If you're new here, you may want to subscribe to my RSS feed. Thanks for visiting!
How To Save Money And Recover Faster From Disc-Related Pain Pt.1
The above video is the first in a series that I recently produced that explains simple ways to save money and recover as quickly as possible from sciatica and disc-related back pain.
In this first part, I explain the cost savings that can be had from simply paying for your health care at the time of service (and then getting reimbursed by your health insurance after the fact, if you have insurance). While it is illegal in most cases for health care providers to give you a discount just because you don’t have insurance, it is legal for them to provide a discount in exchange for payment in full at the time of service - as long as that discount is available to everyone (including those who have insurance). In some cases, that discount can be pretty substantial.
Using the example in the video, a high-end service such as an MRI may be discounted as much as 50-75% when you arrange in advance to pay at the time of service. Even for someone who has insurance, this can make a difference of as much as a few hundred dollars in the copayment amount for that service (for example, a 20% copayment on a $1500 MRI would be $300, but a 20% copayment for the same MRI done in the exact same facility at the payment at time of service price of $500 would be only $100).
This cost-saving approach can be used with the vast majority of health care services, not just those involving sciatica and back pain. The important thing to remember is to negotiate your discounts by phone BEFORE you show up at the health care provider’s office. Why? Because if you are calling on the phone, they know you are shopping for the best price, and they are more likely to give you their best deal. If you show up to have the services done and then try to get a discount, they’ll be more resistant to discounting (the fact that you’ve shown up means you’ve already somewhat committed to getting the services done at that facility), and the amount of the discount they offer will probably be less.
For those who have insurance, they may be intimidated by the thought of trying to get reimbursed by their insurance company. In most cases, it’s actually pretty easy. First you need to make sure that you get a receipt from the health care provider with the diagnosis and procedure codes. Next, you can either obtain a claim form from your insurance company (many have them available online to download) and fill in the information on name, address, social security number, date of birth, and policy number where indicated or, you can simply write them a letter with all of that information and attach it to the receipt. Then you just mail it in and follow-up in a few days by phone to make sure they’ve received it. Once your insurance company receives the claim, they’ll usually pay it within 30 days.
Now, if you are on an HMO, this strategy may not be all that helpful, but it has been my experience that people on HMO’s often decide to go outside of their insurance and pay out of pocket to get things done because they get frustrated with the lack of results from the “bare-bones” care that often comes with HMO policies. So keep this technique in mind if you have an HMO, you aren’t getting results, and you need to consider other options.
In the next installment in this series, I’ll be discussing ways to work with your health care providers to get the most effective and efficient treatment to help you recover as quickly as possible.
If you’ve found this information helpful, I would very much appreciate it if you would leave a comment on YouTube about it.
The last few years, spinal decompression has been widely publicized as a breakthrough in spinal disc herniation treatment. But the treatment has received some negative reviews by skeptics and some promoters of the technique have been the subject of disciplinary actions by various regulatory agencies for certain advertising claims. So does spinal decompression offer new hope for disc pain sufferers, or is it just a hoax? Let’s begin by first discussing what spinal decompression is… Spinal decompression is a ”high-tech” form of spinal traction. Despite the great lengths that decompression system manufacturers go to in order to distinguish decompression from traction, decompression IS a type of traction. Traction has been used for many years in the treatment of herniated discs, but with minimal effects in many cases, and it even aggravated symptoms in some patients. The problem with regular traction is that it activates the body’s muscle guarding response and can trigger muscle spasm, which produces pain and may even result in increased pressure on herniated discs.
Spinal decompression systems have supposedly solved this problem of provoking muscle guarding. True spinal decompression systems pull very slowly and gradually in order to keep the muscles relaxed and avoid triggering spasm. In addition, the more advanced of the spinal decompression systems also have computer-controlled motors and have sensors to measure the body’s resistance to treatment. Any hint of muscle contraction sensed by the system causes it to reduce its pull and allow the body to relax again. The most advanced of these systems can respond to what the body is doing in an amazing 1/17th of a second. Since the body’s reactions take place in approximately 1/5th of a second, these advanced spinal decompression systems can supposedly modify treatment before the muscles can spasm, allowing for comfortable herniated disc relief. In my experience, advanced spinal decompression systems do in fact provide very comfortable treatment and avoid the muscle spasm responses in most patients.Â
This ability to avoid the body’s muscle spasm response allows spinal decompression systems to dramatically lower the pressure within a herniated disc. This has been shown in research studies that measured intradiscal pressure during decompression treatment. Prior studies on regular traction did show some reduction in disc pressure, but not nearly as much as has been demonstrated with spinal decompression. In fact, during spinal decompression, disc pressure is actually dropped into the negative pressure range, creating a suction that pulls the bulging disc material back towards the center of the disc and away from sensitive nerves. In addition, fluid and nutrients are pulled into the disc from the surrounding tissues, and this assists in disc healing. Over time and repeated treatments, the herniated disc material is pulled back in, and the healing of the disc provides stabilization of the outer wall of the disc to prevent further bulging.
The frequency and duration of spinal decompression treatment will vary depending on the age and condition of the patient, the severity of the herniated disc, and the number of herniated discs. Spinal decompression can be used in both the lumbar and cervical spine very effectively.
