The predictors for pain and the likelihood of undergoing back surgery can vary based on individual cases, underlying conditions, and the specific causes of back pain. However, some common factors that are often considered include:
The intensity and persistence of back pain symptoms play a crucial role in determining the need for medical intervention. Severe and chronic pain that significantly impairs daily functioning may increase the likelihood of considering surgical options. This may seem obvious, but it is important to keep in mind that this is independent of whether a person’s individual case might respond better to other interventions.
Imaging studies, such as X-rays, MRI scans, or CT scans, can provide insights into the structural issues causing back pain. Conditions like herniated discs, spinal stenosis, or spinal deformities may be identified through diagnostic imaging. Important to note here is that these imaging studies should never be used as sole indicators of whether someone should consider surgery. Many people have disabling pain without consistent imaging findings and many people with imaging findings of hernias, stenosis, and deformities live perfectly normal lives without pain or major disability.
Before opting for back surgery, healthcare providers should recommend conservative treatments beyond just medications or physical therapy. If these interventions fail to provide relief over time, surgery may be considered but in my experience, there is a lack of emphasis placed on these alternatives, even with a pile of research pointing to their effectiveness or even their better performance in terms of long-term results. When your primary care provider fails to provide you with optimism about alternatives you are less likely to put trust in them and more likely to pursue surgical intervention.
Back pain that leads to functional limitations, such as difficulty walking, standing, or performing daily activities, may indicate a need for surgical intervention to address the underlying issue.
The presence of neurological symptoms, such as numbness, tingling, or weakness in the extremities, may indicate nerve compression or damage. In some cases, back surgery may be necessary to alleviate pressure on nerves, but this varies from case to case and as long as functional impairment and severity of symptoms allow for it, alternatives should be attempted first, oftentimes leading to better long-term outcomes than surgery.
P.S. Even with a surgical intervention, rehabilitation is often pivotal to preventing similar problems from occurring in the future, depending on the case.
Congenital or acquired structural abnormalities, like severe spinal deformities or spondylolisthesis, may increase the likelihood of surgery to correct or stabilize the spine.
The patient’s preferences and goals for treatment play a significant role in decision-making. Some individuals may prefer back surgery to address the root cause of their pain, while others may opt for conservative measures. This is an interesting one because I have treated many people who simply did not want to change their lifestyle, unwilling to introduce any changes to their habits, or commit to a treatment plan despite it being a better long-term solution.
Overall health and medical history are important considerations. Certain health conditions or comorbidities may affect the feasibility and safety of surgical interventions. Whether or not you are deciding to go the surgery route it is important to ask lots of questions about the alternatives, the risks, and the underlying cause of the issue.
Often surgery does not result in the functional improvements people are looking for and they must still commit to new routines and habit change to recover and to prevent a similar issue from happening in the future. Getting in the best shape you can prior to and after a surgery can make all the difference.
It’s important to note that each case is unique, and decisions regarding back pain treatment, including surgery, should be made on an individual basis. If you are considering back surgery try your best to understand the issue from several different perspectives. Seek multiple opinions and decide only once you are confident. Finally, have a plan for pre- and post-op. This may mean coming to terms with some of the habits you require changing and prioritizing your health.
If you are looking for a second opinion, or if you want to know if your pain could respond well to a non-invasive treatment, book an evaluation with us today by clicking here.
