Do I need spine surgery?

When back or neck pain symptoms strike, it’s natural to want instant relief. Some will seek surgery, a procedure or a pill as the solution. But it’s important to understand that surgery is not appropriate for some back or neck problems. For example, surgery is never appropriate for a back or neck muscle strain.

Surgery can accomplish two objectives:

  • It can correct a herniated disc that is pressing upon a nearby nerve root.
  • It can correct an instability of vertebrae that is causing symptoms.

If the surgeon can identify a disc problem or problem segment from an MRI, that would make you a candidate for spine surgery. There are also some symptoms that require emergency spine surgery to correct or the symptoms can become permanent and lifelong.

Take the Symptoms Quiz

Have you experienced any...

Loss of bowel/bladder control is an EMERGENCY symptom. You need to see a spine surgeon or go to an Emergency Room within 24 hours, or the symptom could become permanent.

Call our office IMMEDIATELY: (408) 377-3331
Or go to the Emergency Room

This is called "cauda equina" and relates to a compression of the nerve bundle at the base of the spine. If left untreated, it could cause permanent paralysis of the nerves that control the bowel or bladder, making the symptom permanent and lifelong."

When a nerve in the low back is compressed by a herniated disc, it can cause weakness in a foot. This is called “footdrop” and is characterized by a toe that drags on the ground because the front of the foot doesn’t raise up while walking. When a nerve in the neck is compressed by a herniated disc, this can cause weakness in a hand. Weakness or numbness are both emergency symptoms that need to be seen and treated by a spine specialist (spine surgeon or spine-specialized physical medicine physician) with 3 days. In some cases, spinal injections may be used to relieve symptoms. In other cases, spine surgery may be needed promptly to relieve the pressure on a nerve root.

Call our office at (408) 377-3331 or request an appointment

This is called “radicular pain” or “radiculopathy” in that the pain radiates into the leg or arm. While you cannot use watchful waiting with the above emergency symptoms, a person can use watchful waiting for a period of time to see in non-surgical treatment options can provide relief. In many cases, radicular pain can be treated successfully with non-surgical treatment options like spinal injections or manual therapy that relieve inflammation around a nerve root. In other cases, like “stenosis” spinal surgery may be needed to open the spinal canal to relieve the compression on the spinal cord and adjacent nerve roots. Stenosis is a narrowing of the opening in the vertebrae for the spinal cord and can related to aging. Those over 50 years of age may notice pain when standing or arching their back. Radicular pain that is not relieved by non-surgical treatment options over a three month time period may need spine surgery. Some research studies, however, have concluded that waiting an excessive amount of time (beyond 3 months) can reduce the likelihood for a successful relief of symptoms from spine surgery. In a sense, it is like a car parked on a garden hose for several months. Even when you eventually move the car, it may have cause a permanent crimp in the garden hose. Spine researchers theorize that compression of a nerve root that lasts several months may cause more permanent damage that isn’t relieved by a subsequent surgery. In conclusion, there is a window of time where a person should proceed to spine surgery for radicular pain if non-surgical options fail to provide relief over the first three months.

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Any traumatic fall or car accident could have fractured bones in your spine, or herniated a disc. You should see a spine specialist promptly who may perform X-rays to assess you. Any trauma to the back needs to be evaluated promptly with at least several X-rays to rule out a fracture to vertebrae in the spine. A fracture could allow vertebrae to shift out of position and damage the spinal cord resulting in permanent paralysis.

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Neck pain with headache/nausea is an EMERGENCY symptom. See a doctor within 24 hours.

Call our office IMMEDIATELY: (408) 377-3331
Or go to the Emergency Room

Did the pain come on after lifting, or after aggressive exercise or sports activity?

Lifting or sports activities can strain muscles, ligaments & tendons, causing painful spasms. Extreme pain can require a spine specialist. Home remedies include anti-inflammatories like Advil/Nuprin, rest, ice and some simple stretching exercises. However, if symptoms don’t improve over 3 days, you need to be assessed by a spine specialist.

Call our office at (408) 377-3331 or request an appointment

Is the pain mostly in your low back, AND accompanied by a FEVER, or making you sick?

Pain in the low back, along with a fever, could be a kidney infection. You should see a spine specialist immediately.

Call our office IMMEDIATELY: (408) 377-3331
Or go to the Emergency Room

Back or neck pain that doesn’t radiate pain or numbness into a leg or arm can be caused by a variety of problems, including a strain of the muscles or ligaments in the back or neck.

Home remedies include anti-inflammatories like aspirin, Advil or Nuprin, rest, ice and some simple back/neck exercises. Don’t do any exercise that causes an increase in pain.

If pain persists you may need to see a spine specialist. Call our office at (408) 377-3331 or request an appointment

Remember: Those who self diagnose themselves and self treat themselves do so at their own risk. Back and neck pain can arise from a variety of causes and may require a spine specialist to perform diagnostic tests to identify your problem and the best treatment. A spine specialized therapist can also create a home exercise program customized for you.