Why Pain Doctors View Surgery as “Last Resort” For Back Pain

Two orthopedic spine surgeons performing surgery for vertebral compression fracture in an operating room.

If you’re one of the millions of people who experience back pain each year, remember you aren’t alone. It’s one of the most common reasons to miss work or visit a doctor. You may think surgery is inevitable, but in reality, only a small minority of patients require surgery for back pain. Typically, you can resolve your back pain issues within four to 6 weeks if you seek the advice of a physician.

While surgery can be necessary for treating certain life-threatening issues and preventing permanent nerve damage in patients who have certain “red flag” symptoms, many patients still experience pain after recovering from surgery. A 2018 medical literature review reported the failure rate for lumbar spinal surgery ranges between 10-46%.

physical therapy alternative therapy for pain management

Options to Avoid Surgery

Most physicians consider surgery a last resort and only after trying more conservative methods for about a year. These effective treatments include:

Physical therapy: Back pain is often caused by improper body mechanics — moving, sitting, or lifting incorrectly. The therapist teaches you proper ways to move your body without straining and promotes good posture. He or she will also teach you exercises to strengthen your back and core muscles which makes you less likely to suffer from back pain.

Medication: It’s often necessary to take anti-inflammatory medications to reduce the swelling. Alternating heat and ice is another way to help reduce inflammation and nerve irritation. Muscle relaxers and narcotics are also sometimes prescribed when necessary to help heal your body.

Injections: Sometimes a physician recommends an epidural injection of an anti-inflammatory medication or facet joint injections.

Alternative treatments: These include massage therapy, acupuncture, yoga, or a chiropractic adjustment.

Coping with Pain

Before referring a patient to a neurosurgeon, we frequently have them assessed for psychological issues. If you’re often anxious or struggle with depression, you have a higher risk of pain, including back pain. Studies indicate that if you can improve the anxiety and depression with appropriate treatments, your pain level will also improve. Such treatments include:

  • Cognitive behavioral therapy.
  • Relaxation training.
  • Hypnosis.
  • Exercise.
  • Medications like antidepressants, acetaminophen or Ibuprofen.

When Surgery is Necessary

Signs that indicate surgery is necessary include:

Severe or progressive motor weakness: This occurs when you cannot move one of your arms or legs or it’s very difficult to do so. True motor weakness isn’t when you avoid moving one of your limbs because it causes more pain.

Symptoms of cauda equina syndromeThis includes numbness, tingling or weakness in your saddle region — the parts of your body that would touch a horse while riding it. Loss of bladder or bowel control is another common symptom of this syndrome.

It’s vital that you seek the advice of a physician when you experience back pain. The doctor will advise you on the most effective ways to resolve the pain quickly and to improve your quality of life.


The information included in this document in no way substitutes for medical advice.

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