If you’ve been dealing with back pain for quite a while, you’ve probably wondered if back pain surgery might be a solution and whether now is the right time. Although many people find relief with time and non-surgical treatment, you may need more if you still have chronic back pain that is limiting your life.
In some cases, back pain surgery is the best treatment option. But before you decide, it’s important to consult a Denver spine specialist to determine if surgery is the right choice for you.
Here are three signs that it may be time to consider back pain surgery:
1. You Have Pain That Doesn’t Go Away
In most cases, acute back pain lasts a few days to a few weeks. Although most people get better, some continue to experience pain as part of their daily life.
Chronic, unrelenting pain can affect your quality of life in many ways. Pain that limits your mobility can impact your job, family, and social life. Plus, chronic lower back pain is exhausting. Medication and pain management techniques can help, but they don’t always offer a permanent solution, and can have unpleasant side effects.
Neurosurgery One’s Denver spine surgeons work in teams with advanced practice providers, pain management physicians, and physical therapists to create a personalized plan to effectively treat your back pain. In most cases, you will start with physical therapy and other pain management treatments, such as spinal injections. If those don’t relieve the pain, you’ll be assessed to see if you are a candidate for an interventional pain management procedure, such as spinal cord stimulation.
Unless you have emergency symptoms, spine surgery is the last option considered to treat your pain. Back surgery may offer you long-term relief for your back pain if three conditions are met:
- Your spine condition is one that has been shown to benefit from surgery through extensive and published medical research. Some conditions, such as chronic, intractable lower back pain without leg pain, may not be helped by surgery, according to studies such as this one published in Spine journal.
- Your spine surgeon selects the appropriate procedure for your specific condition, your overall health, and your goals. While minimally invasive surgery offers benefits such as smaller incisions, it may or may not be the right answer for you.
- Your overall health supports surgery and, just as importantly, successful recovery and rehabilitation from surgery.
2. You Have Pain That Radiates to Your Arms and Legs
When your back pain radiates to your extremities, it may indicate pressure on a nerve root of the spine. In these cases, surgery may be the best option. Neurosurgeons are particularly good at this type of spine surgery because they are specially trained in understanding and treating the nervous system.
There are many causes of radiating back pain, including osteoarthritis, bone spurs, and herniated discs.
Chronic back pain is often the result of spinal osteoarthritis. Over time, the articular cartilage of the spinal joints can wear away. This can lead to bone-on-bone contact and become very painful.
With a disc herniation, the inner jellylike layer of the spine protrudes through the outer, tougher layer. If this herniation presses on a nerve root, it results in ongoing pain and discomfort. If the affected disc is in the lower, or lumbar, part of your spine, it can put pressure on your sciatic nerve. That often causes a condition called sciatica where pain runs down one or both legs.
Bone spurs can be a very painful condition. Arthritis is often the cause of this condition, which can put undue pressure on the spine. In many cases, bone spurs are harmless and may cause no pain. But for some, bone spurs are more serious. They can grow over time and may compress the spinal nerves, resulting in pain, tingling, or weakness. The pain often radiates to the extremities.
3. You’re Getting Shorter
Osteoporosis and other diseases can weaken the spine. As bones weaken, they can become brittle, and the chances of fractures increase.
Osteoporosis can cause small fractures in the spine that result in a hunched posture or loss of height. This condition is called kyphosis and occurs most frequently in women over the age of 60, who also are at higher risk of osteoporosis in general. In many cases, kyphosis can be subtle and not cause pain. In some people, however, it can cause pain that needs to be treated to avoid immobilization.
The most common surgeries to treat kyphosis are vertebroplasty and kyphoplasty. During these procedures, a special type of “cement” is injected into your spine to help reduce your pain and restore mobility. During kyphoplasty, a balloon is used to help create space between the vertebrae.
Both vertebroplasty and kyphoplasty are minimally invasive procedures. Your Denver spine surgeon will insert a needle—and balloon, in the case of kyphoplasty—into your spine while you are sedated to inject the cement.
