Elon Musk says ‘disc replacement’ worked for him. But evidence this surgery helps chronic pain is lacking
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Last week in a post on X, owner of the platform Elon Musk recommended people look into disc replacement if they’re experiencing severe neck or back pain.
According to a biography of the billionaire, he’s had chronic back and neck pain since he tried to “judo throw” a 350-pound sumo wrestler in 2013 at a Japanese-themed party for his 42nd birthday, and blew out a disc at the base of his neck.
In comments following the post, Musk said the surgery was a “gamechanger” and reduced his pain significantly.
Musk’s original post has so far had more than 50 million views and generated controversy. So what is disc replacement surgery and what does the evidence tells us about its benefits and harms?
What’s involved in a disc replacement?
Disc replacement is a type of surgery in which one or more spinal discs (a cushion between the spine bones, also known as vertebrae) are removed and replaced with an artificial disc to retain movement between the vertebrae. Artificial discs are made of metal or a combination of metal and plastic.
Disc replacement may be performed for a number of reasons, including slipped discs in the neck, as appears to be the case for Musk.
Disc replacement is major surgery. It requires general anaesthesia and the operation usually takes 2–4 hours. Most people stay in hospital for 2–7 days. After surgery patients can walk but need to avoid things like strenuous exercise and driving for 3–6 weeks. People may be required to wear a neck collar (following neck surgery) or a back brace (following back surgery) for about 6 weeks.
Costs vary depending on whether you have surgery in the public or private health system, if you have private health insurance, and your level of coverage if you do. In Australia, even if you have health insurance, a disc replacement surgery may leave you more than A$12,000 out of pocket.
Disc replacement surgery is not performed as much as other spinal surgeries (for example, spinal fusion) but its use is increasing.
In New South Wales for example, rates of privately-funded disc replacement increased six-fold from 6.2 per million people in 2010–11 to 38.4 per million in 2019–20.
What are the benefits and harms?
People considering surgery will typically weigh that option against not having surgery. But there has been very little research comparing disc replacement surgery with non-surgical treatments.
Clinical trials are the best way to determine if a treatment is effective. You first want to show that a new treatment is better than doing nothing before you start comparisons with other treatments. For surgical procedures, the next step might be to compare the procedure to non-surgical alternatives.
Unfortunately, these crucial first research steps have largely been skipped for disc replacement surgery for both neck and back pain. As a result, there’s a great deal of uncertainty about the treatment.
There are no clinical trials we know of investigating whether disc replacement is effective for neck pain compared to nothing or compared to non-surgical treatments.
For low back pain, the only clinical trial that has been conducted to our knowledge comparing disc replacement to a non-surgical alternative found disc replacement surgery was slightly more effective than an intensive rehabilitation program after two years and eight years.
Complications are not uncommon, and can include disclocation of the artificial disc, fracture (break) of the artificial disc, and infection.
In the clinical trial mentioned above, 26 of the 77 surgical patients had a complication within two years of follow up, including one person who underwent revision surgery that damaged an artery leading to a leg needing to be amputated. Revision surgery means a re-do to the primary surgery if something needs fixing.
Are there effective alternatives?
The first thing to consider is whether you need surgery. Seeking a second opinion may help you feel more informed about your options.
Many surgeons see disc replacement as an alternative to spinal fusion, and this choice is often presented to patients. Indeed, the research evidence used to support disc replacement mainly comes from studies that compare disc replacement to spinal fusion. These studies show people with neck pain may recover and return to work faster after disc replacement compared to spinal fusion and that people with back pain may get slightly better pain relief with disc replacement than with spinal fusion.
However, spinal fusion is similarly not well supported by evidence comparing it to non-surgical alternatives and, like disc replacement, it’s also expensive and associated with considerable risks of harm.
Fortunately for patients, there are new, non-surgical treatments for neck and back pain that evidence is showing are effective – and are far cheaper than surgery. These include treatments that address both physical and psychological factors that contribute to a person’s pain, such as cognitive functional therapy.
