Vincent Fortanasce, M.D.
Neuro-orthopedics Rehabilitation Medicine
Assistant Clinical Professor, USC
“Your efforts have saved lives and brought comfort to many, and your steadfast devotion has earned you the trust and respect of your community.” –Former U.S. President Bill Clinton
“Dr. Fortanasce’s experience in orthopedics, neurology, and psychiatry at the mecca of spine pain at U.S.C. and Yale (Institute of Living) makes him unique in diagnosing and treating spine pain. His help has been invaluable to my patients.” –William Sears, M.D., author of The Sears Parenting Library Series
“Few authors, if any, who have written on this subject, have the broad training in neurology, psychiatry, and rehabilitation that Dr. Fortanasce has. His approach to “the spine risk factors is novel.” –Joseph P. Van Der Meulen, MD, past chairman of the department of neurology at the USC and Los Angeles County Hospital.
“Dr. Fortanasce’s End Neck and Back Pain is the perfect game plan to diagnose, prevent, and treat spine pain. Both my wife and I know.” –Tommy Lasorda, Hall of Fame Major League Baseball Manager
“When it comes to diagnosis and surgery, Dr. Fortanasce and Dr. Watkins are in a class of their own.” –Sylvester Stalone
Dr. Vincent Fortanasce has helped thousands of individuals over a prestigious medical career of nearly four decades as a world-renowned neurologist, psychiatrist, and rehabilitation specialist. End Back and Neck Pain stands alone as a comprehensive guide to both neck and back pain, offering advice from the best health care professionals. Together with Dr. Robert Watkins, spinal surgeon to the most prestigious athletes in America, and Dr. David Gutkind, physical therapist and clinical professor at USC School of Biokinesiology and Physical Therapy, we present a unique book that empowers patients with spine (back and neck) pain to be victims no longer. End Back and Neck Pain will teach the spine patient to recognize spine symptoms, find their proper treatment, and prevent their recurrence. Their science based, medically sound, patient tested program is based on the HELP method:
H – History. An adequate history is the most important element in a proper diagnosis. Learn what to tell your doctor.
E – Exam. What is an adequate spine exam? Learn how to help your health care professional diagnose your problem.
L – Lab. What tests should be performed? How to prepare? What to expect?
P – Prescription. Based on the history, exam, and lab, your treatment will help and not harm you. Patients who are diagnosed with the HELP method have an 86% chance of success with surgery compared to a 33% success rate for those who are not diagnosed with the HELP method.
Spine Disorder Facts
- Back pain is the 1st most common reason for ER visits
- Spine pain is the 2nd most common reason for a doctor visit
- Spine surgery is the 3rd most common elective surgery
- 95% of people will experience spine pain, 48% of whom will experience recurrent spine pain
- 30% will experience chronic spine pain
- Spine pain prescription with opioids is the major cause of addiction in America
- MRIs are a major cause of misdiagnosis of spine pain
- $70 billion is spent annually on spine pain
- Despite a 30 fold increase in cost, the prevalence of chronic spine pain is increasing
Questions and Answers
- The book answers such questions as:
- When is time to take out an ice pack or rush to the ER?
- How to find a spine specialist?
- Why patients with spine pain don’t get better?
- How to know if your health care professional can back up their credentials?
- Who to see for a second opinion
- Have you been told that you need surgery?
- Current treatment failing?
- Need an expert on spine care?
- What to look for:
- Conflict of interest
- Have you been advised to have surgery?
- What are the indications?
- What are the risks?
- How can you evaluate the competency of your surgeon?
- How the HELP method of diagnosis improves your chances of a successful surgery
- How to find the right doctor to diagnose your problem? Does your health care professional use the HELP method to advise you on the correct diagnosis?
- Did you know that spine pain is the #1 cause for people taking time off work, the second most common reason for an ER visit, and the third most common elective surgery
- Why the MRI and CT scan can lead to the wrong diagnosis and unnecessary treatments and surgery? One of the major reasons for drug use due to spine pain is the random use of MRI and CT scans, as well as an inadequate history and exam.
- Have you been referred to a pain specialist? How can you evaluate your spine specialist?
- Did you know that if you know what to look for you can diagnose yourself correctly in 8 of 10 cases?
- Learn the voices of spine pain.
- Has your doctor done an adequate spine exam?
- Learn the ABCs of what your spine specialist should tell you before he prescribes treatment.
- Did you know that, in the USA, treatment of spine pain is biased? Your treatment usually depends not on your diagnosis, but your health care professional’s treatment remedies.
- Did you know that spine pain is a 110 billion dollar industry?
- Did you know that despite all of our new technology and treatments, the cost of spine treatment has increased 30 fold and chronic spine pain problems have tripled since the 1950s and 1960s?
- Did you know that our technology using MRI and CT scans misdiagnose our spine problems more often than identify them, and is a major reason for misdiagnosis?
- Did you know that treatment of spine pain with medication has doubled in the past 10 years and spinal injections and pain pumps have quadrupled?
- Did you know that chronic pain for spine problems is rising rapidly despite our new technology and treatment remedies?
- Did you know that the most effective prevention of back pain can be done at home without any cost or equipment?
- Would you like to know how to prepare for your test, injections, or surgery, and know what to expect?
- After a spinal injection or surgery, would you like to know when your complaints are normal or a serious complication?
- Do you know when your spine complaints are serious and when you need to be seen now versus a month from now when your doctor has an appointment available?
