Is Surgery Necessary to Relieve Back Pain? - HealthProAdvice - Health and Wellness
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Is Surgery Necessary to Relieve Back Pain?

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

When other treatment options fail to relieve your back pain, or for certain pain conditions, surgery may be a good option.

When other treatment options fail to relieve your back pain, or for certain pain conditions, surgery may be a good option.

The second most common complaint your family doctor hears is about low back pain, and it is not always easy to diagnose the cause. The pain might be dull, sharp, burning, or aching. Usually, it will resolve within three months with conservative treatments, including anti-inflammatory medications, physical therapy, and application of ice or heat.

I have had two back surgeries due to osteoporosis from long-term prednisone use for my systemic lupus. I actually need a third surgery, but I do not want to go through another long procedure and an even longer recovery period. But my case is different. Some people actually do quite well after surgery.

In this article, I'll introduce some common causes of back pain, give tips on how it can be prevented, and discuss the various types of back surgery and when they might be necessary.

What Causes Back Pain?

Back problems may occur for a multitude of reasons. It could be a sprain or fracture caused by an accident; diseases including fibromyalgia, spinal stenosis, some autoimmune diseases like lupus, and arthritis.

One of the most common causes is osteoarthritis, which may cause bone spurs to form on your vertebrae, which sometimes causes pain. Hinge joints on the back of the spinal column that narrow the space where nerves are located can cause nerve pain.

Another common cause is bulging or ruptured (herniated) spinal disks, which—although they may not directly cause the pain—can lead to pain because there is no more cushion to prevent the vertebrae from pressing on spinal nerves.

Can Back Problems be Prevented?

There are several ways to help prevent back problems, including simple exercises and lifestyle changes:

  1. Regular physical exercise eases muscular tension and reduces inflammation.
  2. Stay within ten pounds of your ideal weight. Extra weight, especially in your midsection, can shift your center of gravity forward and cause back pain.
  3. Stop smoking as it restricts the flow of blood to the spinal discs.
  4. Sleep in a good position. If you sleep on your side pull your knees up slightly, or if you sleep on your back put a pillow under your knees and one under your back. Sleeping on your stomach is hard on your back, so you might put a pillow under your hips.
  5. Good posture is important. A straight back chair is ideal or one with low back support. Stand with you head up, stomach pulled in and shoulder straight.
  6. Lift objects with your knees bent, without bending over, and using your leg muscles. Hold the object close to your body. Never twist your body when lifting.
  7. Avoid high heels as they also shift your center of gravity. If you need to wear heals, a 1” heel is ideal.
  8. Skinny jeans can be a problem as they interfere with sitting, bending, or even walking.
  9. Fat wallets in the back pocket can cause discomfort, especially if you are sitting for an extended period of time.
  10. A handbag or a briefcase can cause an imbalance in your posture if you always carry it on one side. The perfect design is similar to a messenger bag that has a strap on the opposite shoulder. Lighten your purse, and switch hands occasionally while walking.
  11. While back supports are readily available, they do not help prevent back pain.

7 Simple Core Exercises That Prevent Lower Back Pain

When Is Back Surgery Appropriate?

Despite efforts to prevent the pain, sometimes it can still occur. What is the solution then? There are some back problems where surgery is the only recourse to relieve pain and restore movement.

These conditions include:

  • Spinal stenosis: The narrowing of the spinal column, which puts pressure on the spinal cord and branching nerves.
  • A ruptured (herniated) disc: When one or more discs of the spine are damaged.
  • Vertebral fractures: Caused by an injury to the vertebrae in the spine.
  • Degenerative disk disease or damage: Occurs more often with aging.
  • Rare conditions: These include infections, tumors, or cauda equina syndrome (a nerve root problem).

Types of Back Surgeries

Minimally invasive back surgeries are used more commonly today. However, major back surgeries are still done frequently. There are several newer techniques used over the past few years, but some major surgeries remain the same.