While Musk reported a good immediate outcome with disc replacement surgery, given the evidence – or lack thereof – we advise caution when considering this surgery. And if you’re presented with the choice between disc replacement and spinal fusion, you might want to consider a third alternative: not having surgery at all.
Giovanni E Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney, and Joshua Zadro, NHMRC Emerging Leader Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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I can’t afford olive oil. What else can I use?
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If you buy your olive oil in bulk, you’ve likely been in for a shock in recent weeks. Major supermarkets have been selling olive oil for up to A$65 for a four-litre tin, and up to $26 for a 750 millilitre bottle.
We’ve been hearing about the health benefits of olive oil for years. And many of us are adding it to salads, or baking and frying with it.
But during a cost-of-living crisis, these high prices can put olive oil out of reach.
Let’s take a look at why olive oil is in demand, why it’s so expensive right now, and what to do until prices come down.
Joyisjoyful/Shutterstock Remind me, why is olive oil so good for you?
Including olive oil in your diet can reduce your risk of developing type 2 diabetes and improve heart health through more favourable blood pressure, inflammation and cholesterol levels.
This is largely because olive oil is high in monounsaturated fatty acids and polyphenols (antioxidants).
Some researchers have suggested you can get these benefits from consuming up to 20 grams a day. That’s equivalent to about five teaspoons of olive oil.
Why is olive oil so expensive right now?
A European heatwave and drought have limited Spanish and Italian producers’ ability to supply olive oil to international markets, including Australia.
This has been coupled with an unusually cold and short growing season for Australian olive oil suppliers.
The lower-than-usual production and supply of olive oil, together with heightened demand from shoppers, means prices have gone up.
We’ve seen unfavourable growing conditions in Europe and Australia. KaMay/Shutterstock How can I make my olive oil go further?
Many households buy olive oil in large quantities because it is cheaper per litre. So, if you have some still in stock, you can make it go further by:
- storing it correctly – make sure the lid is on tightly and it’s kept in a cool, dark place, such as a pantry or cabinet. If stored this way, olive oil can typically last 12–18 months
- using a spray – sprays distribute oil more evenly than pourers, using less olive oil overall. You could buy a spray bottle to fill from a large tin, as needed
- straining or freezing it – if you have leftover olive oil after frying, strain it and reuse it for other fried dishes. You could also freeze this used oil in an airtight container, then thaw and fry with it later, without affecting the oil’s taste and other characteristics. But for dressings, only use fresh oil.
I’ve run out of olive oil. What else can I use?
Here are some healthy and cheaper alternatives to olive oil:
- canola oil is a good alternative for frying. It’s relatively low in saturated fat so is generally considered healthy. Like olive oil, it is high in healthy monounsaturated fats. Cost? Up to $6 for a 750mL bottle (home brand is about half the price)
- sunflower oil is a great alternative to use on salads or for frying. It has a mild flavour that does not overwhelm other ingredients. Some studies suggest using sunflower oil may help reduce your risk of heart disease by lowering LDL (bad) cholesterol and raising HDL (good) cholesterol. Cost? Up to $6.50 for a 750mL bottle (again, home brand is about half the price)
- sesame oil has a nutty flavour. It’s good for Asian dressings, and frying. Light sesame oil is typically used as a neutral cooking oil, while the toasted type is used to flavour sauces. Sesame oil is high in antioxidants and has some anti-inflammatory properties. Sesame oil is generally sold in smaller bottles than canola or sunflower oil. Cost? Up to $5 for a 150mL bottle.
There are plenty of alternative oils you can use in salads or for frying. narai chal/Shutterstock How can I use less oil, generally?
