Today, I have the pleasure of publishing an interview with Dr. Richard E. Busch III, noted chiropractor, developer of the DRS Protocol and the author of the book Surgery Not Included.
Dr. Busch is well known as an innovator in the chiropractic healing arts and I appreciate the generous time he allotted for this interview, published exclusively on The Cure Back Pain Network.
Q: Could you tell the readers something about yourself and your background in back pain care? What are your educational credentials?
A: My undergraduate studies were done at Indiana University, and I graduated as a Doctor of Chiropractic from Parker College in January 1996. April 1996 I launched Busch Chiropractic Pain Center and began private practice.
My family publishes (TAC) The American Chiropractor magazine, a leading national trade publication for chiropractors, and I reviewed and made editorial recommendations for the magazine. This position provided me access to some of the newest technologies available in the noninvasive and conservative healthcare market. I became seriously interested in a new nonsurgical treatment for herniated and degenerative discs– spinal decompression. I had implemented this decompression therapy into my practice, and I had remarkable success in treating disc conditions, that prior to, I would not have been able to treat.
Because of my editorial relationship with TAC, I had the opportunity to interview the well- known neurosurgeon and pain management specialist, Dr. Norman Schealy. He was instrumental in the development of spinal decompression and the DRS System. This was a spinal decompression table designed to help in the nonsurgical treatment of herniated and degenerative discs. It was a timely opportunity to interview Dr. Schealy, and this experience defined much of the manner in which I treat my patients. Since using spinal decompression in my clinic, I have successfully treated thousands of patients with herniated, degenerative discs and other appropriate conditions.
Q: Can you describe your philosophy of patient care? What makes you unique as a care provider?
A: My philosophy is patient-centered healthcare, and I focus on the whole patient not just a symptom or category of disease. With this approach I am better able to determine and customize the best treatment options for each individual and to ensure my office provides a gold standard of care. When we focus on the patient and their true needs, I believe we can address almost any problem.
It is necessary patients clearly understand their condition, not just their symptoms, and they understand the course of treatment. The patient’s understanding is instrumental in care and is an integral part of the success of treatment. I explain to each patient that they will be an active participant in their care and not just an observer. It is essential patients take responsibility for their involvement in care and proceed with the attitude of – “they want to get well”. Essentially, the patient is as influential as I am in the successful outcome of their care.
Q: Can you detail your family’s history as part of the chiropractic industry?
A: As I had previously mentioned, my family is highly involved in the profession as publishers of the national trade publication, (TAC) The American Chiropractor magazine. In fact, TAC recently celebrated its 30th anniversary. Currently my brother, Dr. Joe Busch, is the managing director. He too is a chiropractor. My sister, Jaclyn, is the editor, and she has done a fantastic job in not only growing the magazine but taking it in a new direction. My father started the magazine while he was in practice, and he retired shortly thereafter. It was his vision that parlayed the magazine to its successful position.
I have been surrounded by chiropractic my entire life. Not only did my father practice, he was also a national consultant to other chiropractors. I am also a consultant. I train and consult both chiropractors and medical doctors in the DRS Protocol™. This is a complete treatment protocol, with many elements, that I developed and successfully use for the nonsurgical treatment of appropriate disc conditions.
Q: Can you describe your DRS Protocol™ for the readers?
A: Traditional chiropractic care is recognized as highly effective in the care and management of back and neck pain and disc-related conditions. However, there is a level of severity that surpasses the effectiveness of standard chiropractic treatment. This is the stage where the DRS Protocol™ is the logical next step, rather than surgery and other invasive procedures.
The protocol includes spinal decompression, specific chiropractic manipulation, nutritional therapy, specific exercises, and the mind-body relationship. Both chiropractic and decompression are gentle and noninvasive and are intended to restore normal function. They interface well to allow natural healing. As the DRS Protocol™ is patient-centered, each patient is assessed and treated individually. Generally, a treatment period will be over a six-to-eight week period. Again, every patient is different as each condition is different.