The various surgeries include:

  • Discectomy: Treats pinched nerves, removes a bone spur or the herniated portion of a disk, and treats sciatica, which radiates pain through the limbs.
  • Foraminotomy: This procedure enlarges the tunnel in the spine where the nerve root exits the spinal canal to keep bulging disks or thickened joints from pressing on the nerve.
  • Kyphoplasty: This is an outpatient procedure that involves the injection of bone cement into a fractured vertebra to relieve compression.
  • Nucleoplasty (plasma disk decompression): This involves the removal of a portion of the herniated disc using a plasma field. This surgery treats a mildly herniated disk.
  • Laminectomy: This procedure enlarges the spinal canal by removing the bone overlying the spinal canal to relieve nerve pressure due to spinal stenosis.
  • Spinal fusion: This procedure connects two or more bones permanently, which adds stability in cases of spinal fractures.
  • Artificial disc implantation: One or more artificial vertebral discs are implanted between the vertebrae—usually in cases with degenerating or injured discs.

Laser Surgery

Laser spine surgery is a good alternative to the long midline incision in conventional back surgeries. It is minimally invasive, which means less blood loss, less pain, and a shorter hospitalization. The surgeon can remove portions of soft tissue pressing on a nerve or a tumor from the spinal cord or bone. It can also shrink disk material that is pressing on a nerve. The caveat is that laser surgery only treats particular conditions. Discuss with your doctor to see if laser surgery is an option and whether it is the best option for your condition.

Dr. Matthew Neal: Minimally Invasive Spine Surgery

What to Expect When Recovering From Back Surgery

Patients are usually hospitalized for 1-4 days, depending on which type of surgery was undergone and the patient's general health. There are typically stitches or staples on the incisions. The pain following back surgery can be significant, but it is managed while in the hospital. If you are taking pain medications at home, remember to avoid activities like driving or operating other heavy machinery.

Physical rehabilitation after most back surgeries is the best way to regain strength, but it will take at least 4-6 weeks for the back to heal. It can take months following some major surgeries to regain your previous activity level, particularly if you are elderly.

Complications That Need Immediate Medical Attention

There are some obvious times when you should call your doctor, or for more severe problems, call 911. Some of those times include:

  • The wound is leaking fluid or blood.
  • Stitches start coming out.
  • You have a high temperature.
  • You have increasing pain, weakness, and numbness in your back, legs, or buttocks.
  • You have a severe headache.
  • You experience sudden shortness of breath.
  • You can’t move your legs.

Final Thoughs

Major back surgeries require good rehabilitation. There are many things you must not do, like try to pick something up off the floor. All did not go smoothly when I had two eight-hour back surgeries only a few months apart, and recovery was difficult. Ultimately, I got my life back, but the recovery was difficult.

I know others who had a smooth recovery after back surgery and went back to full health relatively quickly. It never hurts to get a second opinion before proceeding with any surgery.

References

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Pamela Oglesby

Comments

Pamela Oglesby (author) from Sunny Florida on February 29, 2020:

Hi Lora,

I am so sorry to hear about your sister. I have severe osteoporosis also due to the treatments I received for systemic lupus. The neurosurgeon never told me I would be at a higher risk when having back surgery.

I have given myself injection every morning of Forteo for almost 2 years and my osteoporosis has greatly improved. You cannot take Forteo for more than 2 years and only once in a lifetime. I don't know if this would be a better option for you but your doctor would know. I wish you the best of health in the future and hope you can avoid back surgery. Thank you so much for your generous comments.

Lora Hollings on February 29, 2020:

Pamela, You present much to think about in your excellent in-depth article about back surgery. My sister had a lot of degeneration of discs going on in her back and ended up with metal discs being used as a replacement. She was in constant pain and died of septicemia as a result. I think if she hadn't gone that route, she would still be alive today! I have degeneration of my spine going on mainly in the lumbar region as I was diagnosed with severe osteoporosis in that area but it is only primarily in that area and my bones are actually too brittle to do major surgery there. It may be due to warfarin which I've been taking for a long period of time as the result of having a couple of DVT's in my legs and PE's. I have an excellent diet and exercise every day but I have factor V Leiden mutation so it causes my blood to be more prone to developing blood clots, thus I have to be on an anticoagulant. At this point because of the connection between warfarin and osteoporosis, I'm going to a hematologist to see if they can put me on another blood thinner that's also effective for people with my mutation. I'm also going to a bone specialist who is starting monthly injections of evenity to strengthen my bones. I agree with you that people really need to seriously consider other options before they jump too quickly to back surgery. Thanks for all the great information!

