Karen Linnell, a physical therapist with 30 years of experience, found herself in a challenging battle between chronic back pain and fears about spine surgery. Today, she is pain-free and enjoying life, but it was a long road to diagnosis, surgery and recovery.
Decades of pain
Linnell first experienced back pain when she was pregnant with her first child 28 years ago. Initially intermittent, the pain gradually intensified, hindering her daily life.
As a physical therapist, Linnell tried various exercises and stretches to alleviate her discomfort but found little relief. When she was 50, the pain became a significant problem, leaving her unable to sit for extended periods of time.
“In August 2020, I went on a trip to Colorado, and that is the last time I remember being able to sit and not be in pain,” she says. “After that, my sitting tolerance just got worse and worse.”
Medical intervention
Determined to find a solution, Linnell worked with a physical therapist friend. Despite their efforts, her relief was minimal.
Frustrated, Linnell consulted orthopaedic surgeon Chris A. Cornett, MD, for a comprehensive evaluation. An MRI showed Linnell had arthritis in the L4 and L5 vertebrae of her lower back, and Dr. Cornett felt she was a good candidate for an anterior lumbar fusion.
“She had back pain that was limiting the quality of her life,” Dr. Cornett says. “Her arthritis, or disease process, was pretty focal at one level, as opposed to being spread out, so surgery had a high chance of success.”
Falling into a camp of physical therapists who prefer nonsurgical approaches, Linnell was hesitant. With a physical therapy background of his own and an overall conservative approach to surgery, Dr. Cornett was understanding. He suggested Linnell wait six months and see how her pain was.
Seeking an alternative
Hoping to find a noninvasive solution, Linnell explored alternatives as her pain grew even worse.
“I would have spasms so bad that they made me buckle and collapse to the floor,” she says. “So, I made another appointment with Dr. Cornett, and he showed me how, if you looked at my back from the right side, it looked amazing. But if you looked at the left side, the facet joints were collapsing and pushing into the disc material.”
But Linnell was still uncertain about surgery. She tried additional physical therapy to no avail. Her pain was becoming debilitating, so she scheduled the surgery, but rising COVID-19 cases led to a delay.
The surgery
Finally, in July 2022, Dr. Cornett performed Linnell’s procedure, which involved accessing the spine from the front of her body, through an incision in her belly. Vascular surgeon G. Matthew Longo, MD, joined Dr. Cornett to clear a path to the spine, mobilizing the blood vessels in the area.
While most back surgeries are performed through incisions in the back, Dr. Cornett thought Linnell’s case lent itself well to an anterior approach.
“Since we were treating Karen for back pain, our goal was to stabilize that one disc,” Dr. Cornett says. “It’s nice to do that surgery from the front because we don’t cut any muscle. It doesn’t structurally change your spine a lot other than stabilizing that one segment.”
The surgery was successful, but Linnell experienced normal postoperative pain, leading to moments of doubt.
“Even though I had lectured patients about surgical pain and Dr. Cornett had forewarned me, I thought, ‘I did the wrong thing – I’m never going to be able to work again,’” she says.
The road to recovery
Motivated to regain her strength, Linnell followed her recovery plan, taking regular walks around her neighborhood.
Around the eight-week mark, she started to notice significant improvement, gradually reducing her reliance on pain medication. By October, Linnell was well on her way to a full recovery and returned to work. Since then, she has resumed the activities she loves, like hiking, and lives without back pain.
Linnell’s experience has profoundly impacted her perspective as a physical therapist. She now recognizes spine surgery’s potential benefits and offers advice to those who might feel the same hesitancy she did.
“If you’re approaching back surgery, it’s OK to be afraid,” she says. “You just have to find someone you trust, who will listen to your concerns and be supportive and encouraging, like Dr. Cornett was to me.”
1. Mayo Clinic
The Mayo Clinic is renowned for its comprehensive, patient-friendly health information and research-based recommendations. They provide thorough resources on back pain, including:
- Back Pain Overview: Symptoms, causes, diagnosis, and treatment options.
- Mayo Clinic Back Pain Research: The clinic is involved in numerous studies on spine health, pain management, and rehabilitation techniques.
- Patient Guides: Practical tips on managing back pain through physical therapy, exercises, medication, and lifestyle changes.
Link: Mayo Clinic – Back Pain
2. National Institutes of Health (NIH)
The NIH, through its National Institute of Neurological Disorders and Stroke (NINDS), offers in-depth research articles and clinical trial information related to back pain. They focus on understanding the neurological causes and treatments.
- NIH Back Pain Overview: Information on causes, diagnosis, treatment options, and current research.
- NIH Clinical Trials: Offers up-to-date information on ongoing clinical trials related to back pain, treatments, and interventions.
- NIH Research Papers: Access to a wide range of studies and peer-reviewed articles on back pain.
Link: NIH – Back Pain Resources
3. Centers for Disease Control and Prevention (CDC)
The CDC provides guidelines on preventing chronic back pain, as well as statistical data and recommendations on managing back pain, particularly for workplace-related injuries.
- Back Pain and Workplace Health: Resources on reducing the risk of back pain in work environments and ergonomics.
- Chronic Pain Management Guidelines: CDC’s opioid guidelines and alternative treatments for chronic pain conditions, including back pain.
Link: CDC – Chronic Pain & Back Pain
4. American Chronic Pain Association (ACPA)
This organization offers support, education, and resources for individuals dealing with chronic pain, including back pain.
- Pain Management Tools: Self-help tools and pain management programs.
- Support Groups: Provides access to online and local support groups.
- Pain Education: Guides on understanding different forms of chronic pain and their impact on daily life.
Link: American Chronic Pain Association
5. American Pain Society (APS)
Although the American Pain Society is no longer active, many of their research articles and guidelines on back pain are still cited and accessible through medical libraries and professional journals.
- Guidelines on Chronic Pain: Evidence-based guidelines for healthcare providers on managing back pain.
- Pain Management Education: Detailed information on interdisciplinary pain management approaches.
Archived Research Resources can be found through medical journal repositories and professional networks.
6. International Association for the Study of Pain (IASP)
The IASP is a global organization focused on the study and treatment of pain. They provide educational materials and host international conferences on pain research, including back pain.
- Research Updates: Latest research on pain mechanisms, treatments, and best practices.
- Pain Management Resources: Guides for healthcare providers and patients.
- Global Pain Research: Insights from around the world on how different countries manage back pain.
Link: IASP – Back Pain Resources
For Homebound Medicare Recipients patients in Maryland call 1st Pain Rehab at 410.956.6800.