- Are you fed up with treatment after treatment and bill after bill with no relief? Learn what you can do about it. Empower yourself, don’t be a victim to the same treatment industry that may cause more harm to your spine than good.
On October 1st, Dr. Fortanasce’s latest book End Back and Neck Pain will be featured in all book stores in the U.S.A., as well as internationally in Beijing and Frankfurt, Germany. It is the first comprehensive patient & physician empowerment book to diagnosis, treat, and prevent spine pain. It addresses questions such as:
- What is the real cause of your back pain
- How treatment is based on a proper diagnosis
- The cost of treating back pain has increased 40 fold and yet the amount of time of missed work due to spine pain has doubled in the past 50 years
- Why MRI and CT scan often lead to the wrong treatment
- How to prevent spine pain
- How a physician, through the HELP method, can explain the cause and proper treatment of spine pain
- How to know if it’s simply a time to put ice on your back or go to the ER
- The Problem
- In the U.S.A., health care professionals’ specialty dictate your treatment and not your diagnosis
- The Solution
- How to get a proper diagnosis through the HELP diagnostic method
- H – history
- E – spine exam
- L – lab and proper use of MRI and EMG
- P – prescription based on history, exam, and lab
- What are the essential questions to ask your doctor and how to recognize you’ve been given a proper spine exam?
- What are the most effective and safest medications?
- Learn when you are becoming addicted
- Learn when to inject and when to refer to a surgeon
- What are the indications for surgery and the latest techniques?
- What are the reasonable expectations?
- What are possible complications to medication, injections, and surgical treatment?
- When are they serious and when are they not?
- What is one of the least ordered yet most important diagnostic tests? An electromyography test (EMG) is 97% specific versus 40% specificity for an MRI
“Your Back or Your Buck”
Integrity: Can Your Health Care Provider (HCP) Back Up Their Credentials?
Problem: Since 1960, despite medical advances the cost of spine care has risen 30-fold and the recovery rate is half of what it was. Why?
Fact: $110 billion is spent on spine care every year.
Fact: Treatment seems to depend on HCP’s special interest. Upon 1st visit, for the same condition:
- 92% of medical doctors prescribe medication; 64% chance two medications, with a 40% one of these two medications is a narcotic
- 99% of chiropractors provide manipulation or therapy
- 54% of pain specialists provide injections
- 27% of surgeons prescribe surgery
Discussion: Why treatment must be based upon proper diagnosis. Does your HCP provider care about your back or your buck? Why MRI scans are a major cause of misdiagnosis.
Medication and Back Pain: The State of Medication
Problem: A major cause of addiction in the U.S. is the misuse of narcotic medication (opioids) for back pain.
Fact: In the past 10 years, prescription for pain medication has doubled.
Story of Francis
Within three weeks of narcotic use became addicted and within three months lost her job and almost died of liver damage – all from doctor-prescribed and over-the-counter remedies.
- When it is appropriate to order a medication.
- What medication is best for acute vs. chronic spine pain.
- What are the serious side effects?
- Are you or a loved one addicted? The 4 signs of addicted behavior.
Back and Neck Pain Diagnosis: Have You Been Mislabeled?
Problem: Have you been told that you have sciatica, spinal stenosis or radiculopathy?
Story of John
“I have three herniated discs, sciatica and I need surgery.” What do these labels mean? And, have you been mislabeled?
- How to get the correct diagnosis.
- The HELP method – History, Exam, Laboratory, Prescription.
Surgery and Back Pain
“To Cut or Not to Cut”: That is the Question
Problems: How can you be certain of a good outcome? What are the indications of surgery?
- The HELP method is the only way to ensure proper treatment.
- The compelling, reasonable and relative indications for surgery.
- How to be certain your doctor knows what they are doing.
Tests and Back Pain: The Crystal Ball and Technology
Problems: The MRI and CT scans are a major cause of misdiagnoses. The EMG is the most specific, yet least ordered, test for spine pain.
Fact: 50% of patients over 40 years old with no spine pain have seriously abnormal MRI results.
- Are all of the tests necessary?
- Which tests are best?
- What to expect and how to prepare for tests.
“Analysis and Paralysis”
Why You Cannot Find Relief From Back Pain
Story of Jane
She had emergency surgery after two months of misdiagnoses. No one visually inspected her back.
Problem: Misdiagnosis and mistreatment of back pain.
Discussion: The Real Problem
- Lack of proper history.
- Lack of physical exam.
- Inadequate training.
- Overreliance on MRI and CT scans.
“Patient Empowerment Book”
Do not Be a Victim Any Longer: What the three most sought-out names in spine pain have to say.
Problems: What is chronic back disorder and what are the causes?
Fact: Most chronic pain is due to misdiagnoses and misuse of medications, surgery and injections.
- Know the voices of spine pain.
- Know what to tell your HCP. Be prepared.
- Know what an adequate exam is.
- Know what a HCP must tell you before ordering tests or advising treatment.
“My Aching Back”
Spine Pain: Am I in Trouble?
Story of David – thought this was the end.
Problem: Know the voices of back pain – when to take an aspirin and when to go the ER.
The voices of back pain caused by a:
- Muscle and/or tendon
There are two reasons for injections:
- Help with identifying the cause of pain
- Relieving pain
What are the types of spine injections?
Post-injection – what to expect and when is it a complication.
How to Find a Spine Specialist – 10 Questions to Ask
10 Tips to Avoid Back Pain
What to do When You Get Sudden Back Pain
5 Exercises to do Every Day