Most back pain does not need surgery
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| Dr. John Neblett, who specializes surgery of the brain and spine, performs surgery at Jackson-Madison County General Hospital. |
That depends, says Dr. John Neblett, a neurosurgeon who specializes in spine, neck and brain surgery. “Most back and neck pain will get better with conservative measures and a little bit of time.” Board certified in neurosurgery, Dr. Neblett does surgery to treat back and neck pain in the most severe cases.
Most people, however, won’t need surgery, he says. Back and neck pain are the most common reasons people seek medical attention and for most of them, the pain is caused by wear and tear on joints, muscles, and ligaments and the narrowing of spinal disks as people get older. People also abuse their backs by lifting heavy objects improperly, poor sitting habits, poor back support, too many sedentary habits, and not stretching or exercising the back.
“A lot of back pain can be prevented if people pay attention to their backs, stretch daily, and exercise,” Dr. Neblett says. “Walking is excellent for toning up the back and abdomen and preventing injuries.”
People with back pain should try limiting their activity and avoiding what caused the pain in the first place, Dr. Neblett says.
If the pain persists, they should see their primary care physician, who can prescribe medicines and schedule the appropriate tests to determine the cause of the pain, says Dr. Neblett. Most of the time, the test will be an MRI. Physical therapy, massage therapy and chiropractic manipulation also help with neck and back pain, he says.
However, certain types of neck and back pain indicate evidence of spinal cord or nerve root compression and warrant a visit to your physician as soon as possible, Dr. Neblett says. Symptoms that suggest a more serious problem and need more immediate action, he says, include…
• Neck pain that includes pain shooting down the arm or into the fingers. • Weakness or numbness in the hand or fingers.
• Lower back pain with pain shooting down the legs.
• Dragging your foot or unsteadiness when walking.
• Difficulty urinating.
• Pain that prevents everyday activities.
An MRI will help determine if that pain is being caused by a herniated disk, spinal stenosis (a narrowing of the spinal cord), compression fractures, or other more serious conditions. Surgery then becomes a option for treatment.
The three main indications, Dr. Neblett says, for the need for surgery are…
• Intractable pain: You cannot lie, sit or stand because of throbbing pain.
• Motor weakness: For example, you have lost the ability to lift up your arm or you are stumbling because you cannot pick up your foot.
• Loss of sphincter control because of nerve disruption.
“The principal behind surgery is decompression – people are hurting because they have pressure on a nerve or disc,” Dr. Neblett says. For a large percentage of people with severe back or neck pain, he says, surgery will improve the problem.
“And, for a much larger percentage of people, that back and neck pain will go away with conservative treatment and they won’t need surgery at all.”