Why is Elon Musk recommending disc replacement for neck and back pain?

As a chiropractor, I work with people with neck and back pain on an almost daily basis. One of the top considerations when it comes to spinal pain treatments, is if the treatment works as well as the risks involved. Conservative treatments can range from chiropractic adjustment, acupuncture or TCM, to rehabilitative exercises. Surgery is often thought of as a last resort treatment if conservative care fails.

If you’re experiencing severe neck/back pain, I recommend looking into a disc replacement.

If you do, err on the side of a disc with limited movement. A simple hinge is more likely to be effective than a high mobility artificial disc that can translate, as well as rotate.

— Elon Musk (@elonmusk) April 15, 2024

The recovery from surgical intervention is often challenging. Therefore, I was surprised about Elon Musk’s tweet recommending people with severe back or neck pain to consider a disc replacement. Is disc replacement surgery really the ultimate cure that Elon is suggesting?

What’s wrong with Elon Musk spine?

It is impossible to have a complete picture of his case from his tweets and online resources. Based on what others have gathered, it seems like Elon suffered from a disc herniation. However, the extent of his injury is unclear. According to New York Post, Elon “blew out” a spinal disc during his birthday party as he trying to do a judo throw on a sumo wrestling champion. The same article also reported that have had three surgeries for his C5-C6 intervertebral disc.

It is unclear how many surgeries Elon Musk had in total. But if you are going for three surgeries for a disc herniation, I would say that’s good evidence surgery is not a good treatment for disc injuries.

Mind you, this is one of the richest person on the planet. I would expect him to have access to the best healthcare and best orthopaedic surgeon.

What is the best back pain relief?

Broadly speaking, exercise and advice to stay active are the best treatments for back pain relief. Virtually all clinical guidelines in the world agree on that. It is probably not what most what people want to hear because it challenges our biases.

When we are in pain, we identify ourselves as being sick. Sick behaviour, accordingly to our bias, means resting and being cared for. Unfortunately, evidence-based treatments suggest this is not true. In fact, bed rest has been reported to make spinal pain worse.

If you need quick pain relief, painkillers can be a good consideration. Yes, it does come with its side effects but they are nothing close to the risks associated with a surgery. Sometimes we do need immediate pain relief to get us through a bad day. I 100% appreciate that.

Commonly prescribed medication for back pain in Singapore include Anarex (paracetamol and orphenadrine) and diclofenac. For topical NSAID applications, Kefentech and Salonpas® Diclofenac Patch 1% are popular choices. No, we are not sponsored.

What is the problem with Elon Musk recommending disc replacement surgery?

In my opinion, it is highly irresponsible for someone with influence to make recommendation outside of their subject matter expertise. Sure, Elon Musk talk about electric cars or how-to-be-a-billionaire. But giving advice on musculoskeletal conditions is definitely not something that he should be doing.

It is also unsurprising that someone with a tech background may be receptive to surgery and the latest medical devices that are available on the market. In his tweet, he talked about the types of disc replacement and what to choose for (i.e., simple hinge over one that translate and rotate). This is clearly gear talk but may I remind you that your body is not a car!

There is a misconception that surgery is the ultimate solution for back pain or neck pain because it is seen as a last resort treatment. It is a last resort treatment not because it works. It is because it works poorly.  High risks don’t always translate to high rewards.

Also, appeal to technology (or novelty) is a fallacy! New technology doesn’t always better.

Disc replacement surgery is quite literally not an evidence-based treatment

This is where giving advice when it is outside your subject matter expertise is a problem. There is no compelling research done to suggest that disc replacement treatment is effective for back pain or sciatica.

The Conversation article, authored by the leading musculoskeletal experts in Australia including a Professional of Orthopaedic Surgery, aptly pointed out that only one clinical trial reported improvements from disc prosthesis to be better than rehabilitation. However, the improvement was small and not clinically meaning (i.e., not enough for patients to perceive additional benefits).

Furthermore, a third of the patients in the study had a complication after the surgery. One of them had to receive a revision surgery, which resulted a leg amputation due to damage to an artery during the surgery.

These are the facts Elon failed to include!

Orthopaedic surgery has a place in pain management

Don’t get me wrong. Orthopaedic surgery definitely has a place in pain management. However, the risks often far outweigh the benefits.

It is 100% possible for Elon to have good outcomes from his disc replacement surgery. What he should have also mentioned are the number of surgeries he had to undergo before telling 50 million people that it’s a game changer.