Back pain is one of the most common reasons people visit a doctor, second only to colds and respiratory illnesses. For some, the first recommendation they hear is surgery. But is surgery always the best option? The truth is, for most patients, back surgery should be avoided when possible.
At TruStrength Performance and Rehab, we’ve helped countless patients in Denver and Centennial overcome back pain without the risks, costs, and complications of surgery. If you’re considering surgical treatment, here’s what you need to know.
Understanding Back Surgery
Back surgeries typically aim to relieve pressure on spinal nerves, stabilize unstable segments, or correct structural issues. Common procedures include:
- Discectomy: Removing part of a herniated disc pressing on a nerve.
- Laminectomy: Removing bone or ligament to relieve nerve compression.
- Spinal Fusion: Joining two or more vertebrae to stabilize the spine.
- Artificial Disc Replacement: Replacing a damaged disc with an implant.
While these surgeries can help in very specific cases, they are not always successful — and often come with significant downsides.
The Risks of Back Surgery
Surgery is never without risk, and spine procedures carry unique challenges. Some of the most concerning risks include:
- Failed Back Surgery Syndrome (FBSS): Up to 40% of patients continue to experience pain after surgery.
- Scar Tissue Formation: Can cause stiffness and nerve irritation.
- Nerve Damage: Potential for weakness, numbness, or chronic pain.
- Infections or Blood Clots: Surgical risks that can prolong recovery.
- Extended Recovery Times: Patients may spend months regaining function.
- Financial Cost: Even with insurance, back surgery can cost tens of thousands of dollars.
Why Conservative Care First Makes Sense
Research consistently shows that many people with back pain improve through non-surgical treatment such as physical therapy, exercise, and lifestyle changes.
Benefits of conservative care include:
- Lower Risk: No anesthesia, incisions, or invasive procedures.
- Faster Recovery: Many patients feel improvements within weeks.
- Cost-Effective: Far less expensive than surgery.
- Long-Term Success: Treats not just the pain but also the root causes, like poor posture, weak muscles, or movement dysfunction.
How Physical Therapy Helps Back Pain
At TruStrength, our physical therapists use a comprehensive, active approach to back pain that includes:
- Manual Therapy: Hands-on techniques to improve mobility and reduce stiffness.
- Exercise Prescription: Core stabilization, hip mobility, and functional strengthening.
- Dry Needling and Cupping: Techniques to release muscle tension and improve circulation.
- Education and Movement Training: Teaching patients how to move safely and avoid flare-ups.
- Whole-Body Approach: Addressing sleep, stress, and lifestyle habits that affect pain.
Learn more about our back pain and sciatica treatment in Denver.
When Surgery Might Be Necessary
To be clear, surgery is sometimes the right choice. Absolute indications include:
- Severe spinal cord or nerve compression causing loss of bladder or bowel control
- Progressive neurological weakness (such as foot drop)
- Major structural problems that do not respond to months of conservative care
Even in these cases, physical therapy plays a vital role both before and after surgery to optimize outcomes.
Alternatives to Back Surgery
Before pursuing surgery, patients should explore these proven treatments:
- Physical Therapy: Builds strength, mobility, and stability.
- Exercise Programs: Walking, yoga, Pilates, and strength training can reduce pain.
- Lifestyle Modifications: Improving posture, workstation setup, and sleep habits.
- Medication Management: Non-opioid options for pain and inflammation.
- Injections (Selective Use): Steroid injections may temporarily reduce pain to allow therapy to be more effective.
- Mind-Body Approaches: Stress reduction, breathing techniques, and mindfulness to reduce tension.
The Hidden Costs of Surgery
It’s also important to consider the long-term implications of surgery:
- Fusion Surgeries Can Limit Mobility: Fusing vertebrae reduces motion, often leading to additional stress and degeneration above or below the fusion.
- Repeat Surgeries Are Common: Once one spinal surgery is performed, the likelihood of future surgeries increases.
- Time Away From Work: Recovery can take months, impacting finances and quality of life.
Frequently Asked Questions About Back Surgery
1. What percentage of back surgeries fail?
Studies suggest up to 40% of patients experience continued pain after surgery, a condition known as Failed Back Surgery Syndrome.
2. How do I know if I really need surgery?
Unless you have red-flag symptoms (like loss of bladder control or severe nerve weakness), surgery is rarely the first option. A thorough evaluation by a physical therapist and physician can help determine the best course of care.
3. Can physical therapy really fix back problems?
Yes. Most patients with back pain improve significantly through therapy, exercise, and education without ever needing surgery.
4. What are the long-term risks of back surgery?
Scar tissue, reduced spinal mobility, and the likelihood of additional surgeries in the future are common concerns.
5. Is back pain always structural?
No. Many cases of back pain are influenced by posture, muscle weakness, stress, and lifestyle factors, not just structural changes seen on imaging.
Practical Steps if You’re Considering Surgery
If your doctor has recommended back surgery, here are some steps to take before deciding:
- Get a Second Opinion: Especially from a non-surgical spine specialist.
- Try Conservative Care for at Least 12 Weeks: Most guidelines recommend exhausting non-surgical options first.
- Understand the Risks and Benefits: Be realistic about potential outcomes.
- Ask About Recovery Expectations: Know how long you’ll be out of work and activity.
- Consult a Physical Therapist: Even if surgery is necessary, PT can prepare your body for the best results.
Final Thoughts
While back surgery can be life-changing for some, for most patients, it should be a last resort. The risks, costs, and uncertain outcomes often outweigh the potential benefits when conservative care has not been fully explored.
At TruStrength Performance and Rehab in Denver and Centennial, we believe in helping patients avoid unnecessary procedures by restoring movement, strength, and confidence through physical therapy.
If you’re struggling with back pain and wondering whether surgery is the only option, there’s good news: it usually isn’t. Let our team show you a safer, smarter path to recovery.
Schedule your appointment today and take the first step toward lasting relief—without the need for surgery.