Back surgery: When is it a good idea?

Back surgery can ease some causes of back pain, but it's rarely necessary. Most back pain gets better on its own within three months.

Low back pain is one of the most common reasons people see a healthcare professional. Common treatments may include anti-inflammatory medicines, heat or ice, and physical therapy.

Back surgery might be an option if other treatments haven't worked, and your pain is disabling.

Many people with back pain also have pain that goes down a leg. These symptoms are often caused by pinched nerves in the spine. Nerves may become pinched for a variety of reasons, including:

• Disk problems. Disks are the rubbery cushions that separate the bones that make up the spine. A bulging or herniated disk sometimes can get too close to a spinal nerve. This can cause pain and affect how the nerve works.
• Overgrowth of bone. Osteoarthritis can result in bone growths, often called spurs, on the spine. This excess bone can reduce the amount of space available for nerves to pass through openings in the spine.

Back surgery relieves this leg pain better than it does back pain. Many people who have back surgery continue to have back pain.

It can be hard to pinpoint the exact cause of back pain, even if imaging tests show disk problems or bone spurs. Imaging tests taken for other reasons often reveal bulging or herniated disks that cause no symptoms and need no treatment.

Herniated disk and bone spurs on spine

As the spine ages, it's more likely to have bone spurs or herniated disks. These problems can shrink the amount of space available for the spinal cord and the nerves that branch off it.

Different types of back surgery include:

• Diskectomy. This surgery removes the damaged part of a disk in the spine. A diskectomy can relieve the pressure caused by a herniated disk.
• Laminectomy. This surgery removes the back part of a spinal bone to make more room for the spinal cord and nerves.
• Fusion. Spinal fusion removes joints affected by arthritis and may use metal implants to help permanently connect two or more bones in the spine.
• Artificial disks. These devices are made of plastic and metal. They can replace the damaged cushion between two spinal bones.

Before you agree to back surgery, consider getting a second opinion from a qualified spine specialist. Back and leg pain can be a complex issue that may require a team of health professionals to diagnose and treat.