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Generally, when patients have failed everything other than surgery, it’s time to talk about surgery. And usually I approach it by getting to know them on their initial visits where we’re treating them conservatively and early on laying down the treatment pathway, in case they don’t get better from more conservative treatment.

I’m not sure it’s quite that simple. I do think muscle problems do cause a lot of back problems, but there’s so many other things that come into play.

There are degenerative changes. There’s acute or chronic mild trauma or severe trauma, and it can manifest in so many different ways, whether it’s back pain, sciatica. So there’s a lot more than just this muscle or that muscle doing too much or too little

Ironically, great spine care involves doing everything you can to avoid having to operate on the patient. So it generally, in most cases, involves an incremental approach, starting with the most conservative and least invasive treatment, such as physical therapy or chiropractic, and then progressing to injections as needed.

And then, of course, ultimately surgical intervention, which is typically treatment of last resort.

I think that video held some good advice. You wanna avoid too much flexion, tilting forward at the low back. Don’t go excessive on the swing, as that twisting can really cause problems with the, with the low back. And warm up first. Maintain good core conditioning.

Medicine is a service industry just like any other. So I want patients to feel satisfied with their visit the same way they may feel satisfied if they go to a restaurant or hotel. I don’t want anybody to feel like they were rushed or shortchanged, and I want them to feel like their, their time was respected and all their questions were answered.