Is surgery the right option for your back pain?

September 29, 2020 in Disease Management  •  By Miles Varn, MD
back pain

Back pain is one of the most common reasons that adults in the U.S. seek medical attention and also one of the leading reasons Americans miss time at work. But it’s important to know that surgery often isn’t the most appropriate treatment and, in most cases, should not be the first treatment undertaken. Before choosing a treatment plan, it’s a good idea to get a second opinion so you have an overview of all your options.

Many types of back pain can be managed well with conservative treatments, including:

  • Applying ice and heat: Start by using ice to ease pain and swelling, then after a few days, switch to heat, which can help lessen stiffness.
  • Taking over-the-counter pain relievers: These medications can decrease pain and anti-inflammatory pain relievers (ibuprofen, aspirin, naproxen) can also reduce inflammation. Before taking an over-the-counter pain reliever, ask your primary care physician which pain reliever is the best and safest option for you.
  • Remaining safely physically active: Although back pain may make you want to lie in bed, being inactive can actually slow your recovery. While you’re recovering, continue to move as much as you can but don’t take part in vigorous exercise or activities that put strain on the muscles and joints in your back. Gentle stretching may be a good option but talk with your doctor or a physical therapist about what activities are safe for your specific back condition.

There are some back pain symptoms that mean you should see a doctor as soon as possible, including fever, tingling or numbness in your arms or legs, and bowel or bladder incontinence.

Questions to guide your decision making

To gather the information that can help you make an informed decision about your treatment, ask your doctor these four questions:

  • What caused my pain? Ask your doctor if your pain is the result of an injury or overuse due to repetitive motions during exercise or work, being overweight, a condition such as arthritis or osteoporosis, or a herniated disc. It’s also helpful to ask if there are steps you could take to lower your risk of back pain in the future.
  • What non-surgical treatments could I try to relieve my pain? For some types of back pain, physical therapy, steroid injections, weight loss and exercise, and therapeutic massage may provide adequate relief. In most cases, your physician should recommend surgery only after you’ve tried and failed to get sustained relief from all appropriate non-surgical treatment options.
  • What surgical procedure are you recommending and why? Find out which type of surgery your physician is recommending and have him or her explain what the surgery involves. How long does the surgery take? What is the recovery process like? How much pain can you expect during recovery? How long will you be out of work? It’s also important to find out what the potential risks and benefits of the procedure are. Ask why this type of surgery is being recommended. Is the goal pain relief, improved function and the ability to take part in physical activity, or to correct an anatomical problem?
  • How long will the benefits last? Will this procedure solve your back problem permanently or is it possible you will need another surgery in the future to maintain the result? Could this type of surgery increase the likelihood of other back problems, such as degenerated discs or arthritis, in the future?

In addition to getting a second opinion before back surgery, consulting a health advisor can help you gather evidence-based information about all your treatment options, connect you with experienced physicians, and provide guidance and support during your treatment and recovery.