November 21, 2006

Diane Sawyer discusses the epidemic of back pain in America on Good Morning America (GMA) with Dr. Marcus and interviews Sandy, a patient. Sandy had severe back pain radiating down his legs and had two spinal fusion surgeries that failed. Faced with persistent disabling pain, unable to walk for more than a half block, travel, or socialize, he was told that his only treatment options were a spinal cord stimulator or an implanted morphine pump.

His internist referred him for consultation and his examination revealed that two muscles in his low back and buttock were the source of his ongoing pain. Following treatment, his pain has been eliminated for 4 years allowing him to travel and to resume all of his usual activities.

80% of Americans will have back pain at some point in their life. Most physicians do not consider muscles as an important reason for back or neck pain, resulting in an overemphasis on the spine and the nerves exiting the spine as the source of the pain. This is what occurred with Sandy.

A young colleague of Dr. Marcus, Annette Stevens M.D. who had just finished her fellowship in Pain Medicine, was interested but skeptical of Marcus’ approach. She spent four months studying with him and was interviewed for GMA.

Pain fellows should be taught to evaluate and treat muscles as a source of pain prior to more aggressive, expensive, and potentially dangerous interventions. If muscles were always considered as a possible source of persistent neck or back pain, needless suffering and expense could be avoided.