Degenerative disc disease & pain management

I traveled 6 hours to hear a lecture by Dr. Roland Hazard, hoping for some answers for my myriad of spinal issues. (his new book is available). I think his focus is lumbar spine not cervical spine issues. He had just conducted a survey of docs at the spine conference and I was very interested in hearing his thoughts and the results.
The gist , and he backed it up with all the bells and whistles, is there is no good evidence that anything works including NSAIDs, injections, surgery. That doesn't mean things won't work for some....sometimes mostly for a while and of course if there is a loss of function that's another story in terms of surgery but his message is figure out your most important goals and what you need to do to try reach them. He also believes AI will change everything for spinal pain patients. He thinks in the near future we will know the best treatment for each individual patient based on analysis and most importantly evidence. I don't think he had "THE ANSWER" but that's really his message. You can find him on youtube, his book on Amazon or his presentation at the spine conference on Google Scholar....

I did read that as well as this book. https://www.cathrynjakobsonramin.com/books/crooked/overview

I also read The McGill method and actually followed up with a practitioner.
https://www.backfitpro.com/books/back-mechanic-the-mcgill-method-to-fix-back-pain/
I regularly look at the current research on Google Scholar.

Ultimately it appears that a lot of the decision making around treatment for spinal issues is based on beliefs not evidence.

Hopefully, Dr. Hazard is correct and AI will provide a better construct for decision making. I wonder if Mayo is doing any research in this area.

@kdks99 My understanding of artificial intelligence is that is looks at statistics of outcomes. For example, I'm typing here, and it can suggest grammar changes and correct spellings based on how language has been used and recorded, but I don't think AI and the computer has any critical thinking ability. I do think that in decision making, we have to try to understand what will happen in the future, and our best understanding on if surgery can improve upon that future. Success of surgery also depends a lot on patient overall health and age, and their motivation for a good recovery. Surgeons do have preferred methods of operating and favorite implants to use, so you can find differing opinions if you consult several. There are just different ways to approach a problem, and some may be a better solution for some patients and not others. In some instances, no surgery is the best choice for the patient.

I think surgical decisions are based on evidence of the findings in imaging and testing, but ultimately, the patient decides to proceed or not with surgery. Those are difficult decisions when you don't know everything that can be known about what you'll go through, and the surgeon most likely doesn't have personal experience in being a patient with the surgery he is recommending. The surgeon needs to educate and recommend what is best for the patient as an expert opinion. For the most part, spine surgery is considered elective unless there is a catastrophic injury that requires immediate action to preserve live or avoid paralysis.

I have compressed lumbar and had treatment for it which did not work. dr ordered ct and insurance co said to do a nerve block. the block worked but for a short time. Now the dr was supposed to do a RFA but ins com. wanted another block. I wish the ins co would mind their own business and stay out of mine. My back is killing me and i told the ins co I need the rfa to get rid of the pain.

@kdks99 My understanding of artificial intelligence is that is looks at statistics of outcomes. For example, I'm typing here, and it can suggest grammar changes and correct spellings based on how language has been used and recorded, but I don't think AI and the computer has any critical thinking ability. I do think that in decision making, we have to try to understand what will happen in the future, and our best understanding on if surgery can improve upon that future. Success of surgery also depends a lot on patient overall health and age, and their motivation for a good recovery. Surgeons do have preferred methods of operating and favorite implants to use, so you can find differing opinions if you consult several. There are just different ways to approach a problem, and some may be a better solution for some patients and not others. In some instances, no surgery is the best choice for the patient.

I think surgical decisions are based on evidence of the findings in imaging and testing, but ultimately, the patient decides to proceed or not with surgery. Those are difficult decisions when you don't know everything that can be known about what you'll go through, and the surgeon most likely doesn't have personal experience in being a patient with the surgery he is recommending. The surgeon needs to educate and recommend what is best for the patient as an expert opinion. For the most part, spine surgery is considered elective unless there is a catastrophic injury that requires immediate action to preserve live or avoid paralysis.