Do You Need Back Surgery?

Back pain? You’re in good company. About 80 percent of people worldwide will experience back pain at some point in their lives. Most cases of back pain don’t have an identifiable cause and go away within four weeks. 

But what if it doesn’t? What if your back pain sticks around? Do you need to go under the knife? Here are some questions to ask yourself and your spine specialist to figure out when back surgery may be necessary.

How Long Has Your Back Been Hurting?

As noted, most back pain clears up on its own within a month. Those are cases of acute back pain. Back pain lasting between 4 and 12 weeks is known as subacute back pain, and if it lasts longer than 12 weeks it is chronic. 

If you have acute back pain, it’s not worth it to seek out a spine surgeon. By the time you’re checked out and scheduled for surgery, your pain will likely be gone. 

Cases of subacute back pain may still spontaneously resolve on their own, but you should make an appointment with a spine specialist if your pain persists for more than four weeks. If you have chronic back pain, it may be time to consider surgery.

Have You Tried Conservative Treatments?

Almost all spine specialists will first try to treat their patients’ back pain without surgery. Conservative, nonoperative treatment can help relieve symptoms and speed up the recovery process. These measures can include: 

• Exercise and physical therapy
• Rest (but not too much; being active is good for back pain)
• Heat or ice
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroid injections
• Nerve blocks
• Muscle relaxants

Using one or more of these methods for a period of weeks before considering surgery is an almost universal requirement. However, if you and your spine specialist have exhausted conservative treatment options and have not seen a reduction in pain, surgery may be the logical next step.

Do You Have Arm or Leg Pain?

Counterintuitively, back surgery can often be more effective for radiculopathy—pain that radiates into the arms or legs, such as sciatica. That’s because this pain originates in the spine; usually it is caused by compression of a nerve root. 

Pure back pain is often better treated with more conservative measures listed above, but surgery can be very effective for radiculopathy. Some of the more common procedures to treat radiating pain include: 

• Laser disc decompression: This minimally invasive procedure treats herniated discs that are pressing on nerve roots. A surgeon delivers laser energy through a needle into the disc. The heat from the laser changes the disc’s internal pressure, causing the herniated portion to be sucked back into the disc and relieving the pressure on the nerve root. 
• Microdiscectomy: This procedure also treats herniated discs. Surgeons physically remove the portion of the disc that is impinging upon the nerve root. 
• Fusion: This procedure usually treats spinal stenosis, which is a narrowing of the spinal canal, usually in the lumbar spine. In fusion surgery, spine experts place a bone graft between two vertebrae. The bone graft acts as a scaffold that the body uses to build new tissue, effectively growing the two vertebrae into one. Spinal fusion eliminates potentially painful movement of the fused vertebrae.
• Laminectomy: This procedure can treat either a herniated disc or spinal stenosis. In a laminectomy, the back portion of a vertebra is removed, which makes more room in the spinal canal and takes pressure off nerve roots. 

If you are troubled with persistent back pain or radiculopathy, request an appointment at Edison Spine Center. We will diagnose the source of your pain, develop a conservative treatment plan for you and perform spine surgery if needed.