Many patients I treat have already had one or more back surgeries. This is called (FBSS) failed back surgery syndrome. These people are desperate – they do not want any more failed surgeries. Other patients can be dealing with additional health problems such as diabetes, stroke side effects and/or heart problems. Lifestyle and bad habits are also contributing factors. The DRS Protocol™ can be equally successful for those patients, with the understanding that treatment elements and time periods may vary. The protocol is customized for and manages each patient with individual treatment parameters, benchmarking and tracking, reassessments and evaluations, and patient education. We can provide predictable, successful outcomes for severe and chronic disc-related conditions.
Q: How prevalent is the incidence of misdiagnosis in the back pain industry?
A: That is a great question. However, prior to any definitive diagnosis even being given to a patient, most back pain is categorized initially (under medical guidelines) as nonspecific back pain. Often, these patients have a serious problem that is addressed much later.
A back pain suffer is most likely going to have to go through the medical pipeline. Generally, this consists of a series of doctor visits: pain pills and anti-inflammatory drugs are prescribed: then back to the doctor; then referred for physical therapy; then back to the doctor: then referred to a specialist: then diagnostic testing such as MRIs or X-rays are ordered, and then a definitive diagnosis is given: then epidurals or injections are performed, and then back to the specialist. The next option is surgery. When surgery fails, the next step may be a pain specialist for long-term pain management.
Of course, there have been misdiagnoses for causes of back pain – on both sides – positive and negative. There are statistics from a recent study that reports 28% of positive diagnoses of herniated disc, determined by MRIs, were in error. In other words, there were no herniated discs. Conversely, the study shows that 33% of the negative findings were patients that actually had herniated discs. These stats could be significantly lowered with a comprehensive examination performed with orthopedic and neurological testing.
Q: What are your thoughts on back surgery, in general, and spinal fusion in particular?
A: Back surgery can always be done, but it can never be undone. In many cases, the surgeries that are performed are unnecessary and unsuccessful. Studies show fusions do not work in the long-term, and in many cases the patients will have to have another “redo” surgery within two-to- five years, if not sooner.
There are side effects from surgery, even when a surgery is considered successful. A frequent one is scar tissue, and it can become, itself, the cause of pain. There is frequently ongoing pain and weakness, and there are many more side effects. Of course, there are potential risks from surgery such as problems with anesthesia, bleeding and blood clots, and other complications, and even death.
Spinal fusions fix or fuse the vertebrae together. There are different approaches to the surgery, but the goal is stabilize a section of the spine. The result is the fused area of the spine no longer moves normally. This creates more movement and more force on the vertebrae levels above and below the fused vertebrae, and this leads to degeneration and more of the same problems in the areas adjacent to the fusion. This leads to “repeat surgeries” with less than desirable outcomes. Over the years, multiple studies have shown the poor long-term outcomes of spinal fusion.
Perhaps, this is why there has been so much research and so many clinical trials performed with replacement discs, stabilizers and the “X-Stops”. It is well known that fusions are not a long-term cure and can cause many significant problems. I cover in my book *Surgery not Included some of the reasons fusion are still popular. During conversations with my patients, I have noticed that some surgeons are no longer rushing patients to surgery. What these surgeons are recommending is that patients wait until they can no longer bear their pain before even considering surgery.
I treat many patients who have had failed back surgery from spinal fusions with the DRS Protocol™. I can not treat the actual fused level, but I can treat the adjacent levels.
Q: I like your open critique of many treatments for back pain. What gives you the confidence to speak out against many practices, such as excessive pharmaceutical treatment, premature and inappropriate surgical intervention and others you mention in your book?
A: The patients! There has been a transformation in the attitude of the people that we treat. Most come in my office say things like “I don’t want to take anti-inflammatories, or get an epidural, because it’s just a band-aid.” The attitude of the public is changing – they know surgery is not their only option, and it is no longer a situation where – my doctor said I have to do something, so therefore I do it. More are taking charge of their healthcare choices. We now understand that surgical interventions for back pain are statistically not the best choice. We know that many medications have side effects, and in certain circumstances, the side effects can be worse than the problem they profess to treat. Also, some medications can be potentially addictive.
