There Is A Proper Way To Do This...
It is important to understand that a great majority of back problems resolve spontaneously, even apparently severe ones. This lingering truth hangs over the head of all practitioners who care for back problems. We find ourselves effective at relieving short-term symptoms, but we know that improvement will ultimately occur in a great majority of cases. This poses a dilemma for surgical decisions, for the institution of new treatments, and the prescription of treatment where expense or inconvenience is involved.
Years of understanding and a great deal of experience goes into every decision that is made. Decisions "to do" or "to not do" something requires equal amounts of judgment.
Patients may take the decision "to not do something" for granted. However, it should be understood by the patient that these decisions are just as important and significant to the patient as decisions to proceed are. Patients will sometimes say "try anything." We cannot do this either. The decision must still hinge on safety and efficacy.
The proper way, in general terms, to treat a patient with a low back problem follows a series of questions:
1. Can the doctor safely determine what the problem is within a reasonable degree of medical certainty?
2. Is intervention necessary or will the patient's condition improve on his or her own?
3. If the patient will ultimately get better on his or her own, can the degree of pain be lessened in a predictable way by specific treatments or medications?
4. If surgery is necessary, how is the technique optimized to minimize problems and complications, and maximize recovery?
5. Is there a fall back position? Are options left open?
Dr. Stark goes through these questions in his mind with each patient. If you do not understand the thinking process, please ask Dr. Stark. Our office feels it is important for you to understand your care.