When to Consider Surgery for Back Pain

Back pain is a common ailment. Most of the time with rest and good practices, backaches get better and people don’t need surgery. Doctors may prescribe physical therapy, pain medicine, or injections of steroids or other medications to alleviate the pain, and patients are advised to adopt good habits to protect their back and avoid activities that they know will lead to back problems.

When the pain is severe and ongoing, and nonsurgical treatments fail to provide relief, patients may decide to see a spine surgeon. The first step is to determine the precise cause of the pain, which is critical for a good result. Patients should be prepared to provide a thorough medical history and a detailed description of the type of pain they are experiencing. X-rays and  high quality MRIs provide more specific information and help pinpoint the cause of the pain.

A common condition for which we perform surgery is a “slipped” or herniated disc when it causes symptoms such as persistent leg pain and weakness. A herniated disc can be very painful when one or more of the discs that cushion the bones of the spine encroaches on a nerve. However, not every patient needs surgery for a herniated disc, because not every herniated disk causes pain. Conservative treatment should always be considered first.

Other conditions that may lead to surgery include:

  • Spinal Stenosis: A narrowing of spaces in the spine that can put pressure on the spinal cord and nerves
  • Spondylolisthesis: When one or more bones of the spine slip out of placeor a fracture caused by a traumatic event that leads to a break in the bone.
  • Progressive scoliosis: A curvature of the spine, may require surgery in children and adults.

Deciding whether and where to have surgery is one of the most important decisions a patient will make. It is encouraged for patients to research doctors and hospitals for the best opportunity for a good outcome. Individuals should choose a surgeon with experience in the procedure they are considering, with whom they have a good rapport, and who takes the time to answer all of their questions.

Patients should ask about the success rate of the surgery, possible complications, how long the recovery will take, and what to expect after surgery and in the months that follow. Patients should understand how much pain relief they should expect after surgery. It is important to select a hospital in which a large number of spinal surgeries are performed.

Many patients fear surgery, and understandably so, which is why it’s helpful for people to talk to another patient who has had the procedure they’re considering. The doctor may be able to put them in touch with someone who has experienced pain relief and improvement in their quality of life. Talking to one’s peers about what to expect can ease a patient’s trepidation.

 Bernard Rawlins

Dr. Bernard Rawlins is an orthopedic spine surgeon at Hospital for Special Surgery specializing in spinal disorders from the cervical spine to scoliosis in both adults and children. He practices at both the HSS Outpatient Center in Paramus and the hospital’s main campus in New York.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.