Using less oil in your cooking could keep your meals healthy. Here are some alternatives and cooking techniques:
- use alternatives for baking – unless you are making an olive oil cake, if your recipe calls for a large quantity of oil, try using an alternative such as apple sauce, Greek yoghurt or mashed banana
- use non-stick cookware – using high-quality, non-stick pots and pans reduces the need for oil when cooking, or means you don’t need oil at all
- steam instead – steam vegetables, fish and poultry to retain nutrients and moisture without adding oil
- bake or roast – potatoes, vegetables or chicken can be baked or roasted rather than fried. You can still achieve crispy textures without needing excessive oil
- grill – the natural fats in meat and vegetables can help keep ingredients moist, without using oil
- use stock – instead of sautéing vegetables in oil, try using vegetable broth or stock to add flavour
- try vinegar or citrus – use vinegar or citrus juice (such as lemon or lime) to add flavour to salads, marinades and sauces without relying on oil
- use natural moisture – use the natural moisture in ingredients such as tomatoes, onions and mushrooms to cook dishes without adding extra oil. They release moisture as they cook, helping to prevent sticking.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Ikigai – by Héctor García and Francesc Miralles
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Ikigai is the Japanese term for what in English we often call “raison d’être”… in French, because English is like that.
But in other words: ikigai is one’s purpose in life, one’s reason for living.
The authors of this work spend some chapters extolling the virtues of finding one’s ikigai, and the health benefits that doing so can convey. It is, quite clearly, an important and relevant factor.
The rest of the book goes beyond that, though, and takes a holistic look at why (and how) healthy longevity is enjoyed by:
- Japanese people in general,
- Okinawans in particular,
- Residents of Okinawa’s “blue zone” village with the highest percentage of supercentenarians, most of all.
Covering considerations from ikigai to diet to small daily habits to attitudes to life, we’re essentially looking at a blueprint for healthy longevity.
For a book whose title and cover suggests a philosophy-heavy content, there’s a lot of science in here too, by the way! From microbiology to psychiatry to nutrition science to cancer research, this book covers all bases.
In short: this book gives a lot of good science-based suggestions for adjustments we can make to our lives, without moving to an Okinawan village!
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Apple Cider Vinegar vs Apple Cider Vinegar Gummies – Which is Healthier?
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Our Verdict
When comparing apple cider vinegar (bottled) to apple cider vinegar (gummies), we picked the bottled.
Why?
There are several reasons!
The first reason is about dosage. For example, the sample we picked for apple cider vinegar gummies, boasts:
❝2 daily chewable gummies deliver 800 mg of Apple Cider Vinegar a day, equivalent to a teaspoon of liquid apple cider vinegar❞
That sounds good until you note that it’s recommended to take 1–2 tablespoons (not teaspoons) of apple vinegar. So this would need more like 4–8 gummies to make the dose. Suddenly, either that bottle of gummies is running out quickly, or you’re just not taking a meaningful dose and your benefits will likely not exceed placebo.
The other is reason about sugar. Most apple cider vinegar gummies are made with some kind of sugar syrup, often even high-fructose corn syrup, which is one of the least healthy foodstuffs (in the loosest sense of the word “foodstuffs”) known to science.
The specific brand we picked today was the best we can find; it used maltitol syrup.
Maltitol syrup, a corn derivative (and technically a sugar alcohol), has a Glycemic Index of 52, so it does raise blood sugars but not as much as sucrose would. However (and somewhat counterproductive to taking apple cider vinegar for gut health) it can cause digestive problems for many people.
And remember, you’re taking 4–8 gummies, so this is amounting to several tablespoons of the syrup by now.
On the flipside, apple cider vinegar itself has two main drawbacks, but they’re much less troublesome issues:
- many people don’t like the taste
- its acidic nature is not good for teeth
To this the common advice for both is to dilute it with water, thus diluting the taste and the acidity.
(this writer shoots hers from a shot glass, thus not bathing the teeth since it passes them “without touching the sides”; as for the taste, well, I find it invigorating—I do chase it with water, though to be sure of not leaving vinegar in my mouth)
Want to check them out for yourself?
Here they are:
Apple cider vinegar | Apple cider vinegar gummies
Want to know more about apple cider vinegar?
Check out:
- An Apple (Cider Vinegar) A Day…
- 10 Ways To Balance Blood Sugars
- How To Recover Quickly From A Stomach Bug
Take care!
