Book Review: Watch Your Back!

{Through the everlasting grace that is the internet, my humble self was gifted with a youthful edition, or pre-edition, of this tome, through which I am now, as requested, passing such impressions as it has made on me to you, Noble Reader.}

I don’t know whether to classify this book by Richard A. Deyo, MD as self-help or medical research or exposé or what. As he puts it, “If you have pernicious anemia, there’s one treatment: vitamin B12. If you have thyroid deficiency, there’s one treatment: thyroid hormone replacement. . . but for back pain there’s more than 200 different options.” This leads to a lot of politics and even bribery, in the form of kickbacks to doctors, by companies wanting to get an edge on their competitors, or simply make a few more bucks.

One of the most excellent points he makes is how MRI scans are so advanced they can see so many anomalies, but they might not have anything to do with the actual problem. As he writes, the tests “show anatomy, but not pain.”

There’s stories about lawsuits and executives going to jail. One doctor consulted a neurosurgeon for his own back pain, who insisted he needed the same surgery I had, oddly enough, though the guy had no research on the operation, or even data on his own patients’ results. The doctor declined the surgery and recovered over the next two months. Another note, from an obviously more honest neurosurgeon, stated that when she was asked for second opinions, “61% of the recommended operations were unnecessary, and another 33% were the wrong operation. The ‘wrong’ procedures were typically more expensive than necessary.” As another doctor notes, “If you’re willing to get another opinion to remodel your bathroom, shouldn’t you do the same for your spine?”

So what to do about your back pain? Here’s he’s more vague. At one point he quotes: “The choice may be ruling over the disease or being ruled by it.” Another one: “You can’t wait for a doctor to bestow a medical silver bullet on you; there are no easy cures.” and like a book I read many years ago, he also claims stress can be a cause. So what’s his solution? Something I’ve never heard of, and something that I doubt will be very popular, since he admits, “it takes time and requires work, whereas most people want to be cured now.”

But as a book, informative and to the point, it’s excellent.



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