Every doctor dreads the word “internet”

The advent of the internet has been a disaster for doctors, whose waiting rooms are packed with people who’ve read incomplete, inaccurate or flat-out nuts medical information on the Internet. However, there are some useful resources out there that can make you better informed without filling your head with nonsense.

One of the best I’ve seen is Clinical Evidence, which comes from the British Medical Journal. It’s written by medical experts for medical experts, and it provides a summary of the clinical trials of various forms of treatment. Crucially it’s organised by category, so for example you can search for a herniated lumbar disc and then see the effectiveness, risks and potential benefits of surgical, non-surgical and drug treatments.

As I’ve posted before, I have a vested interest in this: I’ve got two herniated discs and in a few weeks time it’ll be a year since I knackered my back, and I’m sick and tired of being sick and tired. The current treatment regime is non-steroidal anti-inflammatory drugs, which I don’t feel make any difference, and chiropractic treatment, which addresses the knock-on postural problems you get from having a duff back but which doesn’t address the slipped discs themselves.

On careful reading of the various reports, it seems that I’m not being overly pessimistic: in trials, the drugs I’m taking (and the other drugs I’ve taken over the last year) are no more effective than a placebo, and while chiropractic treatment and physiotherapy do have an effect it tends to be in the early stages of back pain; generally when a problem becomes chronic (ie. more than 12 weeks in duration) they’re of little benefit. Surgery, on the other hand, is generally very successful: success rates of between 80% and 87%, with relatively low rates of disasters (death on the operating table, post-op infection, surgical mistakes etc). As a result of reading that data (and of checking out similar sites for GPs and other health professionals) I think I’m a reasonably well-informed patient, and I’m making an appointment to see a neurosurgeon to discuss the options once again.

On a related note, you can also find out other interesting things from sites aimed at doctors. For example, various Glasgow hospitals run pain management clinics. These offer a range of treatments – physiotherapy, spinal injections and so on – that can be very beneficial to patients with injuries. If you do a bit of digging you’ll discover that these treatments (assuming your pathology is appropriate for the treatments) are generally very effective if you get treated within 12 weeks of injury, and of little benefit thereafter; unfortunately, the waiting list for an appointment with a pain management clinic in this area is rarely shorter than 16 weeks. Hmmm.