Back Pain

A Spine Surgeon Says Not to Rush to Surgery

If you suffer from low back pain, you know how debilitating it can be. When your back hurts, your life hurts. You’ll do anything to stop the pain, and often surgery is billed as the go-to solution. It’s no mystery why surgeons as a group want to cut (when you have a hammer, everything looks like a nail!), and it’s hard for patients to resist the lure of a “quick fix.” Plus, everywhere you look these days, you see ads touting the life-changing benefits of “one-inch incisions” and “minimally invasive” laser surgeries.

That’s why it tends to surprise people when a spine surgeon (of all people) cautions against spine surgery.

Surgery is risky, it has a long recovery period, and often it just doesn’t work for chronic low back pain. It might even make the problem worse. My advice: exhaust every possible option first.

The good news is there are better options. The system is slowly shifting toward prevention and natural healing methods for spine conditions, and for good reason. Not only are these options a fraction of the cost of surgery, for many patients these methods simply work better.

I advocate for a holistic treatment centered on medically supervised exercise that takes into account the patient’s perceptions, habits, psychology, physical condition, lifestyle, and goals. When a patient fully commits to this more natural treatment regimen, surgery can usually be avoided.

If you’re thinking of pursuing back surgery, here are some reasons to reconsider.

“Minimally invasive” laser surgery is a marketing gimmick. You’ve probably seen ads for spinal laser surgery clinics encouraging you to mail in your MRI results for a “free consultation.” Don’t be fooled. First, an MRI alone cannot determine whether you need surgery. Second, lasers are minimally useful in back surgeries—mechanical grabbers and electrocautery are far more effective—and are primarily used because the notion of laser surgery appeals to consumers. Third, such procedures are still very invasive.

Despite the smaller incision, these laser-performed surgeries often remove bones and ligaments vital to the structural integrity of the spine, still cause scarring around the nerves, and often do not alleviate pain in the long run. And I have seen many patients who have undergone so-called ‘laser surgeries’ where it was clear that standard surgical tools like high-speed burrs were used and whose surgery had the same risks as traditional spine surgeries.

There is no widely agreed-upon surgical treatment for lower back pain. Based on a recent study in Spine, surgeons significantly disagree on methods for treating low back pain. In fact, there was 75 percent disagreement in how to treat back pain sufferers.

It is very telling that surgeons can’t agree on how to best approach a solution for back pain. This lack of consensus should warn patients to proceed with caution and to avoid surgery until they have exhausted all less-invasive treatment options.