Are you struggling with persistent back pain that doesn’t seem to go away? Chronic back pain is a common issue in the United States. While up to 90% of acute low back pain cases resolve within a month, long-term back pain may indicate an injury, arthritis, or another degenerative disc disease. Is surgery the best solution for this kind of pain?
At Coastal Orthopedics, we understand the complexities of back pain and the considerations determining the need for surgery. Read on to find out when the right time to undergo surgery is.
Does Back Pain Require Surgery?
Back discomfort and pain often disappear after a few days without surgical intervention. However, there are conservative methods to treat this pain when it doesn’t go away right away.
Methods such as ice and heat therapy, spinal injections, physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can provide relief without surgery. Studies indicate regular exercise can alleviate back pain and prevent its recurrence.
Unless you have a severe spinal cord injury, your surgeon will typically suggest exploring alternative treatments before considering back surgery. Imaging such as MRIs will be necessary to determine if surgery is necessary. Insurance companies may also require documented attempts and failures at conservative treatment before authorizing surgery.
3 Signs You Need Back Surgery
Pain Doesn’t Go Away
According to a study published in the Journal of General Internal Medicine, between 75 and 90 percent of acute low back pain cases resolve independently within a month. While this statistic may offer hope, it can be frustrating for individuals already two weeks into discomfort and anticipate another two weeks of pain.
However, waiting it out isn’t the only option. During the acute stage of back pain, there are various treatments available, including:
- Physical therapy
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroid injections
- Epidural nerve blocks
- Lifestyle changes such as weight loss or smoking cessation
- Radiofrequency ablation
If these conservative approaches fail to alleviate your back pain within about a month, it might be time to seek advice from a spine surgeon.
Pain Radiates From the Arms and Legs
Radiculopathy, commonly known as radiating pain, often indicates pressure on a nerve root within the spine. This condition can cause significant discomfort and functional limitations. Surgery can be an effective solution for alleviating symptoms associated with radiculopathy.
Herniated discs and bone spurs are among the most frequent culprits behind radiculopathy. A shock-absorbing disc comprising a hard outer layer and a soft inner layer cushions each vertebra in the spine. Herniation occurs when the inner layer protrudes through the outer layer, potentially compressing a nearby nerve root and leading to radiating pain.
Pain from Spinal Osteoarthritis
On the other hand, bone spurs develop due to spinal osteoarthritis, which involves the gradual deterioration of the cartilage that facilitates smooth joint movement. In spinal joints, known as facet joints, this cartilage breakdown can lead to bone-on-bone contact, prompting the formation of bone spurs or osteophytes. These spurs may encroach on the spinal cord or nerve roots, causing pressure and radiculopathy.
It’s an Emergency
“In many cases, surgery for back pain isn’t an immediate requirement. Surgeons often recommend patients wait to assess if the pain resolves naturally or with non-surgical interventions. However, there are instances where back pain constitutes a medical emergency, necessitating prompt surgical intervention,” says Eric B. Sundberg, M.D., Spine Specialist at Coastal Orthopedics.
Emergencies may stem from acute incidents or trauma, such as automobile accidents, or from untreated chronic conditions that escalate into emergencies. One such critical condition is cauda equina syndrome.
Cauda equina syndrome results from severe, prolonged compression of nerves in the lower (lumbar) spine, often due to trauma, infection, or tumor. Symptoms of cauda equina syndrome include:
- Sudden loss of bladder or bowel control
- Intense lower back pain
- Profound weakness or numbness in the lower body
- Sexual dysfunction
Untreated, cauda equina syndrome can lead to permanent paralysis. Therefore, emergency surgical intervention is imperative to prevent irreversible neurological damage and preserve function.
Types of Back Surgery
There are several types of back surgery, including:
- Diskectomy: This procedure involves removing the herniated portion of a disk.
- Laminectomy: In this procedure, bone at the back of the spine is removed to create more space for the spinal cord and nerves.
- Fusion: Spinal fusion is a procedure that removes arthritic joints and often utilizes metal implants to connect two or more bones in the spine.
- Artificial Disks: These devices, made of plastic and metal, can replace the damaged cushion between two spinal bones.
Back surgery is a significant decision that should be made in consultation with a spine specialist.
Non-Surgical Treatment
In most instances, non-surgical interventions are attempted first, even in cases of radiculopathy. However, surgical management of radiculopathy can be highly effective. Surgical procedures typically aim to alleviate pressure on the nerves by removing the source of compression, such as through a discectomy, or creating additional space within the spinal canal, such as in a laminectomy.
Eric B. Sundberg M.D. | Spine Specialist
Back Surgery Appointments at Coastal Orthopedics
When a patient requests to see Dr. Sundberg, the process typically begins with an appointment with one of his physician assistants or nurse practitioners.
- During this initial visit, medical history is reviewed, and an assessment is conducted. This assessment can lead to imaging studies, such as an MRI, to determine if a patient might be a candidate for surgery.
- Once the imaging results are available, Dr. Sundberg reviews them and devises a personalized surgical plan based on the patient’s specific condition and needs.
Next Steps for Back Pain
If you’re experiencing persistent back pain, schedule an appointment with Dr. Sundberg’s team at Coastal Orthopedics today. Our team is dedicated to providing personalized care and guiding you toward the best solution for your back pain.