Pamela Oglesby (author) from Sunny Florida on February 29, 2020:

Hi Peggy,

Actually, they think I could become paralysed if I had another back surgery so that is off the table.

I have heard some people do much better after acupuncture. There are many ways to treat back pain instead of having surgery. I wish I had explored more options before having a back surgery but it is too late now. I hope you uncle is doing well. Thank you for your generous comments, Peggy.

Peggy Woods from Houston, Texas on February 29, 2020:

It is a shame that your recovery was slow from your back surgeries and that you might need another one. Your preventative tips are good ones.

I have an uncle who had severe back pain. He was at one time on a business trip to China. While there, he had acupuncture. He said that it was the most relief that he had experienced in a long time. He regularly did back exercises and probably still does them today.

Pamela Oglesby (author) from Sunny Florida on August 15, 2019:

Hi Maria, I have known several nurses who hurt their backs lifting patients. Prevention is so important!

I always appreciate your comments Maria, and the love. I hope all is well for you. Love, Pam

Maria Jordan from Jeffersonville PA on August 15, 2019:

Dear Pam,

Thanks for weaving your experiences into this informative post on an issue that so many suffer from, especially in the nursing profession.

As always I appreciate your inclusion of the things we can do on a preventive level.

Thinking of you and sending lots of love, Maria

Pamela Oglesby (author) from Sunny Florida on June 26, 2019:

Hi T, I am glad to hear that you currently have no back problems. I will see about getting more information about laser spine surgery, and post it to this page if I find some good information.

I wish I would have fully realized what I was getting into, but I trusted the neurosurgeon. He did not tell me I was at a higher risk due to the treatment I received for systemic lupus.

I could never find a chiropractor that wanted to touch me, but my sister and son have very good results with one. Thank you so much for your generous comments.

The Logician from now on on June 26, 2019:

Excellent hub page Pamela! I especially enjoyed the video by Dr. Neal. I have heard of remarkable results from laser spine surgery with same day recovery and less than a one inch incision! I thought that is what he would be talking about but he didn’t mention laser.

I have had back problems flare up throughout my life and once fell to the floor in pain and couldn’t move or get up because of the pain if I tried. That time I thought I’d be headed for the knife however all my back problems were alleviated by a good chiropractor (and I’ve been to one who wasn’t so good) and bedrest so the fact that manipulation and rest can be a cure makes me very suspicious of Dr.s who want you to go under the knife without even trying that. Right now my back has never been so good.

I found the “true back” device to be a life saver especially if you can’t afford a chiropractor and I use it any time my back seems to begin to bother me.

I have an extra vertebrae in my spine, one in a hundred people do. You can tell because i sit high in a chair and have a long waistline. I don’t know if that may make a person more prone to back problems but if you are active especially in sports I would imagine it could.

From what I’ve read if I needed surgery I would go with laser spine surgery. Maybe you could add some information about that to your hub-page.

Thanks for a very informative article.

Pamela Oglesby (author) from Sunny Florida on June 25, 2019:

Hi Vivian, I have heard many people talk about stretches and core exercises that give them relief. I use lido patches when I really hurt too. I hear you about extra weight around the middle, as I have lost 15 pounds, yet not where I want it gone. LOL

I appreciate your kind comments.

Vivian Coblentz on June 25, 2019:

Pamela,

This is such a thorough and well-researched article that lays a complex subject out in a simple form we non-medical people can easily grasp!

I often experience lower back aches, and I try to remember to do those core exercises included in your video post. It really does help, if I do them regularly! Biofreeze or Perform cream also provide relief.

Now, about those 10+ extra pounds around the middle throwing off gravity.....a little harder to lose, but I'll keep plugging!

Pamela Oglesby (author) from Sunny Florida on June 20, 2019:

Hi Alyssa, You sure did experience back surgery at a young age. I am glad you have management techniques. The stretches in the video are also so good to prevent or help with back pain.

I am glad you found this article so helpful, and I appreciate you sharing your experience.

