Will Back Surgery Work?

If you suffer from severe and chronic back pain, and you're considering surgery, it's important to look at serious alternatives: surgery is final, and if it doesn't work...

Back pain is often treated by surgery, when physiotherapy and drugs fail. But surgery also often doesn't work; in fact, that there's a clinical term for failure: Failed Back Surgery Syndrome! Perhaps this should be something surgeons suffer? - but sadly it refers to back pain patients... To my mind, if a treatment doesn't work and has an expectation of not working.. it is not a treatment at all; it's an experiment at best and desperation at worst...

Some Reasons Why Surgery Doesn't Work

This isn't advice that you should not have surgery. It's offering a window of consideration before making a vital decision: remember once you have surgery, that's final.. There are several surgical procedures for back pain, and they try to do one of two things: remove the pressure on the nerve that registers pain or stabilize the spine.

Say you have a herniated disc: The pain is there because the disc is pressing on a nerve. On the surface of it the solution is to remove the part of the disc that's touching the nerve. But it's not that simple...

1. Once the operation is done, your body goes through a recovery process. That process can include a lot of pain and awkward movement just to get you through each day. Here's where you could meet difficulties.... The awkward movements you're making will be putting unnatural wear and tear on other areas of your body. Areas where that might cause propblems would be above or below the surgery site, and in other joints such as the hips or sacroiliac.

You might have already found that your back condition causes you to hold your body in an un-natural pose that puts strain on limb joints. I used to get knee pain from the way I walked with lower back pain..

2. Back pain surgery is going to done near to nerves. Surgery means scar tissue and a build up in this can make contact with a nerve. This can be painful, just as if the disc was still pressing on the nerve.

3. Post-op rehabilitation is most likely only going to address your post-operative pain. It will aim to improve functional "activities of daily living" - things like taking a bath, dressing yourself, toiletting. This enables you to go home quickly and be safe; but post-op rehab won't address the long-term causes of the pain.

The Causes of Back Pain

Most back pain conditions are related to problems with postural alignment. Think of it as being similar to a car having a tyre out of alignment. For our body, improper alignment means an abnormal curvature of the spine and abnormal orientation of the pelvis. The way to get our bodies back into alignment, so they can function normally again, is to work on getting our muscles back into alignment.

Some Important Questions If You're looking At Surgery

Before you are consider surgery, I'd recommend consulting a qualified therapist. Give this a fair shot. It needs about 60 days to fairly trial the options of doing work on stretching and strengthening your muscles to help re-align your posture. If you do this and still opt for surgery, you'll need good rehab after the operation. Your rehab will need to work on decreasing your pain in the first place, so you can go home safely. Your rehab should also address the following issues that deal with the root cause or causes of your pain.

1. Ask the surgeon and therapist to examine you for dysfunction (poor alignments), including these potential problem areas: the curvature of my spine from top to bottom the position of my pelvis (i.e. is it level or tipping)

2. The therapist should be able to explain how your muscles are out of balance - that is, tell you which muscles are strong or weak, flexible or tight in relation to one another.

3. You need to know which muscles to stretch and which ones to strengthen. You need to get the therapist to explain what each muscle group does, and that will help you to know how to do the exercises correctly.

4. You need to ask both your surgeon and your therapist to write everything down and ask them for a copy: this is part of your long-term treatment plan. What's A Success... Having a long-term plan for your back means you're looking for some measure of substantial improvement, if not cure: let's call that success.. I've been pain-free for 9 years now and having suffered back pain for around 9 years, in my forties, I think I'd have been happy with 5 years remission. That seems a reasonable goal.

One final comment on the option of surgery: the main criterion for success would be that it provides substantial relief, if not cure, for 5 years. The main reason why that goal might not be achieved is that the treatment might not be addressing the underlying cause of pain. If the treatment strategy you chose addresses the issues around muscle imbalance, then you will have a much better chance if getting onto a path to a pain-free life.