About a quarter of Australians suffer from back pain, making it an incredibly common problem. Around 80% of us will have back pain at some point in our lives. In most cases, back pain is annoying but not debilitating. However, about 10-20% of people with lower back pain find that it is intensely painful and can limit their activities. It’s the most common reason for early retirement.
It can be tempting to think of surgery as a silver bullet that will fix back pain quickly and forever. Unfortunately, that’s rarely the case. So, what should you consider when deciding about back surgery? And what are the alternatives?
Things to Consider When Deciding About Back Surgery
Back surgery is a big decision and you should consider the pros and cons carefully.
You’ll need to think about things like the:
- Effectiveness of the procedure (some types of back surgery work better than others)
- Surgical risks such as infections, adverse drug reactions, blood clots or nerve damage
- Out-of-pocket costs for the surgeon, anaesthetist and hospital stay if you’ll be using your private health cover
- Time off work – this might be paid or unpaid depending on your type of employment
- Recovery time needed after the operation
- Rehabilitation afterwards to enable you to regain strength and mobility
When Might Back Surgery Be a Good Option?
Back surgery might be a good option if:
- You have certain conditions like a slipped disc, spinal stenosis or bony growths in your spine due to osteoarthritis that put pressure on your spinal cord
- You’ve tried conservative treatments like physiotherapy without success
- Your back pain is having a significant impact on your life
- You’re generally in good health and therefore a low-risk surgical patient
- The surgery proposed is likely to help
- You can afford the operation, both the financial costs and the recovery time
- You’ve sought a second opinion, which confirmed the surgical option.
When Is Back Surgery Not a Good Option?
Surgery is only ever a good option if the benefits outweigh the risks.
Back surgery may not be the best option if:
- You haven’t tried any other treatments yet
- You have other medical conditions that increase the risks of surgery
- It’s the wrong type of surgery for your pain
- You haven’t sought a second opinion.
There are different ways of managing back pain. If you’d like a second opinion before deciding on spinal surgery, then please visit us at The Brisbane Spine Clinic for a risk-free, no-obligation consultation.
Types of Back Surgery
The most common types of back surgery are:
- Spinal fusion where the surgeon permanently joins (fuses) two or more of the bones (vertebrae) in your spine to improve stability or stop painful movements
- Discectomy, were a damaged portion of a spinal disc is removed to ease nerve pain
- Laminectomy, where a piece of bone is removed to enlarge your spinal canal and so ease nerve pressure caused by spinal stenosis.
About 40% of surgical patients end up with something called Failed Back Surgery Syndrome where the surgery hasn’t fixed the problem. People who’ve had spinal fusion surgery are most likely to be in this category.
Spinal fusion is a popular surgery but it isn’t actually very effective for most patients. It’s most commonly done in private hospitals, where rates increased by 167% between 1997 and 2006. Choosing Wisely, a national campaign against ineffective treatments, does not recommend spinal fusion for uncomplicated chronic lower back pain. In November 2019, the Medicare Benefits Schedule was updated to stop Medicare funding being used for spinal fusion for chronic lower back pain which did not relate to a specific diagnosis.
What Are the Alternatives to Back Surgery?
By now, you may really be wondering ‘Should I have back surgery?’ As you can see, back surgery always involves risks and may not deliver benefits.
That’s why we always recommend conservative approaches such as physiotherapy first. It’s an effective low-risk treatment that may avoid the need for surgery. It may give you greater comfort in a stronger, more flexible body. That improves your health and quality of life. If, ultimately, you do still need back surgery, you go into the operation in a better physical condition which improves your recovery.
Physiotherapy has proven to be just as effective as surgery in treating a type of lower back pain called lumbar spinal stenosis. That’s also true for degenerative disc disease, where a study found no difference between patients who’d had surgery and those who’d had physio when they were followed up five years later.
Here at The Brisbane Spine Clinic, we have helped many people avoid, delay or recover from back surgery. We can teach you how to strengthen your body to prevent or reduce back pain. We have a special interest in helping people who’ve experienced the distress of failed back surgery syndrome. No two stories are ever the same so we promise to listen to you carefully, examine you thoroughly, and develop a personalised treatment plan that helps you face the future with home. Please make an appointment today.