encouraging patients to read the works of Sarno. Through Sarno’s explanation and a shift in my perspective, I was able to overcome carpel tunnel syndrome. I agree with you that his suggestions for Freudian therapy are antiquated but his explanation of the pain dynamic in Type A personalities alone did it for me.

Expand full comment

That's wonderful. It's also sad your surgeon didn't share that with people :(

Expand full comment

I’m happy to say that a orthopedic surgeon suggested that I try following the changes and exercises in “Treat Your Own Neck” by Robin McKenzie. That book kept me living my slightly risk-taking dare devil lifestyle without pain until I hurt my back. Fortunately, Robin had written “Treat Your Own Back” in the meantime. That book and a temporary back brace kept me off drugs once again. The Bible and the two books by Robin McKenzie have been the most important books in my life. They taught me there is a healthy solution to every problem we may face.

Expand full comment

That is one way of utilizing the flexion extension principle.

Expand full comment

Twenty years ago it was suggested I should get back surgery for my bulging disc. Then I started taking pilates and yoga classes, I invested in a good tempurpedic mattress, and also started taking anti-inflammatory herbs and supplements. Back pain gone in 2 months.

Expand full comment

My hope is that people in a similar situation to you will read this article.

Expand full comment

This is relevant to my aching interests........

Expand full comment

Very insightful. Having gone thru a herniated disc i changed many things that I found out caused it. My yoga practice was extremely helpful and so was the loss of 67 useless pounds.

Thank you so much.

Expand full comment

Thank you too.

Expand full comment

Great article covering many drugs commonly used and no relief gained. I took Nabumatone for several years for severe scoliosis. Now I only take a Tylenol if extreme pain from yard work. My scoliosis causes painful muscle tightness and nothing helps. I use a massager for minimal help but just have learned to live with it. Walking seems to help since sitting too long aggregates it. This article was extremely informative. Thanks.

Expand full comment

Thank you. At some point I will write a post about scoliosis on here.

Expand full comment

I will look forward to that. Thank you! From this article I’m interested in the lidocaine injection as a possible treatment if I could find the right doctor trained in this.

Expand full comment

I have scoliosis too. I believe I need a lift in my right shoe as my left leg is longer.

What sort of doctor does one consult for procuring a shoe lift.

Podiatrists are not reliable.

Expand full comment

My chiropractor took xrays of my spine as we tried different size lifts on my shorter leg. FWIW having a cobbler build up the whole shoe bottom toe to heel (3/8" in my case) has been much better for me than just a lift that's inserted.

Expand full comment

Try an orthopedic doctor for proper measurements. Some shoe stores specialize in fitting.

Expand full comment

Thank you for this thorough post on spine pain. In my 26 year neurosurgery solo practice, the nonsurgical pain was the most challenging to help. It is humbling for a surgeon to know spine surgery can’t fix everything. Since discovering BEMER powered muscle stimulator, I am now able to share a modality which is able to support self healing and discomfort recovery. I wish I had known about BEMER before retiring from my career. Now, I am dedicated to sharing this technology which has improved quality of life for over a million users for the past 25 years. https://daria-schooler.bemergroup.com

Expand full comment

Thank you too. I would love to get your thoughts on this part and the next part.

I have a bemer mat and sometimes find it's quite helpful for opening the microcirculation.

Expand full comment

In a previous article on Zeta Potential you said you didn't like them because the polarity can make cancer better or worse depending on direction, and they don't tell the direction. Can you clarify your position on this?

Expand full comment

I remember seeing Andrew Saul in a documentary film saying: "If you go to a Chinese restaurant looking for Italian food you are not going to find it. It is just not on the menu" So if you go to a surgeon there is only one thing on the menu. You have to be responsible for your own healthcare and get 2nd, 3rd and maybe even a 10th "second opinion".

Expand full comment

That is a great metaphor.

Expand full comment

I have seldom used any drugs to treat neck and back pain. Several times I have been unable to move very much with these troubles. But I have always had very good success using a chiropractor. I have never seen a regular doctor for this type of pain. I can't imagine ever doing so.

Expand full comment

Honors graduate of NY Chiropractic College in 1987 and worked as a full-time clinician in a solo practice and did a one year stint in a MD/DC/PT/Acupuncture multicare facility as the lead physician. I had upwards of 300,000 clinical encounters during this time. It was clear in the multicare clinic that some chronics had better outcomes following the addition of active exercises to their spinal adjustments aka spinal manipulative therapy (SMT). This was verified in a well done study published in 2003 or so that was very clear that a regimen of SMT plus active exercises resulted in a synergistic effect of 1 plus 1 equals 3 with regard to improved function and pain using Oswestry scales. Nothing else came close to that combo. I’ve personally seen and experienced the benefits of massage, manual trigger point therapy, and acupuncture added along with stretching for muscle pain relief as having benefits. Without the restoration of normal spinal biomechainics to restore mobility, the muscular system addressed through the above additions, the neuro system will continue to fire abnormally causing pain and disability. Surgery is only in consideration for patients with severe, intractable pain not relieved by conservative care, progressive muscle, weakening due to cord, or spinal nerve compression, or cauda equina syndrome with the loss of bowel or bladder function. Medication use should be reserved for short term situations while the other treatment modalities I’ve mentioned are being utilized.

Expand full comment

I agree, you often have to have the patient participate in the process and avoid recreating the sedentary behaviors which established the issue in the first place.

Expand full comment

Early active restoration of mobility using movement and exercises is indicated always once red flags are ruled out through examination, x-ray, CT and MRI as indicated. Passive manual adjustments to restore neurological integrity and restoration of vertebral mobility very specifically is always indicated. The data is very clear on this. To try meds only constitutes malpractice given the data.

Expand full comment