Back Pain: When To Opt For Surgery, From The Harvard Health Letter

January 27, 2007

Low back pain is an extremely common condition: 80% of Americans

experience at least one bout of it some time during their lives.

Usually, rest, some pain relievers, and perhaps some exercises help

it go away. But for many millions, the pain lingers and may become

severe and debilitating. How do you know when back pain warrants

surgery? The February 2007 issue of the Harvard Health Letter

investigates.

Deciding to have surgery is never simple, but it's especially

difficult when the back is involved. Many studies of back surgery

have been small. Popular procedures have been questioned, and new

ones get introduced before we really know how well they'll work over

the long haul. It's hard enough for doctors to figure out what to do

about surgery for back pain. Patients are often even more confused.

Back surgery is an option for people with long-lasting pain due to

herniated disks, spinal stenosis, or degenerative disease. Studies

have shown good results from spinal stenosis surgery, with any

lingering pain controlled with medication. On the other hand,

doctors are beginning to question whether too many surgeries are

performed to treat degenerative disease. As for herniated disks, a

recent study found that surgical and nonsurgical treatments worked

equally well. An editorial accompanying the study said toss-up

results show that the decision whether to have surgery is a matter

of patient preference more than anything else.

Ideally, your primary care physician can walk you through your

options- surgical and non-to get you to an effective treatment.

Harvard Health Publications

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