When is Back Surgery Necessary?

Back pain is extremely common and is, in fact, the second most common reason people go to see the doctor. Up to 80% of people at some point in their lives have back pain.

Fortunately, almost all people with back pain will not require back surgery.

When back surgery is necessary

One of the reasons to have back surgery is if you’re having nerve symptoms down the leg. If you notice tingling or weakness down your leg, this is a sign of a nerve injury.

This could be caused by a herniated disc crushing the nerve as it leaves the spinal cord. It may also be a sign of inflammation along the sciatic nerve.

The first line of treatment for people with back pain even with nerve symptoms is physical therapy and anti-inflammatories.

It is only people who fail to improve with these conservative treatments or have worsening nerve symptoms will require back surgery.

If someone has a significant accident and breaks there spine, they may need urgent surgery. But even in these cases, most people with spine injuries do not require surgery.

Injections as an alternative to back surgery

People with severe back pain usually do improve and even resolve with physical therapy and medication. If these patients don’t improve, injections done under fluoroscopic guidance in our office may resolve the problem.

These injections work for the neck as well as the lower back and may prevent back surgery. We would consider back surgery only after someone fails to improve despite conservative treatments.

If you’re suffering from back pain, schedule an appointment with the Westchester orthopedic doctors at Westchester Sport and Spine for effective, conservative treatment.


Dr. Rick Weinstein, MD, MBA is an orthopedic surgeon specializing in sports medicine. He is the Director of Orthopedic Surgery at Westchester Sport and Spine and has subspecialty training in knee and shoulder surgery, including minimally invasive surgery and arthroscopy. Dr. Weinstein is a Board Examiner for the American Board of Orthopedic Surgeons, determining certification for other orthopedic surgeons.