NBA Coach Steve Kerr: Bad Advice on Back Pain
http://www.acsh.org/news/2017/05/16/nba-coach-steve-kerr-bad-advice-back-pain-11287
Tuesday night marks the seventh straight NBA playoff game that Steve Kerr will miss due to debilitating back pain. It’s been more than three weeks since the head coach of the Golden State Warriors said he had to leave the team because of the intense discomfort, and to seek additional treatment.
Despite this being the most important time for his team, Kerr is not expected to return to the Warriors bench this season, even if his juggernaut advances to the NBA Finals in June, as expected. That’s how uncertain his situation is.
The lean and trim 51-year-old, whose undergone two failed back surgeries, cannot even manage sitting or standing – or a combination of both – in order to coach and travel to games, which is why Kerr stepped aside.
But during his announcement last month about his specific physical condition, he included some ill-advised medical advice for those in situations similar to his own.
“I’m not going to go into details on the symptoms. It’s just discomfort and pain and it’s no fun,” Kerr said on April 23. “And I can tell you if you’re listening out there, if you have a back problem, stay away from surgery. I can say that from the bottom of my heart. Rehab, rehab, rehab. Don’t let anybody get in there.”
Considering the amount of pain he’s experienced since first going under the knife in 2015 to repair a ruptured disk – also called a herniated or slipped disk – it’s understandable why Kerr said what he did. How
ever, given his celebrity status and high visibility, he should have never offered medical advice of any kind, especially because every back problem is different, and no one approach is appropriate for every patient.
“We really don’t understand the spine very well, particularly the mechanics of the back. We apply a mechanical solution to what’s not necessary a mechanical problem, given that there are nerves and muscles involved,” says Charles Dinerstein, M.D., a Senior Medical Fellow at the American Council and retired vascular surgeon. “That said, while Kerr may have felt let down after two operations with no sustained relief, he should not have directed others with chronic back pain to stay away from surgery.”
The Wall Street Journal reported this week that “[r]esearch has shown the procedure is more successful than nonsurgical treatment for patients whose pain has persisted for several months,” and according to “Hyun Bae, a professor of orthopedic surgery at Cedars-Sinai Medical Center in Los Angeles, ‘When you look at the data, it clearly shows the patients who had surgery had a faster and more reliable recovery.’ “
Yet as many a back specialist will tell you, locating the source of back pain can be a very difficult thing to do. And even if it’s located, coming up with a plan to treat it – and overcoming it – can be just as difficult, if not impossible. Unless it’s under rare circumstances, even back surgeons won’t recommend back surgery from the start, since it’s often not the best approach – and the last option.
“While sufferers are often desperate, and they are experiencing neuropathic pain,” adds Dr. Dinerstein, “in general it is almost never the first choice.”
For those who have experienced a herniated disk and the pain “has not resolved within a few weeks, your doctor may suggest physical therapy. Physical therapists can show you positions and exercises designed to minimize the pain,” according to the Mayo Clinic. Medications – including muscle relaxers and cortisone injections – WHICH THE FDA DOESN’T RECOMMEND… can also be prescribed.
For Kerr, with enough time passed after recuperating from his first surgery, he began working out daily and incorporating yoga into his regimen to battle headaches, to help keep the pain at bay – which worked for awhile. But then he was afflicted by a rare complication from the original surgery: leaking spinal fluid, also called a cerebrospinal fluid leak, from a dural tear. That condition was addressed in his second operation in October 2015, but his awful pain has returned.
It’s this complication that makes Kerr’s situation even more unique, given that the cerebrospinal fluid leak occurs in roughly 1 in 20 disk operations. Just more reason for Kerr to have avoided telling the public to run from back surgeons.
Filed under: General Problems
Expanding from Mary’s comment, I think two essential statistics are missing from the discussion so far. We really can’t know if the Coach’s advice is constructive or not without addressing these numbers.
1. What percentage of laminectomies are successful in greatly moderating or eliminating back pain?
2. In what percentage of patients are cortisone shots in or near the spine associated with later development of chronic arachnoiditis, an inflammation of the myelin layer around the spinal chord?
I would be very interested in papers from the medical literature which address these questions.
I would never recommend a back surgery to anyone!!No-one I have ever met in waiting rooms EVER stated their back surgery made it better,,ever!!My lamectomy to remove 1 of 4 spinal cord tumors,,1 was a tumor due to its large size,,thee other 3 are conscider cyst’s…The large tumor was from T-2 thru T-10,,,exactly where a pancreas when enlarged will push against..Thus since pancreatitis and gallstones were never looked for ,,my thoracic surgery NEVER HEALED TILL THIS DAY,, I endured 5 years of spinal headaches..however,,since they never did a mri after my surgery,,did not see 3 more cyst causing spinal pressure to appear normal,when doing a spinal tap,,Finally mayo did another mri ,,it showed 3 more cyst at the lower part of my spine,,NOT DETECTED w/out contrast..My bandages for 2 weeks after surgery were soaked with spinal fluid..To this day…I use my back for more the 1 hour,, of labor,, or use a any kind of device,lawnmower,,chainsaw,thee vibrations causes swelling on my thoracic muscles/spine,EVERY SINGLE MUSCLE ATTACHED,to thee thoracic,WILL SWELL AND BRUISE from thee inside out,,,EVERYDAY,,Permanent busted blood vessel and this blue hue surround thee entire thoracic spine,,,If I could I’d attach a picture,,,,we have 90 of them to ,”prove harm,”,,,MY BACK IS DESTROYED,,,, NEVER EVER AGREE TO A BACK SURGERY EVER!!