When back pain persists for several weeks or months, the question about surgery will inevitably arise. Preconceived notions about what surgery may be like and how it may impact life and mobility in the future can make
it difficult to navigate the various treatment options available. Sometimes, a patient’s predicted outcomes lead them to instinctively choose a longer road to relieve using modalities such as medication, physical therapy, or chiropractic. In our field, we recognize the advantages and limitations of each.
The question that needs to be asked is at what point is a surgical treatment more advantageous than nonoperative therapies. The answer to this question will be unique to each patient. The same degree of a moderate disc herniation may make one person an excellent candidate for surgery but not yet be warranted for another. To determine the best approach in treating back pain, experts recommend that, even while a patient is pursuing conservative modalities such as physical therapy and medication, they also consult with a spinal surgeon who can provide them with a comparative opinion.
It should not be assumed that a spinal surgeon will always advise a person to have surgery. Some disc herniations may resolve or progress slowly enough to be managed without surgical intervention. Surgery may be the best option, though, when a disc has ruptured or torn. In this type of situation, only surgery can remove matter that is pressing and leaking fluid on nerve pathways. Surgery is also the only way to open channels of bone that have narrowed, causing painful stenosis.
When faced with chronic back pain, it is important to understand that there may be several conservative treatment approaches that would provide suitable relief. Based on the Spine Patient Outcomes Research Trial (SPORT) study conducted several years ago, patients who chose to undergo lumbar discectomy surgery to address sciatica pain reported more rapid improvement and greater satisfaction than patients who chose nonoperative care. Ultimately, it is up to the patient to decide which approach feels right to them based on a qualified surgeon’s diagnosis and prognosis and the quality of life they wish to acquire.
There is value in having a conversation with a spinal surgeon about the potential for surgery. No one but you can make the decision regarding your care. Our job is to make sure you are as well-informed as possible.