Before I explain why you should reconsider knee or back surgery, let me make one thing clear: bulging discs in your back and bone-on-bone knees DON’T directly cause pain. I know this might sound shocking, but it’s true. Most people who have severe back pain who do not try quality physical therapy first and go straight to their PCP or orthopedic surgeon will end up having an MRI. Nine times out of ten, this will show disc herniation, disc bulging, or nerve compression of some sort, which they immediately attribute to causing their back pain. However, over the past 10 years, more and more studies are proving that disc herniations themselves do not cause pain, showing that correlation does not equal causation. While these conditions can be linked to pain, they aren’t necessarily the cause.
Real-life proof? I see patients every day who’ve had knee or back surgery – only to still suffer from chronic pain (sometimes for more than a year). It’s no surprise that about twenty-five percent of my physical therapy clients come from people who had total knee replacements five or fewer years ago and are still in pain. Oddly enough, many of them share the same story: “My surgeon X-rayed it and said everything looks fine, but they don’t know why I’m still hurting.”
Here’s the thing: The surgery removed the “bad parts” and replaced them with metal and plastic, both of which don’t have nerve endings. So, how can something without nerve endings cause pain? It can’t. But what can send pain signals to your brain are the muscles, tendons, and ligaments surrounding your new hardware.
So, ask yourself: Could it be that the bone-on-bone damage or bulging disc seen on your X-ray wasn’t the real source of your pain? What if it was the surrounding tissues – the muscles, tendons, and ligaments – that were the real culprits all along? If that’s the case, wouldn’t simple corrective exercises have been a better, noninvasive solution? I hate to say it, but this idea goes against the traditional American medical model, which often leans toward surgery. After all, we’re talking about a $15,000–$25,000 procedure here. Imagine if two million people every year (that’s how many back and knee surgeries are performed every year!) could fix their issues without surgery…that’s a lot of money lost!
Put Your Pain in the Rearview…with a Stronger Rear?
Let’s dig into the real cause of nontraumatic, insidious onset back and knee pain – meaning pain that seems to come out of nowhere without any major injury or accident. The main culprit? Believe it or not, it’s weak glutes!
I’ve worked with countless patients, and without fail, almost everyone with back or knee pain has at least one glute that’s not firing properly. Think about it: Your glutes are supposed to be the largest and strongest muscles in your body, and their job is to protect your knees and back from strain. But here’s the problem: most of us sit on our glutes for hours each day, starting in grade school. For most Americans, that’s a minimum of twelve hours a day spent sitting, which means the glutes get weaker and weaker over time. When your glutes aren’t working as they should, guess what takes the brunt of the work. Your knees and lower back. As your glutes weaken, they can’t effectively stabilize your joints, leading to more stress on your knees and back – and, ultimately, pain.
So, here’s the point I want to make: if you’ve been told you need back or knee surgery, it’s time to challenge that assumption. If you’re still reading, I hope you’ll at least entertain the idea that bone-on-bone and bulging discs aren’t the root causes of your pain. Want further proof? Ask anyone still in pain who’s had surgery to “fix” a bulging disc or replace a knee joint. They’ll probably be more than happy to share their frustrations.
You Do Have Nonsurgical Options!
If you want a better solution, start by seeking out a qualified professional who specializes in helping people avoid surgery. They should assess whether your glutes are firing properly to support your knees and back. And here’s an important tip: If a provider insists on reviewing your X-ray or MRI before ever touching you, RUN – or limp – out of there as fast as you can! You should never have a preconceived idea of what you’re looking for before you start assessing the human body for efficiency.
Once you find the right person to guide you, give it at least six weeks of dedicated effort. Strengthen your glutes and learn to use them to move correctly. That’s right – don’t expect instant results. In today’s world of instant gratification, it’s easy to expect quick fixes. But if your knee or back has been hurting for six months, don’t expect the pain to go away in six days.
And if you’re still on the fence about surgery, I’ll leave you with this: Read the last sentence of the fourth paragraph again. It’s a pretty important point.
For even more insight on this topic, check out The Berman Method podcast. You’ll get more detailed information on why surgery isn’t always the best answer!
Dr. Jake Berman, PT, DPT, is a physical therapist and the owner of Berman Physical Therapy, where they focus on treating the actual problem causing your symptoms (pain) to help you avoid taking pain pills and dangerous surgeries. So, if you’re tired of feeling “old” and you are looking for another way to keep active and mobile, call Dr. Berman at 239.431.0232 to take advantage of a FREE 30-minute taster session!
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