Coach’s persistent pain from back surgery in ’15 is unusual, doctors say
The blinding headaches and debilitating fatigue that have plagued Warriors head coach Steve Kerr since his back surgery — and now threaten to keep him from guiding the team’s playoff run — aren’t common complaints. But they aren’t rare either, say back pain specialists.
What’s unusual is just how long Kerr has been suffering. Symptoms like his should resolve in a few days, a few weeks at most, doctors say. But Kerr’s surgery was nearly two years ago.
Warriors head coach Steve Kerr before Game 4 of a playoff series against the Trail Blazers in Portland, Ore. Persistent pain kept Kerr from coaching in Games 3 and 4.
“For a patient to have ongoing symptoms of headaches and that sort of thing after several months — that is pretty uncommon,” said Dr. Lionel Metz, an orthopedic surgeon at UCSF who has not treated Kerr.
Most patients who suffer complications of back surgery feel better after a few days of bed rest, said Dr. David Chang, a surgeon with Bay Area Sports Orthopedics in Oakland. “At this point, he’s an outlier,” Chang said.
Kerr’s suffering has been difficult for Warriors fans to witness. The popular and char-
ismatic coach — who played alongside Michael Jordan and won five championship rings as a sharp-shooting guard, but reached new heights two years ago when he led the Warriors to an NBA title in his rookie season as a head coach — has been in obvious pain at times.
The 51-year-old coach stepped away from the bench Saturday, telling players and then the public that he would not be able to lead the team in Game 3 of Golden State’s first round playoff matchup against the Portland Trail Blazers. Lead assistant coach Mike Brown filled in as the Warriors overcame a 17-point deficit to win 119-113 to take a 3-0 lead in the best-of-seven series.
Kerr addressed reporters Sunday, saying he was uncertain when he’d be able to return to coaching games. On Monday, hours before the Warriors completed the sweep, he was clearly in pain, grimacing and moving stiffly during a pregame shootaround in Portland. He’s been reluctant to share details of his ailment, but people close to him said he’s been suffering headaches and neck pain.
“As of now, I’m consulting with my doctors,” Kerr said Sunday. “I’m hoping for some improvement. If I can get some improvement, I’ll get back on the sidelines. But I’m not going to do that unless I know I can help my team.”
Kerr’s medical problems date to a pair of back surgeries he underwent after guiding the Warriors to an NBA championship in 2015. Kerr, who had a 15-year playing career in the NBA, went in to correct unspecified, nagging back pain in late July that year.
Something went awry during the surgery: There was a nick to the dura, the outermost layer of the thin membrane that surrounds and protects the spinal cord. Spinal fluid leaked through the tear, causing headaches, nausea and other complications.
Kerr went in for a second surgery to repair the tear and stop the leak in September 2015, but his symptoms continued. He has not said where he got the surgery.
Before the start of the next season, Kerr announced he would step aside to deal with his health problems, allowing his lead assistant coach, Luke Walton, to direct the team for the first 43 games. Kerr returned to the bench and led the Warriors to the NBA Finals, falling one win short of a second consecutive title.
Now, as the team makes another playoff run, Kerr’s physical struggles have returned. Similar to early last season, the coach has been reluctant to put a timetable on his return or detail his ailments.
Back pain specialists who were not familiar with details of the case said that what Kerr has experienced is a known complication of back surgery. Even relatively simple procedures like epidurals, in which an anesthetic is injected into the space above the dura, can cause puncture wounds and small spinal fluid leaks.
Headaches and other symptoms occur when enough spinal fluid seeps out that it throws off the balance of pressure in the central nervous system, which includes the spinal cord and brain. The drop in pressure puts stress on the nervous system, causing symptoms like headaches, vision problems, ringing in the ears, nausea, dizziness and general nerve pain.
Small tears, such as a puncture wound caused during an epidural, generally heal after a few hours or days. Larger tears may need follow-up treatment, which can include an injection of blood into the site to encourage healing or, in more extreme cases, surgery to suture the injury.
Still, back pain experts said it’s unusual for symptoms to last as long as they have with Kerr. Not knowing the details of his case, doctors said they could not comment on why his problems haven’t resolved.
It’s possible that Kerr suffered an especially large or difficult tear that has not healed properly. Or he may simply need more time to convalesce, quietly, at home. Any activity, even sitting up instead of lying down, can inhibit recovery.
“For Warriors fans, the prognosis is typically good. It should resolve,” Chang said. “But there is concern here, because obviously this is another setback after a prolonged period of convalescence.” Kerr said he’s tried to ease his pain with yoga, meditation, physical therapy, pain medication and medical marijuana. None have provided substantial relief.
Though Kerr has said he needed the surgery because he was out of options to resolve his back pain, he has also advised others to avoid similar procedures at all costs.
Back pain experts said that while they, too, encourage patients to try other means of recovery before surgery, the procedures are safe and successful. They warned people with back pain not to give too much weight to Kerr’s difficult, but extremely unusual, circumstances.
“These are highly effective procedures,” said Dr. Adebukola Onibokun, a surgeon with San Jose Neurospine. “They’re actually very safe procedures.”