Back pain and spine problems are among the most common reasons Americans visit a doctor. But according to a report from John Hopkins Medicine, fewer than 5 percent of people with low back pain are good candidates for surgery.
What should you be asking before you have back surgery? In most cases, most back surgery is an elective procedure. It is not urgent. Let’s look at some important questions that you should be researching as you sort through your choices.
Are There Effective, Safe, Non-Surgical Treatments That May Help Relieve My Back Pain?
A first step in answering this question is finding the underlying cause of your back pain. That process can be complicated and elusive. And if no doctor can locate a structural cause for your pain, any back surgery won’t work. But at the start, if a non- or minimally-invasive option has the potential to work, then that should be your priority focus.
Over-the-counter anti-inflammatory medications like ibuprofen and naproxen and pain relievers that contain acetaminophen can be effective – but make sure you consult with a doctor before starting any ongoing pain medication regimen – even if it is only over-the-counter.
Studies have shown that physical therapy can help manage back pain by decreasing both disability and pain. So can lifestyle changes that are recommended by your doctor, particularly such as losing weight and regular, low-impact exercise, which may also significantly relieve back pain.
Trigger point injections and fluoroscopically (x-ray) guided therapeutic injections can also provide relief if more modest approaches aren’t effective. Beyond that are a series of alternatives including radiofrequency neurotomies, regenerative medicine, pain medication management, spinal cord stimulation, percutaneous lumbar decompression, and minimally invasive interventional spine procedures – to name a few.
Your key takeaway from this should be to explore every option at your disposal before committing to a back surgical procedure.
What Surgical Procedure is Being Recommended to You – and Why Is It Being Recommended?
Main Line Spine works with some of the best spine surgeons in the greater Philadelphia area – and when appropriate, we refer patients to them.
But these spine surgeons also frequently refer patients to Main Line Spine. Their common reason to refer to us is that they determine many patients who visit them haven’t reached a point where spine surgery is yet appropriate. And those surgeons recognize that Main Line Spine’s specialty as Physiatrists is to relieve back pain and restore function and mobility using treatments and therapies that don’t require major surgery.
But if you are considering back surgery, make sure that you are clear on what type of surgery is being recommended – and what it involves. Will discs be removed or vertebrae fused? Will hardware be implanted? Will you need a bone graft? How long will the surgery take, and what should you expect with recovery? Will you need rehabilitation, how long will your activities after surgery be restricted, and how long will you be out of work?
Make sure also that your surgeon explains to you exactly why he or she is recommending the specific surgery. How long will the expected results last and does having this surgery mean that you cannot undergo other types of treatments if the problem recurs? And will undergoing this surgery increase the likelihood of experiencing other kinds of back problems in the future?
Back Surgery Can Be Highly Successful
For patients with serious structural problems or disease, back operations can be highly successful. However, what’s important is that you exhaust your non- and minimally-invasive alternatives for pain relief first before opting for major back surgery.
In some cases, there is a phenomenon known as “Failed Back Surgery Syndrome” (FBSS). This medical term is a bit of a misnomer. It doesn’t necessarily mean that you or your surgeon have failed. It simply means that you have persistent back or neck pain after spine surgery. There are a variety of reasons and causes.
This may evidence itself immediately, or months after the surgery. Statistics can be difficult to come by, although a recent article published by Penn Medicine claims that “up to 40% of patients have experienced continued pain after surgery.”
Some patients can have surgery that feels great for 5 to 10 years – and then an adjacent area of the spine develops a new problem.
In all of these cases, the first step is to get a new diagnosis and figure out with your health care team what the underlying cause is as a starting point.
Recurrent Back Pain
Regardless of whether you have had back surgery or not, there are always new alternatives to try – both those that currently exist as well as those that are emerging from medical science. If you are experiencing recurrent back pain, don’t put off a discussion with appropriate specialists to determine the next step that you should consider to work toward back pain relief.