Back Pain: Is Surgery The Answer?

When suffering from severe, chronic low back pain, it is understandable that many people would think that an extreme pain requires an extreme answer: back surgery. While surgery is often called for in cases of deformity or trauma, in cases of chronic pain, whether or not to pursue surgery can be a much harder call for doctors and patients to make.

First of all, the cause of back pain can be difficult to diagnose. Sometimes, even when a patient is suffering from severe pain, no structural issues will show up on imaging scans. Back pain can be caused by a variety of conditions, including muscle strains, muscle spasms, arthritis, degenerative disk disease, compressed spinal nerves, herniated disks, and many others. For some of these types of back pain, surgery is not indicated, and they must be treated by more conservative means such as physical therapy and steroid injections from the start.

Even when it may be called for, such as in the case of chronic pain caused by a herniated disk, the outcome of surgery can be uncertain. A four-year study of 501 patients with herniated disks did not find a significant difference in improvement after two years between patients who had undergone surgery and those who didn’t. Another review of 161 trials found that most patients who underwent fusion surgery (in which vertebrae in the back are fused for stability and pain relief) did not experience the anticipated outcomes of a full or vast decrease in pain, reduction of pain medication, or return to high-level functioning. Overall, research demonstrates that surgery should be considered a last resort in treating back pain.

Luckily, there are more conservative options available, from which many people have gotten a moderate to high level of pain relief. From acupuncture to massage, exercise to physical therapy, steroid injections to radiofrequency ablation, the double-board certified pain management doctors at Louisiana Pain Specialists have the resources, training, and know-how to develop a comprehensive treatment plan that may help their patients not only achieve pain relief, but potentially avoid a trip to the operating room.