Recent Research Questions the Effectiveness of Back Surgery

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An estimated 38 to 50 billion dollars is spent yearly for the surgical treatment of lower back pain in the United States. While this is commonly accepted as the price to pay for this debilitating condition, Chiropractor and Naturopath Dr. J G Moellendorf examines two recent research studies and a neurosurgical university's health policy questioning surgery's effectiveness and cost.

Why would we spend billions of dollars yearly on spinal surgery that has no better results than conservative therapies, while having increased disability rates and higher dissatisfaction with results?

Many victims of chronic low back pain turn to surgery when the muscle relaxers, anti-inflammatories, and pain killers fail. Considering the recent research, Sturgeon Bay, Wisconsin Chiropractor and Naturopath Dr. J G Moellendorf, DC, ND, LCP questions whether less costly alternatives to very expensive spinal surgeries might be a better solution.

A research team led by Dr. Benjamin J Keeney looked at workers compensation injuries in the state of Washington to determine if it could predict which work injuries would result in back surgeries. Their results were published in the May 15, 2013 issue of the journal Spine titled Early Predictors of Lumbar Spine Surgery After Occupational Back Injury: Results From a Prospective Study of Workers in Washington State. Out of 1,885 injured workers, 174 (9.2%) had low back surgery within 3 years of injury. The researchers discovered that if an injured worker was first seen by a surgeon, 42.7% would result in surgery, while if first seen by a Chiropractor, only 1.5% had surgery. The rate of an expensive surgery was reduced by 96.5%, just by the choice of the first doctor consulted.

Dr. Anne Froholdt’s research group at the Oslo (Norway) University Hospital followed chronic low back pain patients across a nine year period. Participants were randomly assigned to two groups. The first group had lumbar spinal fusion, while the second received cognitive training on doing daily activities without worrying about further injury, along with endurance and coordination exercises. Publishing their results in the December 2012 issue of the European Spine Journal, they found that during the nine years studied, of those who had spinal surgeries, one-third were operated on again. Of those in the non-surgery group, one-third opted to have surgery done. There were no notable differences in daily rated pain intensity, fear-avoidance beliefs, spinal muscle strength, and use of medication between the two groups. Both groups reported significantly less back and leg pain, less fear-avoidance beliefs, less emotional distress, and improved general function. Sixty-eight percent of those having surgery were out of work, while only forty-two percent of the non-surgery group were not working. Forty-four percent of the lumbar fusion group used medications for pain compared to seventeen percent in those who did not have surgery. Seventeen percent of those having surgery were dissatisfied with their results compared to only three percent among those who did not have surgery.

Dr. J G Moellendorf, DC, ND, LCP asks, “Why would we spend billions of dollars yearly on spinal surgery that has no better results than conservative therapies, while having increased disability rates and higher dissatisfaction with results?”

Realizing the high failure rate and heavy costs of back surgery, the University of Pittsburgh Medical Center (UPMC) health plan analyzed recent research for treating chronic low back pain. On January 1, 2012, UPMC implemented a comprehensive clinical initiative focused on the treatment of chronic low back pain. All lower back surgeries other than surgical emergencies require prior determination for surgical necessity. The policy states:

“To be considered for surgery, patients with chronic low back pain must have:

  •     Tried and failed a 3-month course of conservative management, which includes physical therapy, chiropractic therapy, and medication.
  •     Completed UPMC Health Plan’s Low Back Pain Health Coaching Program.”

“This policy was developed using evidence-based literature and professional society guidelines, as well as the input of external medical professionals with expertise in the area”

Chiropractic care often successfully treats lower back pain when other methods fail because it focuses on realigning the spine while increasing movement through normal joint function. This reduces tensions on the muscles and ligaments while reducing the nerve irritation and inflammation that leads to pain.

Through Chiropractic care, many extremely satisfied patients have successfully conquered their chronic back pain. They have regained their quality of life by returning to their favorite sports, enjoying their hobbies, and other aspects of their lives that they had previously given up because of their back pain.

Using the latest research findings, Moellendorf Chiropractic Office, Ltd. uses a comprehensive package of Chiropractic care, decompression traction therapy, active therapeutic movement training, cold laser therapy, and nutrition for the natural treatment of chronic spinal pain. Additional information about Chiropractic, Naturopathy, and other forms of natural health care is provided by Moellendorf Chiropractic Office, Ltd. at

About: Dr. J G Moellendorf, DC, ND, LCP

Dr. J G Moellendorf, DC, ND, LCP attended the University of Wisconsin—Superior where he majored in Physics and Mathematics, with a minor in art photography. While attending the University of Minnesota—Minneapolis, he assisted in research on ribosomal proteins. Completing his Chiropractic studies at Palmer College of Chiropractic in Davenport, Iowa, he graduated Cum Laude (with high honors) in 1983. He started Moellendorf Chiropractic Office, Ltd. in Sturgeon Bay, Wisconsin in 1983. In 1996, Dr. Moellendorf was awarded his Doctorate in Naturopathy from Trinity School of Natural Health. In 2001, he received Chiropractic’s most prestigious award, the honorary Legion of Chiropractic Philosophers degree, for his thesis “The Workings of Innate Intelligence in Obsessive/Compulsive and Addictive Behaviors.” This paper was chosen for publishing in the book Philosophic Contemplations vol. 2 in 2002. In June of 2012, Dr. Moellendorf authored his first book titled Healthcare’s Best Kept Secret which can be ordered on Amazon. Dr. Moellendorf can be contacted by phone (920) 493-2126, fax (920) 743-1145, email jgmoellendorf(at)itol(dot)com, his website at, or send a carrier pigeon to 44.84722N and 87.36416W.

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