Alyssa from Ohio on June 20, 2019:

This is so informative! I started experiencing back pain (in the lumbar spine) at the ripe old age of 26. haha! (Yeah, still pretty young, and I was very upset.) When I was little, around 9, I had to visit a chiropractor for stiff neck issues. I still experience some of that once every ten years or so. I haven't been to the chiropractor since I was little, preferring to manage my back pain on my own. Through Yoga, Feldenkrais, and Icy Hot, I've made due. I did have to visit the doctor several months ago for a Trapezius and Rhomboid strain, though. I realize I'm pretty lucky. I wouldn't want to go through back surgery -- that really scares me, but I love that you broke down the different procedures and explained what they are. For me, fear tends to dissipate with more knowledge. I really appreciate this article!

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on June 14, 2019:

Hi, Pamela, it is well appreciated. Enjoy the weekend.

Pamela Oglesby (author) from Sunny Florida on June 13, 2019:

Hi MG, I am glad you found this article helpful. Thank you so much for your your generous comments.

MG Singh emge from Singapore on June 13, 2019:

Nice article Pamela and very informative too. Though I never had back problem my brother in law has a chronic problem. Your article was a great help

Pamela Oglesby (author) from Sunny Florida on June 13, 2019:

Hi Pop, I am glad to hear that. Thank you for stoppint by and commenting.

breakfastpop on June 13, 2019:

I have had back problems that have resolved on their own without intervention. Frankly, the thought of back surgery scares me to pieces.

Pamela Oglesby (author) from Sunny Florida on June 13, 2019:

Hi Miebakagh, I am glad you have no back problems as they can be painful. I am glad you found the article informative. Thank you for your comments.

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on June 13, 2019:

Hello, Pamela, thanks for sharing this informative and educative article. Although I had not experienced any back issues, I still do regular exercises that ensure I had a back free problem.

All the preventive measures you outlined I have noted. Thanks for the videos demonstrating the exercises.

I have noted that you have undergoes a back surgery and your recovery is very slow. But thank goodness, you do got your life back. I am sorry for the pains you felt. Enjoy your life at the moment.

Pamela Oglesby (author) from Sunny Florida on June 13, 2019:

Hi Linda, I appreciate your nice comments.

Pamela Oglesby (author) from Sunny Florida on June 13, 2019:

Hi Mel, After the age of 50 spinal stenosis is more like, and it does sometimes run in families. It can be in the lumbar or cervial area. Numbness or pain in the arms or legs is a symptom. I hope you won't have this problem, so do those stretches! Thanks for the question and commenting.

Linda Crampton from British Columbia, Canada on June 12, 2019:

Thank you for sharing the information and your knowledge, Pamela. This is an interesting and educational article. I'm sorry that you've had problems with your back.

Mel Carriere from San Diego California on June 12, 2019:

I have had a few back problems, but nothing spinal, only muscular. My father had spinal stenosis, from which he made a nice recovery for a 80 year old guy. Is spinal stenosis hereditary? Great article!

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi Ruby, I am so glad the article and the video were helpful as I think those stretches help. My daughter-in-law does them and has had no problem in a long time. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi Gupi, I think the stretches and yoga are a great help to anyone. Thank you for sharing your experience.

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi Linda, I hope your husband does not need back surgery. I am sorry to hear about your friend with multiple surgeries and your pastor's daughter. That is an awful way to grow up. Thank your for sharing your stories as your stories are all too common.

Ruby Jean Richert from Southern Illinois on June 12, 2019:

This is well worth the time it takes to read your informative hub, I watched the video on the seven back exercises and I'm going to do them this evening. I have back pain, especially this time of year. Window washing, spring cleaning etc. I used to sleep on my stomach. I now sleep on my side. It took a long time to get used to not sleeping on my stomach. Thanks again..

Gupi on June 12, 2019:

This is a very well written article. I used to have trouble with my back but when I started practising yoga postures and stretches the pain went away. I also made other lifestyle choices such as improving my posture which helped. Anti inflammatory medication was helpful for me when I suffered the worst pain but I haven't needed to take it in years :)

Linda Lum from Washington State, USA on June 12, 2019:

Pamela, I am sorry that you had such difficulties. My husband has not had surgery but needs to be very mindful of how he moves. He "throws out his back" very easily. I occasionally experience some pain in the lower back when I've spent too many hours kneeling in the garden, but no injuries.

