I have severe back pain.  Will I need surgery to relieve it?

Most back pain is treatable without surgery.  Eighty percent of people suffer from back pain at some point in their life that requires attention from a health-care professional.  The vast majority can be treated effectively with rest and avoidance of physical exertion for a few days.  Both ice and heat can be helpful as can hot showers and baths.  Various balms and ointments may be beneficial as well and aspirin and other non-steroidal anti-inflammatory medications can be taken on a limited basis.  Chiropractic has been shown to be the most effective of all manual therapies but a variety of physical therapy techniques can certainly be helpful as well.  Massage may be highly effective in reducing symptoms.  If symptoms are disabling or persist for more than three or four days then a health-care professional should be consulted.

How do I know if I need back surgery?

If you have back pain and loss of bladder and /or bowel control than immediate attention by a back specialist is required.  In such a case surgery may well be necessary within 24 to 48 hours to regain bladder and bowel function.  Generally in this condition there is also a loss of sensation around the genitals and anus.  Numbness may also extend down one or both legs. Weakness is also often evident as well.   If a complete foot drop is present (the foot cannot be bent upwards at the ankle) this is also an emergency and requires immediate attention and could well require emergent surgery.

If you have weakness in one or both legs that prevents you from being able to walk than immediate attention by a back specialist is require as well. 

If you have back pain with or without leg pain that fails to resolve with 4 to 6 weeks of non-surgical management and has a impact on your lifestyle, significantly limiting your usual activities,  than surgery may be indicated.

I had an MRI of my lumbar spine that shows a herniated disc.  Do I need surgery to correct it?

It is common for individuals over forty to have at least one abnormal or damaged disc.  Often the abnormal disc may, to a varying extent, be herniated or protruding out of its normal confines.  If the herniated disc is compressing one or more nerves and you experience associated pain, numbness and weakness than surgery may be necessary to relieve the symptoms. 

I have neck pain with the pain running down my arm.  Physical therapy helps for a day but as soon as I become active, the pain recurs.    My physical therapist says I need to see a spine surgeon but I’m afraid of the idea of surgery on my neck. Should I see a spine surgeon?

If you have neck and arm pain that does not resolve with 4-6 weeks of non-surgical treatment than you should consult with a spine surgeon.  This is especially correct if you experience weakness in the arm or hand.  When performed by a board-certified spine surgeon, surgery on the cervical spine (neck) is very safe and very effective.

I have neck pain and I’m having trouble walking.  Could the two be related?

Yes. The spinal cord runs through the spinal canal in the neck and mid-back.  If the spinal cord is being compressed than it can result in stiffness and /or weakness in the legs.  It can also lead to imbalance and altered sensation. Furthermore it can affect bladder control. Compression of the spinal cord in the neck can lead to weakness and numbness in the arms and hands as well.  If you are experiencing any of these symptoms you should consult a spine surgeon immediately.

What is the difference between an orthopedic spine surgeon and a neurosurgeon?

An orthopedic spine surgeon spends most of their residency learning how to operate on the bones, joints, ligaments and muscles of the body.  To become a board certified spine surgeon they complete an additional one to two years of training in a specific spine surgery fellowship program. 

A neurosurgeon spends six years learning how to operate on the nervous system. This includes learning surgery of the spine throughout their training.  They may elect to do an additional year of training in a spine fellowship program but obtaining board certification in neurosurgery does not require additional fellowship training.

How should I choose a spine surgeon?

The surgeon you choose should be a board-eligible or board-certified neurosurgeon or an orthopedic surgeon who has completed a spine fellowship.  You should consider your health-care providers recommendations, the recommendation of friends and acquaintances who have had spine surgery, the recommendations of any health-care workers, such as nurse, whom you may know personally and information about reputation that you can obtain via various websites.  Once you have decided who to consult with you need to be comfortable with that surgeon, one who evaluates you carefully, explains your condition and treatment options to your satisfaction and is eager to answer all your questions and concerns.