Common Questions About Back Pain: Do You Need Back Surgery?
Back pain affects an estimated eight out of 10 people over the course of their lives. So, it’s no surprise that this widespread medical condition sparks many questions among patients.
One of the most prevalent questions that spine specialists receive from back pain patients is whether or not they’ll need surgery. Understandably, most patients want to avoid back surgery and the risks that it involves.
In this article, we’ll answer some of the most common questions about back pain and back surgery. With this information, we aim to give you peace of mind in the range of treatments available for back pain today.
Do I need surgery for persistent back pain?
If you’re experiencing ongoing or severe back pain, you may be wondering if you’ll need back surgery to finally eliminate that constant backache. To answer this question and get on the path to relief from debilitating back pain, you’ll likely need to consult a spinal surgeon.
Your spinal surgeon will need to assess your back symptoms, take a full medical history, and review your general health. But, don’t start worrying about the prospect of surgery. Back surgery is generally only needed in a small percentage of back pain cases.
How many people require back surgery for back pain?
According to the UT Southwestern Medical Center, only 10% of back pain cases require surgery. Additionally, among back pain patients who require surgery, minimally-invasive procedures are widely successful.
So, for most patients, back pain can be resolved with a range of non-surgical options. These trusted treatments can keep you off of the operating table and quickly restore your quality of life.
When conservative treatments don’t help, your physician may recommend back surgery. This is often the case when the doctor is looking to provide relief from severe, disabling back pain that’s limiting your lifestyle, interrupting your sleep, and preventing you from being active.
What non-surgical treatment options are available for back pain?
The most common non-surgical treatment options available for back pain include:
- ice or heat therapy,
- anti-inflammatory medications,
- physical therapy,
- chiropractic care,
- massage therapy.
In some cases, patients may benefit from epidural steroid injections, which can alleviate pain and inflammation in the spine. Unfortunately, steroid injections can also trigger tissue damage if they’re used in excess. Most physicians recommend that patients undergo no more than three to four injections per year.
Additionally, lifestyle changes are often very helpful in treating back pain without surgery. Specifically, changing your diet to lose weight can help remove pressure from the spinal nerves. This can help the irritated tissue heal and recover, as well as lessen neurological symptoms.
Your physician may recommend rest for back pain after your initial diagnosis. However, it’s important to stay active with low-impact activities to prevent stiffness and maintain strength. Once back pain and inflammation have decreased, you’ll likely be able to increase your activity level.
What are the best exercises for back pain?
Exercise is beneficial for back pain because it prevents stiffness in the ligaments and tendons. It can help you maintain mobility in the back while increasing circulation to the injured tissue.
However, high-impact, strenuous exercise can do more harm than good for back pain patients. So, it’s crucial to choose your activities wisely.
Some of the best types of exercise for back pain include:
- Swimming and water aerobics
- Resistance exercises
While exercising with back pain, remember to start slowly with short periods of activity. Make sure to rest in between your workouts. If you feel any pain or other concerning symptoms, such as numbness or tingling in the extremities, stop exercising and consider other activities.
What causes lower back pain?
The most common lower back pain causes include:
Strains and Sprains
Strains and sprains are the most common causes of lower back pain. Strains involve stretching or tearing of the muscles or tendons, while sprains involve stretching or tearing of the ligaments.
The causes and treatments of strains and sprains are similar. Overexerting the back while lifting a heavy object, suddenly twisting the back, or falling are possible causes. To treat lower back sprains and strains, physicians typically recommend rest and at-home care, such as heat/cold therapy.
Patients may benefit from physical therapy for sprains and strains. A physical therapist can recommend stretching and strengthening exercises to alleviate tension while improving support for the back.
Age-related Spinal Degeneration
The spinal structures, including the vertebrae, facet joints, and intervertebral discs, naturally degenerate with age. This degeneration can contribute to spinal conditions like a herniated disc, spinal stenosis, spondylolisthesis, degenerative disc disease, and osteoarthritis. All of these spinal conditions can lead to chronic lower back pain.
What does one-sided back pain mean?
Lower left back pain and lower right back pain can be caused by any of the common back pain causes listed above. However, if you have one-sided back pain along with other symptoms, such as fever and/or pain while urinating, the pain could be stemming from an internal organ. So, in this case, make sure to receive a medical evaluation promptly.
Can sports injuries cause lower back pain?
Especially in young adults, participating in sports is a key risk factor for lower back pain. According to Medscape, 7% to 13% of all sports injuries in college athletes are lower back injuries. Additionally, certain sports are more likely to trigger back pain than others.
The sports that present the highest risk of lower back pain include gymnastics, soccer, and dance, according to a 2009 study published in Sports Health.
Which medical conditions require back surgery?
Here are the symptoms and conditions that might make back surgery an optimal solution for you:
- Spinal nerve compression
Back injuries and conditions that compress your spinal nerves can cause debilitating back pain and/or numbness, tingling, and weakness in the legs.
- Intervertebral disc damage
With a bulging, ruptured, or herniated disc, the rubbery discs that cushion and separate the bones in your spine are injured. So, the spinal structures are subject to more impact with day-to-day movements.
- Vertebral fracture
A fractured vertebra typically causes back pain and spinal instability. Many vertebral fractures heal on their own, while others require surgery. or other damage to your spinal column from a back injury. A fractured disc will cause pain, and also leaves your spine unstable, often causing additional back pain.
You may also be diagnosed with a condition that causes back pain and additional progressive nerve compression:
- Scoliosis, a curvature of the spine that can compress nerves in the back
- Spinal stenosis, a narrowing of the spinal canal typically caused by arthritis
- Spondylolisthesis, the forward slippage of a spinal segment
- Degenerative disc disease, the development of pain in a disc as a result of its normal wear and tear over time
- Radiculopathy, the irritation, and inflammation of a nerve caused by a herniated disc
- Kyphosis, a humpback deformity
What are the main lower back surgery types?
For lower back pain relief in severe cases, spinal surgeons may recommend one of the following types of lower back surgery:
- Spinal decompression
Spinal decompression is the most common lower back pain surgery. It involves alleviating pressure on the spinal nerves by removing certain spinal tissues.
Several procedures fall under the umbrella of spinal decompression, including:
- Laminectomy: Widely used for spinal stenosis, this procedure involves removing some or all of the lamina, which covers the back of the spinal cord.
- Discectomy: Commonly used for lower back herniated disc surgery, discectomy involves removing damaged disc tissue.
- Foraminotomy: This procedure involves creating more space in the intervertebral foramen, where the nerve roots leave the spinal canal.
- Lower back fusion surgery
During fusion surgery in the lower back, your surgeon will secure bone graft material in between one or more vertebrae. This process permanently fuses the targeted vertebrae to prevent spinal instability.
Unfortunately, lower back fusion eliminates all independent motion of the vertebrae. This significantly diminishes patients’ back flexibility and may keep them from performing certain activities. Fusion also largely prolongs the recovery time for lower back surgery.
Recent innovations in spinal surgery, such as the TOPS™ System from Premia Spine, can prevent spinal instability after decompression surgery without compromising the patient’s mobility. The TOPS™ System is a non-fusion spinal implant that moves with the spine, protects neighboring segments from degeneration, and preserves spinal mobility.
Your spinal surgeon’s primary goal is to eliminate your back pain and restore your quality of life. When a progressive condition is diagnosed through testing and examination, back surgery may certainly move to the forefront of your surgeon’s mind. It’s their job to consider the best, most individualized treatment options to eradicate back pain before it becomes worse.