Like all spine surgery, there are pros and cons of these procedures so it’s important to discuss these and alternative treatments with your surgeon.
Common Causes of Chronic Back Pain
In addition to herniated discs and bone spurs explained above, chronic back pain can be due to slipped or bulging discs, spinal stenosis, degenerative disc disease, or vertebral endplate nerve dysfunction. These conditions can be caused by an accident, activity, repetitive movement, and aging.
- Slipped or Bulging Disc: You have a series of discs or buffers between each of your 33 vertebrae. As you age, it’s common for spinal discs to begin to slip, bulge, or even rupture.
- Spinal Stenosis: This common condition usually develops slowly as a result of osteoarthritis-related changes to the spine that create a narrowing of the spinal canal. That narrowing reduces the space for nerves to pass through and the resulting pressure can cause chronic back pain and sciatica. Spine surgery has been found to provide significant pain reduction benefits over more conservative treatments for spinal stenosis.
- Degenerative Disc Disease: Back pain is often a temporary condition. But in some cases, back pain gets worse over time. Everyday wear and tear on your spine can result in degenerative disc disease. This condition may cause mild to severe lower back pain and often radiates to the legs.
- Vertebral Endplate Nerve Dysfunction: Sometimes your pain is not caused by the discs in your back at all. Vertebral endplate nerve dysfunction is when the layer of nerve-packed cartilage that separates the vertebra (bone in the spine) from the disc (padding between bones) becomes compressed, causing pain. It’s a natural side effect of aging but one that is often missed or misdiagnosed because not many spine surgeons are trained to spot the subtle signs on MRI.
Signs Emergency Back Surgery Is Needed
In most cases, back pain surgery is not urgent and is called “elective” surgery you and your spine surgeon decide when the time is right. A spine doctor may advise a patient to wait and try non-surgical treatments first. However, immediate back surgery may be required:
- In the case of an emergency or severe trauma, such as a fall or car accident.
- If you are experiencing acute pain, tingling, or numbness. A sudden feeling of numbness is scary and can lead to a fall or injury. A feeling of weakness, numbness, or tingling may be due to compressed nerves, nerve damage, or obstruction around the spine. If you’re experiencing these symptoms, a surgical procedure may be necessary to relieve your discomfort. Surgery can be urgent in these cases to avoid any long-term loss of function or disability.
- If you are experiencing a loss of motor control or experiencing urinary or fecal incontinence, surgery within 48 hours may be needed to provide the best benefits and reduce the likelihood of long-term issues.
In addition those situations, the American Association of Neurological Surgeons lists these additional “red flag” symptoms that require immediate medical attention:
- Urinary retention when you do not experience the normal sensation or urge to urinate.
- “Saddle anethesia” sensory disturbance, which can involve the anus, genitals and buttock region
- Weakness or paralysis of usually more than one nerve root. The weakness can affect lower extremities.
- Sexual dysfunction
Spine Surgery Can Improve the Quality of Your Life
Chronic back pain can slow you down and interfere with all aspects of your life. Although many people find pain relief through non-surgical means, if those treatments fail to relieve your pain, it may be the right time to consider spine surgery.
The first step is finding a Denver spine surgeon you can trust who can determine which back pain procedures are most appropriate for you. Your spine surgeon will consider many factors to determine if surgery is the next best step, including:
- The type of injury or disorder
- Your age
- Your overall health
- Your fitness level
- The nature of the procedure
- The recovery period and process
Is Back Surgery Right for Me?
You don’t have to live with chronic low back pain. Even if you think you don’t need back surgery, it’s a good idea to consult with an experienced spine surgeon to discuss your options.
Neurosurgery One’s spine surgeons throughout Denver can help you get the proper diagnosis and find the best course of action for treating your pain. Request a back pain appointment online and our schedulers will call you within 24 business hours to set up an appointment at one of our eight Denver area spine clinics or via telehealth.
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