My confidence comes from success. The success I have had in helping people avoid surgery and avoid the “Back and neck pain pipeline”, or get out of it altogether. And the success of other doctors that treat with the DRS Protocol™. However, it should be noted that there are certainly times when surgeries are necessary. One example is when a patient is diagnosed with Caudu Equina syndrome (a condition where there is loss of bowel control or bladder function accompanied by severe, lower back and leg pain).
Q: How do you measure the contribution of non-surgical spinal decompression to the back pain industry?
A: I believe spinal decompression is one of the most important advancements in back pain treatment in the last 100 years, because of the billions of dollars of cost attributed to back pain in the United States. Spinal decompression allows patients to stay on their jobs because there is no recovery time. It is simple to do, pain-free, conservative and noninvasive, risk-free and drug and injection-free, cost effective, and has predictable and successful outcomes.
Q: What are your thoughts about many chiropractors who insist on regular adjustments for their patients, but do not provide any semblance of relief over many years of treatment? Why do you feel chiropractic fails some patients using traditional adjustments? Once a patient is pain free, what do you feel is the right amount of maintenance care?
A: There are instances where some chiropractors may forget that there is more than just a spinal adjustment; there is nutrition, exercise, and even the psychological aspect of treatment. There are some cases where the condition may be beyond what I could help with standard chiropractic care. Then, I look for other answers. This is when I evaluate the patient for the DRS Protocol™.
Many studies confirm that chiropractic treatment should be the first line of conservative care for back pain, and it is necessary to understand that, generally, there is not a singular answer in healthcare, there are many. Very often we develop tunnel vision in our approach. My philosophy and belief is that I will do everything necessary to help my patient get well!
Q: I really like your section on mind-body medicine. Can you share your thoughts about how the mind and body create the states of health and disease? How important do you think it is for patients to consider the mind-body interactions when recovering from back pain or any health crisis?
A: The mind and body are interconnected and influence each other. Clinical studies have shown that imagery, or visualization, can affect the physiological responses of the heart, respiratory system, immune functions, cellular growth, pain, relaxation, and sleep.
Emotions can influence the immune system in either a positive or a negative way, and patients have the ability to choose, merely by their attitude. We are energy at the cellular level. Our thoughts are also energy and will be reflected in our bodies. There are many studies that have found that the patient’s ability to get well, very often, does depend on their attitude. It is much easier to help a patient who believes recovery is possible. Conversely, it is much harder to help someone who does not believe help is possible, or is convinced that the situation is hopeless.
For all patients I treat, I recommend they perform visualization exercises; they are to visualize themselves participating, without any pain, in the activities they were previously able to do, and they are to visualize themselves healing. Before I started making visualization mandatory for all of my patients, there was a certain group of patients that were slow responders. By including visualization and explaining the mind-body connection, their improvement rates definitely increased. It is vital to recognize the emotional, psychological, and mental factors that play into the healing of the patient; this is important for any healthcare treatment.
Q: Are you familiar with the literary works of Dr. Andrew Weil and Dr. John Sarno? If so, how important do you think their contributions are now and how important do you think they will become in the future, as more care providers choose to embrace, rather than ignore, mind-body medicine?
A: I think their work is very important, and they are bringing something to the forefront of the medical community that at one time was thought to be obscure. In the past medicine very often did not believe something could happen unless it took place in the double blind study so they could statistically determine the results. And when they had someone respond favorably to the placebo, they automatically discounted the possibility that that placebo was as important as or more important than what they were studying.
In reality the placebo is the most important part of what we can do in healthcare. This is because it shows that under the right circumstances the mind can actually heal or control every reaction that takes place in the body. Those two gentlemen are helping to bring that reality to the medical profession, and society as a whole. As a chiropractor I have always understood the connection between a patient’s mind and body. This mind-body connection is one of the philosophic foundations of chiropractic. It is also the future of healthcare as a whole, and will affect every aspect of our lives.
Thank you, Dr. Busch, for taking the time and effort to join in the Q&A.