Against the Grain with Dr. Chad Edwards | Back Pain Healing Tulsa| Podcast 10 – Part 4
When I was seeing a lot of my patients with this low back pain, I would look at the results and they would say, “You’ve got a herniated disc at the L4-L5 junction with …”
Dr. Edwards: Yeah, sorry. “… With minor or moderate or severe nerve root compression,” but yet on a physical exam they’ve got none of those findings. It’s something very different. Or it’s on the complete opposite side. That’s not the problem. They may have that, but that’s not why they hurt. I believe that’s one of the reasons that surgery for low back, in certain circumstances, has such a poor track record. I think that’s why low back pain in general can be very difficult to deal with, but yet with prolotherapy it’s very straight forward and we can help a lot of those patients.
Brian: Let’s just say this, let’s lay the options here. For me, if I have lower back pain and I’m looking at the options of surgery, which we’ve already said, most MRIs are [inaudible 00:18:53] by a surgery, so it’s MRI, surgery. You mess up on a surgery, it’s a surgery. There’s a risk of death during the surgery, there’s a risk of infection during the surgery, there’s lost time in recovery time, and let’s say it doesn’t work. That’s a pretty steep price to pay, right?
Dr. Edwards: No question.
Brian: Let’s say we do prolotherapy, which is a liquid injected into a spot, as simple as I can put it, that has a high rate of alleviating pain in certain situations in the joints and that nature. Even if it doesn’t work, there is not a high risk there.
Dr. Edwards: Right. The former surgeon general of the United States said, “The nice thing about prolotherapy, if properly done, is that it cannot do any harm.
Dr. Edwards: The lead physician in the country.
Brian: The problem is, and again, this is definitely against the grain …
Announcer: Against the grain.
Brian: That’s awesome. This is definitely against the grain, is the problem is that most people believe and most doctors believe you get an MRI, they are not conclusive, based on those findings, that are inconclusive, get yourself a surgery that may not work.
Dr. Edwards: I think you said that very well. I want to drive two more points home, talk about two more studies that address this issue. Article in the American Family Physician, AFP, 2012, on knee pain.
Brian: This is better than the Boos reference.
Dr. Edwards: You like that?
Brian: What doctor is going to bring a reference from Boos? It seems contrary to health.
Dr. Edwards: I don’t make up the name, Brian. It’s just …
Brian: Or what medical place is going to be named Boos?
Dr. Edwards: It’s just a scientific fact.
Brian: That’s right.
Speaker 5: And that is a scientific fact.
Brian: Good one, Chad, I like it.
Dr. Edwards: Hey, I’m trying.
Brian: Dr. Chad.
Dr. Edwards: Yeah, that was … Challenge accepted. I’m going to read this, straight from that article. “Several studies have shown MRI may identify signal changes that suggest a meniscal tear,” so talking about the knee, “When the meniscus is not actually torn. Other studies have shown that even when a meniscal tear is detected, it may not be related to the presenting problem or the presenting symptoms. Research suggests that a fairly high percentage of arthroscopic procedures may be performed based on abnormal MRI findings instead of clinical findings.” I think they summed that up very well.
Another, again, from that New York Times paper in 2011, they took pitchers, I don’t remember the number of them, but it says it in the paper. These pitchers, no injury, no pain, MRIs performed on all of them found shoulder cartilage abnormal in 90% of them and abnormal rotator cuff tendons in 87%. The quote from the orthopedic surgeon that wrote this report said, “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an MRI.”
Brian: Wow. This is what I love about this show. Who in their right mind would take on MRIs and surgery, but this guy, Dr. Chad Edwards?
Dr. Edwards: I just want to do the best I can for the patients, let them get educated. If surgery is the best course of therapy, then by all means, let’s do that, and you want to find the best orthopedic surgeon you can to do it. I’m not anti that therapy, but we just have such a low threshold for get an MRI and go get surgery and we’ve got to break that paradigm.
Brian: I think it’s interesting, I could Google it but I’m not going to, because we can just talk about it, as what I would think would be a matter of fact. If you look back through medicine in so many interesting things that were once thought true that now all of us would say obviously is not true. I remember reading articles about blood transfusions in the 1910s or ’20s, where they would literally either take out all of your blood, [sife 00:22:58] it directly back into you, or they would put leaches on you to try to cure you of diseases. What other weird things have we thought in medicine?
Dr. Edwards: Believe me … Well, not necessarily in medicine, but you mean like the world was flat?
Brian: Yeah, the world was flat, right, those kind of things. Medicine is one of those areas that it needs to be constantly challenged, even in areas like MRI and surgery.
Dr. Edwards: That’s right. One day we’ll talk about cholesterol.
Brian: Cholesterol is a good one, right?
Dr. Edwards: That is a really good one.
Brian: I think that one is really making some progress in mainstream because I think that people used to think, I have a cholesterol problem if I have a total cholesterol level of X, so now they’re finding that there’s a balance of cholesterol and it’s much broader than that.
Dr. Edwards: Right.