Is Surgery Really Needed?

RARELY is surgery the answer

Most "good" surgeons will NOT perform surgery just because of back pain (regardless of how severe). Odds are you won't need surgery for back pain. The pain and disability caused by a herniated disc or spinal stenosis frequently diminish with conservative treatment. However, if you develop neurological deficits, or muscle weakness caused by nerve compression, you may need a surgical consultation. Your chiropractor will advise you if this is appropriate.

Before you agree to back surgery, consider getting a second opinion. Surgery to repair a herniated disc is among the most frequently performed procedures in the United States. Yet the outcome is often the same whether you have surgery or choose a less-invasive treatment.

Exercise is the cornerstone of pain prevention

Regular exercise is your most potent weapon against back problems. Activity can increase your aerobic capacity, improve your overall fitness and help you shed excess pounds that stress your back.

Stretching and toning your back and other supporting muscles can help reduce wear and tear on your back. Stretching reduces your risk of injury by warming up your muscles. It also increases your long-term flexibility.

Strength training can make your arms, legs and lower body stronger. In turn, your risk for falls and other injuries decreases. Strong arms, legs and especially abdominal muscles also help relieve back strain. If you have osteoporosis, back strengthening exercises may help prevent additional compression fractures. Ask your chiropractor for advice before beginning an exercise program, especially if you've hurt your back before, or if you have other health problems such as significant osteoporosis.

Then follow these general suggestions

Start slowly- If you're out of condition from lack of activity, your back muscles may be weak and susceptible to injury. Pace yourself and don't overdo. As you become stronger, work up to 15 minutes of exercise daily.

Make smart moves- Generally, swimming and other water exercises are safest for your back. Because they're nonweight-bearing, these activities place minimal strain on your lower back.

Workouts on a stationary bike, treadmill or cross-country ski machine are less jarring to your back than running on hard surfaces. Bicycling is a good option, too. However, be sure to adjust the heights of the seat and handlebars so that you assume proper posture while pedaling. If you golf, protect your back by shortening your backswing.

Avoid high-risk moves-You may need to avoid or modify activities, especially if you've had back problems. Avoid movements that cause you to exaggerate the stretch of your muscles. For example, don't try to touch your toes with your legs straight. Activities that involve a lot of twisting, quick stops and starts, and impact on hard surfaces, such as tennis, racquetball, basketball and contact sports, pose the greatest risks to your back.

The Failed Back Surgery Syndrome


Some 200,000 patients undergo lumbar spine surgery every year. Unfortunately, 20-40% (I've heard of a 55% failure rate) of patients will fail to gain the desired outcome. In fact, 10% of patients will be worse after the initial surgery. The following are a list of the general causes for symptoms following low back surgery: Structural and mechanical problems with the spine itself, related or unrelated to the initial surgery, poor body mechanics and reconditioning, alternative diagnoses that were the actual cause of the initial back pain or a contributing cause which were not diagnosed initially, iatrogenic causes due to the surgery or surgical procedure, psychological variables, and medication problems. In short, there are multiple factors that can contribute to failed back surgical syndrome.

Most patients with failed back surgical syndrome have a peripheral, mechanical, structural lesion that is the source of the symptoms. Therefore these patients generally respond well to chiropractic care.

Failed Back Surgery...Can we Help???

Our office may be able to help with some of the complications, and problematic outcomes associated with spinal surgery. First and foremost, a person considering surgery should be fully educated on the risk to benefit ratio, exactly what is being done, and what possible outcomes a person can expect. The best approach, when considering surgery, would be to start with conservative care first. Consider your alternatives to surgery. If you get no results there, then progressively move up the ladder of choices towards surgery.