Earlier this year, I brought lunch to a local primary care doctor’s office. Now, I am not a caterer; rather, I saw it as an opportunity to share valuable information on the management of patients with back and neck pain. A pearl so powerful that it could transform patient care in our area, and one that should be at the forefront of every provider’s mind who treats patients with these symptoms.

The information I set out to educate on is termed centralization. Centralization refers to the lasting abolishment of spinal pain and radiating symptoms in response to a specific movement or position of the spine. Centralization is present in over half of patients with back and neck pain and is one of the most studied and validated findings in spinal literature. The movement that elicits centralization varies among people and is discovered through a simple yet sophisticated movement assessment. When a patient performs their centralizing movement consistently for several weeks, it almost always leads to an excellent outcome.

Medical communities that assess for centralization not only improve patient care but also dramatically reduce the incidence of unnecessary spinal surgery. This was the case in North Jutland County, Denmark. North Jutland was the subject of a study that tracked disc surgery rates before and after the implementation of clinics that assessed for centralization. Prior to the establishment of these clinics, disc surgery rates in North Jutland were similar to those in the rest of Denmark. Following the implementation of these specialized clinics, rates of disc surgery in North Jutland were reduced by approximately 50%, with a steady downward trend. During the same period, the rates increased slightly in the rest of Denmark.

Kitsap County has roughly half the population of North Jutland; however, we are located in a country (the United States) that performs more spinal surgeries per capita than any other country in the world. If we routinely assessed for centralization in our back and neck pain patients, we would likely see profound reductions in spinal surgery rates, similar to those in North Jutland County.

Back to my lunch meeting at the primary care office. As I outlined centralization and the power it holds for our patients, I drew very little attention from my audience. After eating the salad and sandwich I provided and taking a phone call in the middle of my presentation, the provider asked me to leave after only eight or nine minutes. While I understand that primary care doctors are extremely busy, the phenomenon of centralization deserves more attention than that. If clinicians aren’t referring patients for assessments that search for centralization, they are missing something extremely significant.

With that being said, it is imperative that patients take their pain into their own hands and act as their own best advocate. If you have back and neck pain and centralization has not been assessed for, I would strongly recommend that you seek out a provider who will provide you with this opportunity. It could save you from an unnecessary operation.

Dr. Jordan Duncan is from Kitsap County and writes a monthly health column for Kitsap News Group. He is the owner of Silverdale Sport & Spine.