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Surgery may help chronic back pain

Surgery may help reduce or relieve back pain. But doctors almost always try nonsurgical treatments before recommending back surgery.

If you have ongoing back problems, you and your doctor have probably spent a lot of time trying to find ways to get pain, well, off your back. Chronic back pain can decrease your mobility and significantly affect your life—interfering with your ability to sleep, work or perform daily activities. When other treatments don't help, surgery may be an option, according to the American Academy of Orthopaedic Surgeons (AAOS).

Why surgery?

There are two groups of people who may need surgery to help with back pain. People in the first group have chronic back pain that radiates to the legs or feet, a condition called sciatica. Chronic back pain with sciatica can be caused by:

A herniated or ruptured disk. Disks support and cushion the vertebrae in the back. When the hard outer coating of a disk is damaged, the disk's jelly-like center can leak and irritate nearby nerves.

Spinal stenosis. The spinal canal narrows, compressing nerves. This causes pain and numbness in the legs and sometimes loss of bladder or bowel control.

Spondylolisthesis. This is a condition in which a vertebra of the spine slips out of place, causing nearby joints to enlarge and pinch nerves.

Vertebral fractures. Fractures can be caused by injury or by a crumbling of the vertebrae from osteoporosis.

The second group of people who may need surgery has lower back pain without leg pain, usually caused by the disks wearing down with age (degenerative disk disease).

Types of surgery

There are many types of back surgery. The kind of surgery that your doctor recommends will depend on the nature of your back problem.

In some surgeries, doctors remove bone or tissue to relieve pressure on nerves. These include:

  • Laminectomy or diskectomy.
  • Microdiskectomy.

In other surgeries, doctors stabilize a portion of the spine by removing bone or tissue and strengthening the area with bone grafts, screws, rods polymethylmethacrylate (a cement-like mixture known as PMMA). These surgeries include:

  • Spinal fusion.
  • Vertebroplasty.
  • Kyphoplasty.

Make an informed decision

Surgery may help reduce or relieve chronic back pain, but it has its limitations as well. Surgery outcomes are different for every person. You may continue to have some persistent, achy pain in your lower back after surgery. Some of this pain may be relieved by maintaining a healthy weight and exercising. Full recovery from some types of surgery, such as spinal fusion, may take months, according to the AAOS.

Talk to your doctor about whether surgery may be the right treatment for your back pain.

Reviewed 7/31/2023

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