Many individuals afflicted with back pain look to the experience of professional athletes as they try to decide how to treat it. When sports figures’ backs give out, they don’t adopt a wait-and-see attitude. Instead, they seek help immediately, from a shortlist of high-profile spine surgeons who drop everything to care for them. After their procedures but before they return to the court, field, or course, these players undergo weeks of arduous physical rehabilitation. But the public never sees that grind. Instead, we see that, in record time, they’re back to work, fulfilling the requirements of their multimillion-dollar contracts.

Except when they aren’t.

Failed back surgeries for Steve Kerr, head coach of the Golden State Warriors, and golf legend Tiger Woods offer cautionary lessons about surgery for back pain.


Kerr chose to have disc surgery in July 2015 to relieve pain caused by an intervertebral disc — the shock absorbers that sit between the individual bones of the spine — pressing on a spinal nerve. In this procedure, called microdiscectomy, a portion of the disc is removed. It can help some people get back on their feet, especially if they actively rehabilitate the muscles and ligaments affected by the procedure and address the underlying weakness that caused the problem in the first place.

What often goes unmentioned is that, after two years, the outcome for those who opt for surgery and those who pursue conservative care is essentially the same. For most people, after a few weeks or months, the protruding, pain-causing disc tissue shrivels up and disintegrates, and the pain fades away.

What Kerr recognizes now, as should everyone contemplating back surgery, is that it can come with significant risks. In his initial operation, the surgeon nicked the dura, a tough membrane enveloping the spinal cord. That created a cerebrospinal fluid leak that resulted in headaches, nausea, and severe pain. After his first surgery in July 2015, Kerr sat out dozens of games.

To fix the leak, he underwent a six-hour surgery in September 2016. Months after that procedure, Kerr was still suffering from low back pain and nerve pain, in addition to headaches, blurry vision, and neck pain.

Last month, Kerr checked into the hospital for another spine procedure. The intention was to finally track down the cerebrospinal fluid leak and patch it. Although it is too soon to say for certain, it appears that this time the effort may have worked. After missing most of the Warriors’s undefeated playoff run, Kerr was courtside and looking good in game two of the NBA finals, and he got a standing ovation. The word was that he felt better, and intended to handle coaching duties himself throughout the remaining games.

Tiger Woods’s odyssey to ease his back pain has been equally tortuous. To remove disc tissue that surgeons said was putting pressure on spinal nerves, he underwent microdiscectomy procedures in March 2014, September 2015, and October 2015 to attempt to stop his back pain. Three months after his third surgery, Woods, sounding hopeless, told reporters at a press conference that he didn’t know when or if he would be able to play golf again. “I have no answer for that. Neither does my surgeon or my physio,” he said. “There’s no timetable. There’s really nothing I can look forward to, nothing I can build toward.”

The golfer’s decision to go under the knife again this spring, this time to have spinal fusion (also called lumbar spinal fusion), reflected his desperation. Spinal fusion connects two or more vertebrae in the spine, eliminating motion between them. This procedure usually limits one’s ability to twist the torso, and following fusion other parts of the spine often begin to deteriorate, creating additional problems.

Last week, mug shots of Woods — his face puffy and his eyelids barely at half-mast — were splashed on media sites around the world after he was charged with driving under the influence in Jupiter, Fla. His car was substantially damaged, the tires flat. Woods was asleep, and difficult to wake, when the police discovered him. He hadn’t been drinking, but instead said in a statement that he had “an unexpected reaction to prescribed medications.” Normally, people at his stage of recovery from spinal fusion wouldn’t be behind the wheel.

Spinal fusion has been shown to succeed in barely 40 percent of patients. In this context, though, “success” doesn’t mean much. In one study, two years after what was deemed to be successful spinal fusion, pain had been reduced by barely half, and most patients continued to use prescription painkillers. In another study, about one-third of patients reported that their pain was as bad two years after surgery as it had been before they’d had the operation, and 14 percent believed that they were in worse shape after spinal fusion than they’d been beforehand.