Statistically, spinal decompression with the more advanced machines, and with appropriate patient selection has a success rate in clinical studies of 80-90%, and of those who are successfully treated, the results hold up well long-term in most cases. In the real world, with real patients who have real lives and not everything is as controlled as it is in a research study, the actual success rate is somewhat lower. In my experience, the real-world success rate runs about 70 to 80% (with effects lasting one year or more), depending on the severity and complexity of the case. This is still very respectable in the realm of disc treatment, where the success rate of things like injections and disc surgery run about 50% overall. Given the success rate and the fact that the most common side-effect is some temporary post-treatment muscle soreness, spinal decompression is often the best option in herniated disc treatment.
Unfortunately, the aggressive advertising and hype, and inapproriate use of spinal decompression by some health care practitioners in recent years has led to unrealistic patient expectations and crackdowns by regulatory agencies on advertising claims that have sullied the reputation of spinal decompression. While spinal decompression does represent a major advance in the treatment of herniated discs, it is not a cure-all, it is not 100% effective, and it is not appropriate for every patient.
Spinal decompression, when used appropriately, does produce enough improvement and disc healing in the vast majority of cases to allow patients to resume normal lives and return to most activities (even playing golf or tennis and working in the yard), but it does not restore a herniated disc to 100% normal. No treatment can. Even the still-experimental disc replacement surgery does not restore the spine to a normal condition and future back problems following disc replacement are to be expected. Overwork, poor posture, or failure to use good bending and lifting techniques can set the stage for a recurrence of disc problems no matter how good the results of treatment are initially.
With appropriate patient selection and by giving patients realistic expectations, spinal decompression providers can supply a very safe and effective treatment option for those with a herniated disc.
Many people who visit doctors with the complaints of numbness, tingling, and sometimes weakness in one or both legs with or without low back pain are told that their symptoms are due to lumbar spinal stenosis, but oftentimes doctors don’t really explain what that means. At it’s most basic, spinal stenosis simply means that the tunnel that runs down the spine that the spinal cord goes through is narrower than normal at one or more points along the way. Although it is often used a a diagosis or an explanation of a person’s symptoms by many doctors, it doesn’t really tell you that much.
In fact, there’s more than one kind of spinal stenosis, and the treatment options and potential success of those treatment options varies greatly depending on the cause and severity of the stenosis.Â
First we must differentiate between congenital and acquired stenosis. Congenital means that you were born with a narrower spinal canal than most people. In my experience, congenital stenosis by itself rarely creates problems (as you might expect, the body adapts to things it’s born with). But if congenital stenosis is combined with any type of acquired stenosis, then it tends to make the situation more severe and more difficult to treat.
The term “acquired stenosis” means that the narrowing of the spinal canal is something that developed at some point over the course of your life. The term “acquired” in this context has always seemed strange to me because I tend to associate the word “acquired” with things someone has intentionally come into possession of by means of either great effort, great expense, or great risk. I visualize a stuffy guy in a tuxedo bragging to his friends, “I have managed to acquire an original Rembrandt painting, several bottles of Dom Perignon, and an incredible case of spinal stenosis!” But I digress…
 Acquired spinal stenosis is from one or a combination of a few causes. These include disc bulges/herniations, bone growth related to spinal joint degeneration, and space occupying lesions (tumors, cysts, scar tissue, etc.). Depending on the cause(s) and severity of the stenosis, there are different potential treatments.Â
For stenosis related to disc herniations, treatments such as physical therapy (rehabilitative exercise), chiropractic, spinal decompression therapy, and various surgical interventions are all potential treatment options. In addition, anti-inflammatory drugs and natural anti-inflammatories may be helpful in reducing pressure on the spinal cord by decreasing swelling. Decreased swelling can also be achieved through the use of epidural steroid injections (usually with the drug cortisone).Â
With stenosis related to excess bone growth due to spinal joint degeneration, there are still a number of treatment options, but the results of treatment tend to be less positive overall. Conservative measures such as exercise and chiropractic are effective for some people. Others get temporary relief from anti-inflammatories and/or steroid injections. For some though, surgery may be necessary to get any significantly lasting improvement. Again, depending on severity, different surgical approaches may be used. Some patients get good effects from “minimally invasive” surgeries done by trimming away excess bone using microsurgical tools inserted through small incisions and guided by an inserted viewscope. More severe cases may require more aggressive surgeries. In some cases, the condition is too advanced and/or the patient is too frail for surgery to be attempted, and so those patients can only be kept as comfortable as possible with temporary symptomatic treatments.
Finally, a small number of spinal stenosis cases are caused by space occupying lesions. Spinal tumors, both benign and malignant can grow into the spinal canal and compress the spinal cord. In most cases, these are best treated with surgical removal. Likewise, spinal cysts are usually surgically removed or drained. In the case of scar tissue, the most common source of scar tissue in the spinal canal is past spinal surgery. Because cutting out scar tissue typically results in even more scar tissue development in the future, surgical treatment tends to be avoided if at all possible. For those with scar tissue, stretching exercises and surface scar treatment with massage and perhaps natural or pharmaceutical scar softening agents may be used to try to improve the flexibility of the scar and to reduce it’s compressive effects in the spinal canal.
Although spinal stenosis can be debilitating and can be difficult to alleviate 100%, most people with spinal stenosis can be helped considerably with conservative (non-surgical) treatments. Before considering surgery, I recommend at least getting an opinion from a chiropractor and/or physical therapist as to non-surgical treatment options.
 
