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How to Know When Back Pain Requires Surgery

March 24, 2023

If you’re one of the millions of Americans that suffer from chronic back pain, you may be wondering if surgery could be the answer.

“I tell people that the best surgery is no surgery if you can avoid it,” says neurosurgeon Vijay Yanamadala, MD, with the Ayer Neuroscience Institute Spine Wellness Center in Westport. “But the second best surgery is the surgery that you need and can be life-altering.”

So when can surgery really offer improved quality of life? Here’s how to know when back pain is serious and when surgery may be the answer, according to Dr. Yanamadala.

How do I know if my back pain is serious?

Many issues of the spine, which include the back and neck, can be due to arthritis or other degenerative changes.

“Arthritis can make it difficult for your spine to move normally, sometimes causing muscle spasms resulting in pain or difficulty moving, but most of the time surgery isn’t needed,” says Dr. Yanamadala.

In most instances, back pain can be treated with physical therapy, in combination with over-the-counter anti-inflammatories, stretching or other exercises. If the pain doesn’t subside, it’s time to see a specialist.

If you start to notice numbness, tingling or weakness in your legs, or difficulty with coordination, these may be signs of something more serious.

When would surgery be needed for my back pain?

If physical therapy and injections for pain management aren’t helping, a neurosurgeon like Dr. Yanamdala can explain what the best type of surgery is for your pain.

Laminectomies, which treat the narrowing of the spinal canal due to arthritis or a herniated disc – decompresses the nerve roots by taking out arthritis in the spine. Spinal fusion, another common surgery, uses rods and screws to stabilize the spine because of a slipped disc.

If you are experiencing a pinched nerve with pain or weakness in your legs or you have a spinal cord compression with weakness in your hands (myelopathy), those generally require surgery as a first option.

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Surgery seems drastic. I’ll live with the pain.

“We have a lot of new techniques that make surgery much safer,” says Dr. Yanamadala.

For instance, Dr. Yanamadala was the first surgeon in New England to perform an awake spinal fusion, which allowed the patient to avoid general anesthesia.

While not all patients are candidates, there are many minimally invasive options available, which reduces recovery time.

“There is a lot we can do to minimize complications and make sure that you get the best care possible.”