Writing in the American Journal of Medicine, two University of Mississippi researchers observed that, in the United States alone, about 80,000 spine surgeries fail every year. People who do not do well are referred to as “failed backs,” and often return repeatedly to the operating room with the odds stacked against them, losing ground after each procedure.

Even when the operation goes perfectly, what works for many pro athletes won’t necessarily work for you and me. Why not? Professional athletes are usually superb physical specimens who are accustomed to tolerating a great deal of pain. They are also motivated: With those time-stamped contracts hanging in the balance, there’s a clear incentive to get back in the game.

Those factors rarely apply to ordinary people with back pain. Many of them have lost whatever level of physical fitness they might once have had, and aren’t inclined to follow an intensive physical rehab program when the allure of the sofa and a ready supply of post-op painkillers are so much more compelling. One study showed that in a pool of 725 patients with workers’ compensation claims for spinal fusion, only 26 percent returned to work in a two-year period. All too often, spinal fusion patients wind up on opioids and disability. Approximately three million Social Security Disability Insurance beneficiaries in the U.S. identify musculoskeletal disease — mostly back pain — as the cause of their incapacity, and that number continues to climb.

As an investigative journalist and the author of “Crooked,” a new book about the back pain industry, it’s my hope that the misfortunes that have befallen Steve Kerr and Tiger Woods will open the eyes of ordinary people who suffer from back pain to what can go wrong, surgically speaking, and to think again if they believe that surgery is their only option.

I spent seven years listening to ordinary people tell me how they started out with annoying but still manageable back pain and wound up in much worse shape. Since the book was published, my email and private messages sent to the book’s Facebook page have been full of tales of surgical carnage. Many people told me they chose surgery because they thought it would be a quick fix, insurance would pay for it, and if it was good enough for professional athletes, it was good enough for them.

Kerr had a frank message for people with back pain who might be considering surgery. “I can tell you if you’re listening out there, if you have a back problem, stay away from surgery. I can say that from the bottom of my heart. Rehab, rehab, rehab. Don’t let anybody get in there,” he said during an April 23 press conference.

Instead of initially seeking advice from a surgeon, who is likely to prescribe surgery, turn first to a physical therapist. Search the American Physical Therapy Association’s website for therapists with DPT or OCS after their names, identifying them as having received doctorates and orthopedic clinical specialty certifications. In addition, look to the American College of Sports Medicine’s ProFinder to track down a trainer who knows how to deal with back pain. Another option is to seek the help of a physician who specializes in physical medicine and rehabilitation. But be sure to ask questions — you want a clinician who delivers exercise, not injections.

We could also use some help from professional athletes: Instead of making recovery from back pain look so easy, could you please show us the work and grit it takes to get better?

Cathryn Jakobson Ramin is an investigative journalist whose efforts to resolve her own back pain led her to take a close look at the scientific evidence for what the spine business was selling, a journey described in “Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery” (Harper, May 2017).

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  • My T.L.I.F at The Steadman Clinic in Vail has been a COMPLETE SUCCESS! After being misdiagnosed by 11 medical professionals over 9 years, I’ve been 100% recovered since 2015. I did learn that you should only get back surgery for leg symptoms like stenosis/sciatica.

  • Articles like this annoy me. These are regular age relted issues. I am56 and had 5 spine surgeries. Three because I lost the bility to walk, one because I was going to be a quad and passed out if I tried to sit up, and another because I had a spinal infection that went septic. I am lucky I survived it all. I do not believe any of my doctors were lying to me and were trying to keep me alive and walking. This article fails to mention that people have congenital spinal deformities and spinal issues that are life or death. I am in pain, I am disabled, it was horrible to go through over and over, but I need to be able to walk, sit up and feed myself.

