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Dr. Carri Dominick, PT, CSCS

Back Pain and How I Saved My Patient Nearly $50k!


This blog is based on a talk I gave to a business group I am a part of and it was so well liked that I thought I should share it with more people.

Pain is the most common ailment in America.

pain in america

80% of people will experience low back pain in their lifetime. Back pain can be treated well by physical therapists.

Doctors will most likely have you get an x-ray and MRI if you complain of back pain to them because they don’t know how to fix your back pain. MRI’s can be misleading though.

MRI misleading

I have a lot of patients who come to see me telling me about their “L5 disc bulge” or something similar. The reality is that most people are going to have abnormal findings on their MRI and maybe it is just a normal part of aging. It isn’t necessarily the cause of their pain.

If the MRI shows a disc bulge what does that mean for you as the patient? Do you want surgery to correct this? Research shows surgery doesn’t have the better outcome and it can be quite costly. We all know that health insurance in America today does not pay for 100% of anything. Copays and deductibles are quite high.

back pain surgery

cost of orthopedic surgeries

A spine surgery could cost up to $50,000! Even with insurance the copay could be costly for this procedure. Physical therapy, or any form of non-surgical treatment would be a better option. Not only are the costs high but there are risks with any surgery.

exercise reduces back pain

Exercise is as effective in the long term as surgery for back pain. If exercising on your own seems overwhelming physical therapy is a great place to start. A physical therapist can help guide your exercises and your exercise progression, as well as help reduce the pain and give advice on how to prevent the pain from returning.

Here is how I saved my patient nearly $50, 000.

He is a nurse at a local hospital. We will call him Bill. (All identifying info has been changed in accordance with HIPAA laws). Bill had a sudden onset of “sciatica” one day with pain starting from his back and running down the back of his leg. Bill was friends with a lot of the doctors at the hospital, so he got an MRI right away because he was afraid he had a herniated disc. His MRI revealed he in fact had a herniated disc, so he showed the results to the back surgeon who recommended he schedule surgery right away. The symptoms and MRI results matched, according to the way the spine surgeon sees things.

Luckily Bill asked another doctor friend who suggested Bill try physical therapy first, and that is when I met Bill. When I talked to Bill about his pain and his job and what else he likes to do with his time I learned he was a nurse, he liked to lift weights at the gym every day and he played softball a few times a week. Bill was mid-40’s and very fit. When we talked a little more about his gym and softball routine I learned Bill had the mentality of a 20-year-old, which I find very common. He never warmed up or stretched before or after his workouts and softball games. When I examined Bill I found his hamstrings were very tight and reproduced the pain in the back of his leg. I gave Bill homework of stretching his hamstrings every day. When he came back to PT the next visit he said he felt better and his pain was gone since he had been stretching every day. That is pretty much all Bill needed was to stretch his hamstrings and warm up before his softball games. His pain was coming from his tight hamstrings, not his herniated disc! He continued to come to PT for awhile because he was scared his pain would return, but as long as he kept up his stretching routine the pain never returned. A few physical therapy visits does not cost much compared to a $50,000 surgery and that is how I saved my patient a large sum of money!

If you have back pain, or sciatica pain, and think you need surgery please come see me or another physical therapist first. With a thorough evaluation and plan we can save you from surgery and ongoing pain that is limiting you from doing the things you love. Again a few physical therapy visits does not cost much compared to having surgery as well as not having any downtime to have to recover from surgery. Surgery will require time off work to have the procedure and recover depending on your job. Physical therapy takes about an hour for an appointment and no missed days of work. Comment below if you have any questions.

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