Every year, nearly 2.5 million people go under the knife unnecessarily, often with devastating consequences. Make sure you're not one of them
Two years ago, when Leah Coppersmith went in for back surgery, she expected to be lacing up her running shoes within days. She's been in pain ever since.
A car accident in 1991 left this mother of four with nagging lower-back pain--annoying, but not bad enough to keep her from running 5-Ks. But in 2005, the nag grew to a scream.
An MRI revealed that two disks--the gel-filled cushions between the vertebrae--were badly worn. Coppersmith expected the doctor to recommend a diskectomy, in which part of a troublesome disk is removed to relieve pressure on the nerve; the low-risk surgery had helped her once before. But this time, the surgeon wanted to replace a disk with an artificial one. The procedure was getting great results, he said. Coppersmith was skeptical until he told her she'd be back running 5-Ks again in no time. She laughs bitterly at the memory.
Pain is now the defining feature of her life. She can't sit down to family dinners. She quit her job because she can't work at a desk. Her misery has company: While looking for help online, she found a study showing that 64% of people who received the disk, called the Charité, still needed narcotic painkillers 2 years after surgery.
Every year, upward of 15
million Americans go under the knife--and for most of them, surgery provides
relief or a new lease on life. Joints are replaced, organs are transplanted, lives are saved. But Congress has estimated that surgeons
perform 2.4 million unnecessary surgeries a year in the
"The majority of surgeons who perform these procedures are actually very enthusiastic about their benefits," says Mark Chassin, MD, chair of the department of health policy at Mount Sinai School of Medicine. "It's not like they get up in the morning and ask themselves, How many unnecessary procedures can I do today? But there's a lot of financial incentive to do surgery that may not benefit the patient, and very little oversight."
So how do you know when someone is suggesting surgery you don't need--and what can you do to prevent it? Your first line of defense is to become your own advocate. One study showed that when patients and doctors share the decision making, rates of surgery drop by as much as 44%. Here, we explain what's behind four of the procedures most often done unnecessarily and give you expert advice on the best alternatives.
BE SKEPTICAL: SPINAL SURGERY
The waiting room of Charles
Rosen, MD, a spinal surgeon and an associate professor of orthopedic surgery at
The spine is ground zero for
unnecessary surgeries partly because back pain is incredibly common and
notoriously tough to treat. More than 1 million sufferers opt for surgery each
year, and spinal fusion--the use of bone grafts, screws, and other devices to
secure one or more vertebrae--is one of the most popular choices. Between 1996
and 2001, the number of spinal fusions skyrocketed 113%, while the number of
knee- and hip-replacement surgeries rose just 15% and 13%, respectively. But
unlike those procedures, spinal surgeries often fail--instead of relieving pain, they can turn it into agony. According to Aaron
Filler, MD, PhD, director of the Peripheral Nerve Surgery Program, Institute
for Spinal Disorders, at
Pinpoint the pain: If your doctor labels your back pain as "nonspecific," it means he doesn't know the cause; if he suggests surgery, alarm bells should go off, says Filler. Spinal fusion is most beneficial when vertebrae slip out of place and press on the ones below, which is easily detected on an x-ray. "When properly done for the right reasons, spinal surgery can be extremely effective," says Filler.
Make lifestyle adjustments: A 2003 study compared spinal fusion surgery with a lifestyle approach to back pain: Docs taught patients how to protect their backs, by bending at the knees when lifting, for instance. They also encouraged exercise, like water aerobics. A year later, the nonsurgical approach reduced pain and increased mobility just as much as surgery did. Alternative treatments such as chiropractic and acupuncture can also pay off, studies show. For more info on finding alternative treatments, go to prevention.com/links.
Consider a helpful shot: A nerve-blocking injection called an epidural, given by a surgeon or a rehab specialist like a physiatrist, may quiet the pain for up to a year; it helps in about 50% of patients.
Skip the hardware: If surgery seems like the right approach, get the simplest procedure possible. There's a much smaller chance of complications if you have a diskectomy, for example, than if you have an artificial disk implanted.