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Brown Rice Protein: Strengths & Weaknesses
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I had a friend mention that recent research showed Brown Rice Protein Powder can be bad for you, possibly impacting your nutrient absorption. Is this true? I’ve been using it given it’s one of the few plant-based proteins with a full essential amino acid profile!❞
Firstly: we couldn’t find anything to corroborate the “brown rice protein powder [adversely] impacts nutrient absorption” idea, but we suspect that the reason for this belief is: brown rice (not brown rice protein powder) contains phytic acid, which is something of an antinutrient, in that it indeed reduces absorption of various other nutrients.
However, two things are important to note here:
- the phytic acid is found in whole grains, not in protein isolates as found in brown rice protein powder. The protein isolates contain protein… Isolated. No phytates!
- even in the case of eating whole grain rice, the phytic acid content is greatly reduced by two things: soaking and heating (especially if those two things are combined) ← doing this the way described results in bioavailability of nutrients that’s even better than if there were just no phytic acid, albeit it requires you having the time to soak, and do so at temperature.
tl;dr = no, it’s not true, unless there truly is some groundbreaking new research we couldn’t find—it was almost certainly a case of an understandable confusion about phytic acid.
Your question does give us one other thing to mention though:
Brown rice indeed technically contains all 9 essential amino acids, but it’s very low in several of them, most notably lysine.
However, if you use our Tasty Versatile Rice Recipe, the chia seeds we added to the rice have 100x the lysine that brown rice does, and the black pepper also boosts nutrient absorption.
Because your brown rice protein powder is a rice protein powder and not simply rice, it’s possible that they’ve tweaked it to overcome rice’s amino acid deficiencies. But, if you’re looking for a plant-based protein powder that is definitely a complete protein, soy is a very good option assuming you’re not allergic to that:
Amino Acid Compositions Of Soy Protein Isolate
If you’re wondering where to get it, you can see examples of them next to each other on Amazon here:
Brown Rice Protein Powder | Soy Protein Isolate Powder
Enjoy!
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Tuna vs Catfish – Which is Healthier?
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Our Verdict
When comparing tuna to catfish, we picked the tuna.
Why?
Today in “that which is more expensive and/or harder to get is not necessarily healthier”…
Looking at their macros, tuna has more protein and less fat (and overall, less saturated fat, and also less cholesterol).
In the category of vitamins, both are good but tuna distinguishes itself: tuna has more of vitamins A, B1, B2, B3, B6, and D, while catfish has more of vitamins B5, B9, B12, E, and K. They are both approximately equal in choline, and as an extra note in tuna’s favor (already winning 6:5), tuna is a very good source of vitamin D, while catfish barely contains any. All in all: a moderate, but convincing, win for tuna.
When it comes to minerals, things are clearer still: tuna has more copper, iron, magnesium, phosphorus, potassium, and selenium, while catfish has more calcium, manganese, and zinc. Oh, and catfish is also higher in one other mineral: sodium, which most people in industrialized countries need less of, on average. So, a 6:3 win for tuna, before we even take into account the sodium content (which makes the win for tuna even stronger).
In short: tuna wins the day in every category!
Want to learn more?
You might like to read:
Farmed Fish vs Wild Caught (It Makes Quite A Difference)
Take care!
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Military Secrets (Ssh!)
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Can you keep a secret?
When actor Christopher Lee was asked about his time as a British special forces operative, he would look furtively around, and ask “can you keep a secret?” Upon getting a yes, he would reply:
“So can I”
We can’t, though! We just can’t help sharing cool, useful information that changes people’s lives. Never is that more critical than now, as the end of January has been called the most depressing time of year, according to Dr. Cliff Arnall at the University of Cardiff. It doesn’t have to be all doom and gloom, though:
Today we’re going to share a trick… It’s called the “secret of eternal happiness” (yes, we know… we didn’t come up with the name!) and is taught to soldiers to fend off the worst kinds of despair.
The soldiers would be ordered to take a moment to reflect on the sheer helplessness of their situation, the ridiculous impossibility of the odds against them, all and any physical pain they might suffer, the weakness of their faltering body… and just when everything feels as bad is it can possibly feel, they’re told to say out loud—as sadly as possible—this single word:
“Boop”
It all but guarantees to result in cracking a smile, no matter the situation.
Now this knowledge is yours too! Keep it secret! Or don’t. Sharing is caring.
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