“How do I know if I need spine surgery?”
I am a 41 year old male. I have some issues with my back/spine area. How do I know if I need spine surgery?
7 Answers
Usually people have physical therapy and manage pain with medication. Once an xray or MRI is done an orthopedic surgeon can be consulted and see if surgery is necessary. Your opinion matters too if pain is too much to bear and surgery is an option. Try to prolong surgery as long as you can tolerate.
When you’ve tired everything else, Physical Therapy and your quality of life begins to suffer, it’s time.
It depends on the history and presentation. Usually those who have disabling pain affecting job and activities of daily living, severe weakness, severe numbness of extremities, loss of control of bladder/bowel, radiating pain, loss of balance are the considerations for surgery. These patients commonly have either herniated discs with pinched nerves, or narrowing of their spinal canal, cord compression due to trauma/accident. Others develop worsening symptoms due to degeneration of their spine. You will need further evaluation, imaging studies, muscle/nerve studies, etc. before surgery will be ultimately recommended. Conservative treatments (like meds, therapy, injections) usually are exhausted first before jumping into surgery.
See a physician.
Before considering a spine surgery, you need to make sure that, first, you do know what problem you have. Second, even before thinking of spine surgery, you should make sure that you eliminated all the treatments possible for your back problem, such as physical therapy, interventional pain management, acupuncture, medication (not narcotics), even job modification. (I do know that is hard, but I try to give you options.)
Hope I was helpful.
Hope I was helpful.
You need to see your doctor for evaluation and to determine the cause of your pain. Not all pain requires surgery. Most of the time pain could be originating from muscles which can get better with just physical therapy.
Hello,
As a Physical Medicine & Rehab specialist, I have to admit I have a rather biased opinion against surgery for your back because I only see the failures. But I see a lot of them!! My advice is to view surgery as an absolute last resort. The only reasons I send for surgery are the following:
1. Bowel and bladder changes associated with your back. This is an emergency and would require immediate surgery.
2. Loss of muscle function due to nerve compression in your spine. Because the longer a nerve is compressed the longer it takes to come back this would be a reason to see a neurosurgeon for evaluation. Let me clarify that I am not talking about a feeling of weakness. I’m talking about actual loss such as a foot drop.
3. Severe pain that has been unresponsive to every conservative measure and is so bad that you literally have no quality of life.
I have found that surgery as an option sounds very appealing because it sounds like a fix all in one quick day. This is usually not the case. And even in the best scenario you will have different anatomy if the surgery is any more invasive than micro-discectomy. It is impossible for me or any spine specialist to give more detailed information to you without knowing more details about your back, pain, and functional difficulties. My best advice is to make sure you have really adequately tried physical therapy. Not the heat, stim, and ultrasound, but the important work of stabilizing your core muscles that support your spine. It takes serious work and discipline, but I have had a lot of success with re-visiting the therapy experience. I hear that “PT didn’t work.” I hate that because this often implies that the patient thinks that the therapist has the ability to “fix” them. Only you can do that. And regardless of whether you have
surgery or not your best outcomes will occur with appropriate weight loss, and good muscular support for your core and your back and hip muscles. Walking in the water, swimming (if not painful) and non impact exercise such as stationary recumbent bike can allow you cardio without aggravating your back. Avoid pain if any of these hurt. Educate yourself! Make sure your doctor explains your X-rays and MRI so you understand what they believe is the source of your pain. Epidural steroids are used to validate the source of the pain but also to help reduce the swelling around the nerves. Physiatrists (what I do) in your area are a good choice to help you through this process. You can find one in your area at AAPMR.org. Look for a spine
and pain specialist. The North American Spine Society (NASS) is a great resource and has a lot of educational pages including the details of what most surgeries accomplish. PT, exercise, heat/ice/electrical stimulation, weight loss, smoking cessation, work on flexibility, massage, acupuncture, traction, assisted stretching and yoga in combination with medications, pain management interventions such as injections and epidurals can all help to dramatically decrease pain and improve function.
All best to you. Remember to always feel that you can communicate with your doctor and understand what they are recommending and why. Second opinions are never a bad idea as the more information you have the better!
As a Physical Medicine & Rehab specialist, I have to admit I have a rather biased opinion against surgery for your back because I only see the failures. But I see a lot of them!! My advice is to view surgery as an absolute last resort. The only reasons I send for surgery are the following:
1. Bowel and bladder changes associated with your back. This is an emergency and would require immediate surgery.
2. Loss of muscle function due to nerve compression in your spine. Because the longer a nerve is compressed the longer it takes to come back this would be a reason to see a neurosurgeon for evaluation. Let me clarify that I am not talking about a feeling of weakness. I’m talking about actual loss such as a foot drop.
3. Severe pain that has been unresponsive to every conservative measure and is so bad that you literally have no quality of life.
I have found that surgery as an option sounds very appealing because it sounds like a fix all in one quick day. This is usually not the case. And even in the best scenario you will have different anatomy if the surgery is any more invasive than micro-discectomy. It is impossible for me or any spine specialist to give more detailed information to you without knowing more details about your back, pain, and functional difficulties. My best advice is to make sure you have really adequately tried physical therapy. Not the heat, stim, and ultrasound, but the important work of stabilizing your core muscles that support your spine. It takes serious work and discipline, but I have had a lot of success with re-visiting the therapy experience. I hear that “PT didn’t work.” I hate that because this often implies that the patient thinks that the therapist has the ability to “fix” them. Only you can do that. And regardless of whether you have
surgery or not your best outcomes will occur with appropriate weight loss, and good muscular support for your core and your back and hip muscles. Walking in the water, swimming (if not painful) and non impact exercise such as stationary recumbent bike can allow you cardio without aggravating your back. Avoid pain if any of these hurt. Educate yourself! Make sure your doctor explains your X-rays and MRI so you understand what they believe is the source of your pain. Epidural steroids are used to validate the source of the pain but also to help reduce the swelling around the nerves. Physiatrists (what I do) in your area are a good choice to help you through this process. You can find one in your area at AAPMR.org. Look for a spine
and pain specialist. The North American Spine Society (NASS) is a great resource and has a lot of educational pages including the details of what most surgeries accomplish. PT, exercise, heat/ice/electrical stimulation, weight loss, smoking cessation, work on flexibility, massage, acupuncture, traction, assisted stretching and yoga in combination with medications, pain management interventions such as injections and epidurals can all help to dramatically decrease pain and improve function.
All best to you. Remember to always feel that you can communicate with your doctor and understand what they are recommending and why. Second opinions are never a bad idea as the more information you have the better!
