Four out of every five American adults will experience lower back pain at some point in their life, according to the National Institutes of Health (NIH).  In fact, back pain is one of the most common reasons in the US that people go to the doctor or miss work. If you are someone who suffers from chronic low back pain, the idea of having surgery to vanquish the pain may be tempting.

While there are many back surgery success stories, surgeons advise that the decision for surgery should not be rushed. First, the precise cause of the pain needs to be identified, the potential for surgery to help quantified, and then the decision should be validated by a second opinion.

Low back pain is often caused by overuse, muscle strain, or injury. However, it can also be caused my emotional and psychological issues, neither of which surgery addresses.

According to medical experts, most back pain symptoms can get improve if you stay active, avoid positions and activities that may increase or cause pain, rest when you need to, use ice, and take nonprescription pain relievers when you need them.

"There are some patients," says Jeffrey Goldstein, MD, medical director of the Spine Service at the New York University Hospital for Joint Diseases, "who come in and say 'Doc, you have to operate, I just can't live with this pain.' And quite honestly you have to say: 'I empathize with your pain, and I wish I could make it better. But I don't have a clear source for it, and I can't be confident that surgery will help you. Surgery without having that indication may make you worse.'"

Factors to Consider

  • If you have muscle or soft-tissue pain, you're not likely to benefit from surgery.
  • If your lower back pain is caused by a herniated disk, spinal stenosis, or nerve damage, you might be a candidate, if non-surgical treatments haven't worked. According to some estimates, laser surgery used to decompress herniated discs is successful up to 90 percent of the time, while, surgery to treat stenosis is effective about 70 percent of the time.
  • Surgery for lower back pain that is caused by degenerative disk disease (ordinary aging) is often less predictable and successful.
  • When it is difficult to determine the exact cause or origin of lower back pain, sometimes the pain can be due to social, psychological, and emotional, none of which surgery address.
  • While back surgery may initially be successful and may address low back pain more rapidly than non-surgical treatments, long-term follow-up studies show that people who've had surgery aren't much better off than those who don't. In some cases, patients had to repeat the surgery within 10 years.
  • It's also important to consider that surgery always presents a risk for unforeseen complications even with the best surgeons. These risks include nerve damage, infection, and adverse reactions to anesthesia.

What to Do 

  • Make an appointment with your doctor to get an evaluation. Partner with your doctor to identify the source of your low back pain.
  • Try non-surgical treatments such as acupuncture, massage, physical therapy, ice, and pain relievers. 
  • If you sense your lower back pain might be from physiological issues or emotional issues such as stress, seek out cognitive behavioral therapy, relaxation and/or yoga classes.
  • Adapt a healthy lifestyle including maintaining a healthy weight, eating healthy meals, exercising and quitting smoking.
  • Use proper body mechanics, including lifting with your legs, sitting and standing tall (no hunching).

If it comes to the point where your healthy lifestyle and all the physical therapy, acupuncture, pain relievers, and ice aren't helping to relieve your low back pain, talk to your doctor about the option of surgery.


Erstad, S. Low Back Pain: Exercised to Reduce Pain. Accessed March 14, 2010.

How to Decide If Surgery Can Solve Your Low Back Pain.,,20188210,00.html. Accessed March 14, 2010.

Levy, S. A Step-by-Step Guide to Making a Good Decision About Back Surgery.,,20188361,00.html. Accessed March 14, 2010.

Low Back Pain and CAM. NIH: National Center for Complementary and Alternative Medicine., Accessed March 14, 2010.

Mayo Clinic Staff. Back Pain: Treatment and Drugs. Accessed March 14, 2010.