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Back pain changes everything. It may mean that you have trouble sitting for long periods of time, or maybe you can’t stand. Maybe you can’t do either without that nagging, piercing back pain. Chronic back pain turns your whole life upside down: things you used to be able to do just fine are now impossible. Moving hurts. Lying down hurts. Changing position hurts. And forget about walking or exercise anymore. Something has to be done about this back pain, but what can you do?

Do I Need Back Surgery?


Back surgery can definitely help with some forms of back pain, but it’s not needed most of the time. In fact, back surgery can sometimes be decidedly worse for your back than just leaving it alone. So how do you know if you need back surgery?

Most back pain typically goes away on its own in a few weeks or a few months, but if you’re researching back surgery then you’ve probably suffered longer than that. If time and rest hasn’t helped your back get better, then seeing a doctor is the next step, but here at the Phoenix Desert Spine and Scoliosis Center we find that only about 10% of our patients really need any form of invasive surgery on their back. For most people, anti-inflammatory medication, heat, and physical therapy will do the trick. It may take a while–the back is a complex combination of muscles and bones–but for the majority of patients, surgery isn’t needed.

One of the signs that you might need back surgery, however, is if you’re having numbness or pain that goes down one or both of your arms or legs. Numbness and pain in the legs and arms is often caused by compressed nerves, and compressed nerves typically happen either when you have a disk problem (a bulging or ruptured disk that is pressing against the spinal nerve) or when you have bone growths, usually spinal arthritis, that affect the hinge joints on the spinal column and narrow the amount of space for the spinal nerve to pass through.

That said, not every disk problem or bone spur means that surgery is the best option for you. Even if you’ve had x-rays that show these problems, it may be unclear where the specific source of your pain is coming from and how to solve it. And, just because you’re having numbness in your legs or arms doesn’t mean that you always have a disk problem or a bone spur.

Reasons You May Be Referred to a Spine Surgeon

If you’ve gone to your family doctor and they’ve recommended that you see a spine surgeon, that still doesn’t mean that you definitely need surgery. But here are some of the possible reasons that you would visit a surgeon:

  • You have a slipped disk that isn’t getting better over time
  • You have bone spurs
  • You have a degenerative spinal condition like stenosis (a narrowing of the bony canal around the spinal cord). This is typically associated with feelings of weakness.
  • You have trouble walking or using your hands
  • You’re having bowel or bladder control problems that may be associated with nerves in your back
  • You have a high fever with back pain, which is a sign of a spinal infection
  • You have a broken or dislocated bone in your back
  • You have a tumor on your spinal cord and or vertebrae

All of these reasons are perfectly legitimate reasons to see a spine surgeon, that surgeon should be able to help you–but you still may not need surgery.

What Are Alternatives to Back Surgery?


When you sit down with your spine surgeon, whether it’s for a first time visit, or a second or even third opinion, you want your doctor to take their time with you. They will want to do a full examination and history. You should expect to spend at least 45 minutes just talking with the doctor and their expert team before any decision is made about a treatment plan.

Odds are good that the spine surgeon is going to prescribe ice, heat, nonsteroidal anti-inflammatories (NSAIDs like ibuprofen), and/or physical therapy. Exercise, even minimal exercise, can also be a big help. The doctor may even suggest a spinal injection. As a rule of thumb, a good spine surgeon will exhaust all of these avenues before they will ever recommend surgery (with a few exceptions, such as a serious spinal cord injury).

So What If I Do Need Spinal Surgery?


If you’ve exhausted all the other options and aren’t seeing success, and your spine surgeon is certain that more of those therapies won’t help, they’ll seriously consider back surgery.

The reason that a spine surgeon doesn’t rush into back surgery is because the back is a tricky part of the body that has a number of peculiar pitfalls. The spine might seem close to the surface, but it’s wrapped in muscle and tissue on the back side of your body, and blocked by organs and blood vessels on the front. Traditional spine surgery requires opening you up and cutting muscles to access the spine which creates a large amount of soft tissue damage, and going in from the front is fraught with even more uncertainties.

Don’t get us wrong: miracles can be done in the field of back surgery, and our physicians are at the top of their field. But any back surgery comes with risks, and sometimes the risks outweigh the benefits.

All of that said, if you do need back surgery, after you’ve tried the regular treatments, and after you’ve worked extensively with our spine surgeons, we have some of the best back surgery techniques and treatments available, including some minimally invasive surgeries that can spare you a lot of lingering side effects.

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