My heart goes out to those with chronic pain and back problems. I have a dear friend who has a degenerative disease that is affecting all of his joints. He has surgery on both shoulders, 2 hip and 2 knee replacements, and spinal fusion front and back. But he still greets every day with a smile on his face.

My pastor's daughter was born with spina bifida and, at the age of 13 has just recently had spinal fusion after many years of multiple surgeries with the implant of rods that would have to be lengthened every 6 months. Hopefully, this fusion is her last surgery.

Back pain is a problem that affects so many people and the pain is debilitating. Thank you for explaining this, and your recommendations for things that can be done to prevent back injuries.

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi Liz, I know they do successful surgery for scolitis. Thank you for your comments.

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi Flouish, I am sorry to hear about your sister, and it sure seems to run in the family (hope not for you). I am glad your dad did well, and thank you for commenting.

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi Eric, I'm glad you do exercise, and I liked your little hernia joke. Thank you so much for commenting.

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi Clive, The answer is not, but there are individual discs that they are using now. I think those are fairly new.

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi Bill, I know how bad back pain in, and back when you had that surgery they did not treat pain as well as they do now. I'm glad there you didn't have a repeat performance. Thanks for commenting.

Liz Westwood from UK on June 12, 2019:

This is an interesting and well-written article. Back pain is suffered by many to varying degrees. Some recover from muscular skeletal pain with anti-inflammatories and exercise. Other more severe cases require surgery. I know of friends whose daughter underwent surgery at a very young age for scoliosis. Thankfully she has not required any further intervention.

FlourishAnyway from USA on June 12, 2019:

Both my sister and dad have had back surgeries. My sister had a terrible time with it. The surgeon had to flip her over and cut her on both sides (abdomen and the back). It was very painful for her. My dad had an easier recovery and was especially determined not to use many pain meds for whatever reason. He could barely walk before and was all hunched over from pain but is now a new person. I’m sorry you had a difficult experience. I used to do workers comp and would sincerely caution people who seemed too eager to receive surgery as I had seen how difficult back surgery can be for people. It’s not always the magic solution people hope it will be.

Eric Dierker from Spring Valley, CA. U.S.A. on June 12, 2019:

Cha Cha Ching! Thank you. I have to work hard at "exercises" to prevent problems in what I call "down there". But after a bit you look forward to it. That video was/is excellent.

I am of the mind that it is nature and not nurture. But both require strong commitment to stay good with or without surgery.

(just a funny one - hernias - they actually are good for the back because you learn to move right or else ;-)

Clive Williams from Jamaica on June 12, 2019:

Is there an artificial spine

Bill Holland from Olympia, WA on June 12, 2019:

The only time I've ever been in a hospital as a patient, 1989, back surgery for a bulging disc. That pain was the worst I have ever felt. I couldn't walk...cried often...crawled around my apartment. Since the operation, no problems at all. Thirty years of no pain. I am grateful.

Pamela Oglesby (author) from Sunny Florida on June 12, 2019:

Hi RTalloni, I am sorry to hear that. Osteoporosis was a good part of the reason I have had a rather poor result. What I have learned is to take vitamin D, K2 and calcium to strenghten my bones. I perhaps should mention this in my article. I get a lot of relief from an ice pack.

A chiropractor is often very helpful, and my son sees one just occasionally for an adjustment due to back pain. I hope you can avoid surgery. A pain doctor can give you an injection that should relieve your pain for a period of time, but it does have some type of cortisone in it, which is not good for bones. I wish you a healthy back!

RTalloni on June 12, 2019:

Thanks much for this information. Your nursing background and personal experience significantly add to this post. I am dealing with a small vertebral fracture located in a place causing a good deal of painful cramping. My chiropractor has already provided significant relief but am looking at an extended period of healing. Wanting to avoid surgery I plan to follow her instructions carefully. Primary care physician determined my vitamin D was extremely low so began taking prescription to bring it up, then will go back to over the counter D in two months. This was helpful info to me as I do not know how this will go and know I could face surgery in spite of efforts to avoid it.

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