Tiger Woods recently had another back surgery. News leaked this week that Tiger has undergone his 5th, yes, count them 1-2-3-4-5, back surgery in the last six years. Despite an incredible comeback after his spinal fusion back surgery, it seems like his body may finally be giving it out, or are his team of advisors and medical staff missing why he continues to have more back problems despite their best efforts? What can we learn from his and the experience of millions of others who had failed back surgeries for lower back pain? Tiger has had four micro discectomies and a lumbar ALIF. Microdiscectomy- typically a minimally invasive procedure that trims away offending parts of the disc that is done outpatient through a 10-15mm endoscope. It results in less disruption to the muscles. ALIF- an anterior lumbar interbody fusion. Yup, the surgeon goes through the stomach to access the segment, grabs as much disc as possible, and slaps a stabilizing plate across the front of the vertebral bodies. The latest surgery probably took place at L4-L5 (above his L5-S1 fusion). Likely, L4-L5 wasn't doing too well to begin with, but after an ALIF in 2017, the stress on that level was dramatically increased. The takeaway for the average patient is that going back to the activities that (at least in part) caused a surgical intention is likely to increase your risk of needing another surgical intervention. Also, surgery does not permanently "fix" many issues. In the case of Tiger, it looks less and less likely that he will win that 19th major. His future back problems were predicted in an earlier 2012 blog Is Tiger Woods Achilles heel a bigger problem? Here’s how to fix Tiger Woods before it is too late. I never predicted any of his surgeries, however, my predictions of him having future lower back issues was based on biomechanical analysis from photos freely available on the internet. The analysis was discussed in my book Cheating Mother Nature, what you need to know to beat chronic pain. This was published in 2012 and then discussed again in 2017 in our blog How did this doctor accurately predict Tiger Woods and Roger Federer’s past injuries? If you are interested in how the surgery was done, this doctor offers an excellent explanation in his video here. If you suffer from lower back pain, you should be more interested in why Tiger had so many injuries and why I was able to predict them. Spinal fusion as a cure for lower back pain has a poor long-term record in resolving back problems and typically leads to more procedures years later. Few of these patients have positive experiences. Even JFK suffered greatly at the hands of surgeries recommended by medical experts years ago. The evidence does not support the use of surgery as a cure for lower back pain, although occasionally it is needed. The Annals of Internal Medicine in 2017 offered guidance on what works and what doesn't work for back pain based on the current scientific evidence. Medication and invasive procedures were recommended on things you should consider last in this paper which listed a number of things that chiropractors regularly use including manipulation of myofascial release and exercises to resolve lower back pain, The common element for improving lower back pain is movement. This may be why holistic chiropractic care which is based on improving movement has been so successful in the treatment of patients suffering from lower back pain. Consumer Reports suggests that seeing a chiropractor first may be the best medicine. They now suggest you see a chiropractor first for back pain as they rate chiropractors with the highest level of satisfaction for the treatment and management of lower back problems. The VA which has slowly integrated chiropractic has had great results with its program and is now using chiropractors outside the VA to help meet the demand. There are many other studies and magazines that have come to the same conclusion; see a chiropractor first for lower back pain. Who you visit first for a medical condition will determine your overall experience in the healthcare system. Patients who visit chiropractors for their back problems have the highest level of satisfaction. Chiropractors are primary care for the musculoskeletal system. What you should expect during your first chiropractic visit The doctor will do a thorough history and ask you about things you may not think are relevant but may be part of why you hurt. Then an evaluation using active tests, orthopedic tests, and movement assessments are performed to determine why you hurt. X-rays may be taken on that visit if needed. Treatment is often performed on the same day and may include spine and extremity manipulation, exercises, myofascial release to improve movement, and foot orthotics may be recommended if there is an imbalance in the way you walk. Treatment is resolved to improve the way you move, reduce pain and help you understand why you hurt. Exercises will restore strength and retrain poor movement patterns. Foot orthotics and proper footwear can help you stay healthy. Who should you visit first for a lower back problem? All roads lead to the chiropractor. Book on line here.