  • There are situations where surgery is recommended first, and for good reason. I don’t expect to heal at the same rate as a professional athlete, but my injury is eight years old. My ligaments have ossified, I have bonespurs everywhere, and in addition to radiculopathy that makes my arms (right more so than left) numb and half functional, I have myelopathy, lasting damage to my spinal cord, from severe long term compression. The bias against the need for surgery in the article may be applicable to those with mild, and relatively recent spinal damage, but this is not my reality. Nor is it the reality for many of us. When you are blindsided by a spinal cord condition that you don’t understand, you look for answers and advice. It makes me sad that someone looking for those things may stumble upon this bs, and go against their doctors recommendation. I was misguided into believing that injections and committing myself to physical therapy would help. I even got two additional opinions that confirmed whatever it was that I wanted them to confirm. They make money off of your injections and pt, just the same as your surgery. It was obvious (to me, now that I look back) to my surgeon from the beginning that none of those things could help me. He referred me to a pain management specialist instead, at my wishes. I tried it all anyway, worked my ass off. All because I “didn’t want surgery” and “surgery is a last resort”. For a year and a half, my healing was stalled, and my condition worsened, because of the hesitancy to get treatment articles like this plant in a persons brain… you need to at least add some sort of disclaimer. If your surgeon tells you that you need surgery, there’s a huge chance you NEED FUCKING SURGERY. Thanks for listening ✌️

    • Thank you Ellen LSW! I couldn’t agree more. If you’re able to manage your pain and work your way out of it of course that’s the best way. I was doing that for a few years and then my L4/L5 completely blew out in my sleep of all places! Blinding sciatica, couldn’t stand, couldn’t walk, couldn’t work. Six weeks I toiled with this. Physio, chiros, accupuncture, pharmaceuticals and rest, epidural nerve blocks, I tried it all. My surgeon said if your not standing by Wednesday we operate, on the Monday I was begging for the operation. I walked out of hospital on the same day and haven’t looked back. Yes it’s been a slow, rocky, emotional journey back to recovery. I know my back will never be perfect again but I’m thankful everyday that I was lucky enough to have access to the medical procedure that ended my misery. For some people they have no choice and these articles can be really scary for those facing these operations. Anyone reading this who is, don’t be afraid, do what’s right for you and know there is life after back surgery.

    • That’s all they want to do is give injections they don’t work for me made sick I have had five back surgeries and I am still working but my spine is breaking down and a lot more people are going to be having more surgeries because pain management sucks. Pt is important if the therapist is good he’s rich he can get the best of everything but sometimes you end needing surgery no matter how rich you are

  • But many more athletes and stunt men have had successful spinal surgeries. Such as Peyton Manning, Tony Romo, Dwight Howard, and many others. A quick Google search can show that sometimes the surgeries are successful and sometimes they are not…the majority being successful if the surgery was performed by a qualified/skilled surgeon. Many times, people read artIicles like this and put off needed surgical intervention only to later realize that it is absolutely necessary and the wait caused permanent nerve damage to their body and they then have to deal with radicular neuropathy for a lifetime.

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  • I disagree with the tone of this article. I am 60 now, triathlete, marathoner, working out daily. I herniated a disc in 2007, 3 weeks before an Ironman race. after PT, cortisone etc. all did little to make it better I opted for surgery. Best decision ever! Was back doing marathons, Ironman races etc. Still work out every day. It is NOT for everybody and not a cure all but back surgery can be dramatic- for me it was a positive experience. It gave me my life back

  • It took a long time, but P.T., moving around often, and a lot of walking did it for me. I was ready to work something like 6 months after the worst of my back pain. IMHO, letting the pain immobilize me contributed greatly to my decline.

    OTOH, I know someone who seems to have been helped by back surgery, though it’s hard to know for sure if that’s what did it. And we don’t know how long the relief will last. But she’s got her life back for now.

    Don’t put too much credence on anecdotal evidence. It’s very easy to see a cause and effect relationship that isn’t really there.

  • Conspicuous via absence from your article is the profession of chiropractic, dedicated to conservative care and supported by modern research and scientific imaging.
    Perhaps the underlying philosophy of a back pain patient should be one of “slow medicine” and avoidance of rushed decisions. A brief course of conservative care can be the best advice.

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