Back surgery and back "cracking"

Science is always moving, and therefore healthcare must continue moving to keep up. As healthcare providers, its easy to get left behind. I see it all the time; physical therapists, doctors or chiropractors using out of date treatment and out of date science as explanation for their treatments.

For example, it is well established in the scientific community that the spine does not go "out of alignment". If this were the case, your spinal cord would be in real danger of getting damaged if you didn't see someone frequently to pop it back into place. Its fear-mongering and its creating a situation where patients feel dependent on their healthcare provider (PT or chiropractors alike), in order to feel better. I'm here to tell you that in MOST cases, neither your back nor your hips are out of alignment. Your body might be in pain or feel stuck, but its not because its out of alignment.

The body's nervous system can be extra sensitive in certain areas when it feels its been threatened. For example, if you lift something extra heavy and feel back pain later that evening, its likely because the muscles of the back were not strong enough to pick up that object, and your body is letting you know. If the pain persists, its likely because of the nervous system, not because your back is popped out and needs put back. Getting your back "cracked" can be helpful in reducing back pain but its because of how it affects your nerves (the mechanism is not well understood). Don't even get me started on back surgery (lumbar laminectomy), or what has been referred to as the modern day "lobotomy" because of the lack of evidence to support its benefits.

It is dangerous to rely on out of date medical knowledge and treatments because it puts real people in real harm. A fearful person is a hurting person.

To any healthcare providers reading: I do not mean to demonize orthopedic surgeons who perform lumbar laminectomies or chiros/PTs who perform spinal manipulations (as I perform these in the right context). But look at the evidence for what you're doing, especially as it continuously changes with time. Empower your patients rather than creating a dependent relationship, requiring them to return week after week, after year after year. Our job is to help people get out of the healthcare system, and the only way to do that is with proper patient education and guiding them toward a more healthy and happy lifestyle.

To any patients or non-healthcare providers reading: Pay close attention to what your healthcare provider is saying. Ask as many questions as it takes for you to properly understand what is going on with your body. I encourage you to take responsibility for your health, and put in the time and effort required to maintain a healthy lifestyle.

Please let me know if you have any questions!

Dr. Cameron Dennis, PT, DPT

IG: @scdennisdpt