Surgical or non-surgical – which back pain treatment is best for me?

Living with a bad back or neck can be painful and discouraging. The range of pain can be minor to debilitating and in severe cases, can lead to loss of movement and even disability. The physicians at Nebraska Medicine provide comprehensive care for the treatment of acute and chronic conditions of the spine – all coordinated in one central location.

The goal of all treatment is to achieve the most relief possible for a patient’s given problem. Our aim is to help you navigate all of your treatment options and educate you about the potential risks and benefits of each approach. Ultimately, it is your choice whether a proposed option is right for you.

Non-surgical approach

Not all patients with back or neck pain need surgery, and not all problems can be fixed by it. Typically, non-surgical, conservative treatments are tried first. Whenever possible, we do our best to make patients well without surgery. The answers to the following questions all play a significant role in the determination of whether or not you may need surgery: 

• What is your overall health?
• What are the results of your physical exam?
• What is the problem?
• How severe is the problem?
• What other treatments have been attempted?
• Will surgery actually fix your problem?
• What are the results of any imaging tests?

Non-surgical options can include physical therapy or rehabilitation, which is a common first line treatment. Chiropractic treatments can be tried for many routine spine problems. Bracing or avoidance of certain activities may be needed. Medications such as anti-inflammatory medications or steroids may be tried. Referral to a pain management specialist may be recommended. Pain management may include therapies such as epidural steroid injections, trigger point injections, facet injections or nerve blocks. More specific problems may benefit from these interventional treatments, often including a numbing medication and a steroid. Interventional treatments can be particularly beneficial for nerve pain, such as pain from a disc herniation or spinal stenosis.

Surgical approach

Surgery is generally reserved for conditions that won’t respond to non-surgical options, conditions that may be damaging or worsen without surgery (neurological deficit or significant instability), and cases where other treatment attempts have failed. Surgery may be offered if it is felt to be the best option for your individual case.  

We use the least invasive treatments in order to restore maximum function. There are usually multiple surgical options available for a particular problem. Surgical options may include outpatient procedures, such as a microdiscectomy for a disc herniation. Laminectomies or decompressions can be done for spinal stenosis. Fusions may need to be performed for deformity or instability. 
 

Our team approach to care

At Nebraska Medicine, we have a Comprehensive Spine Program and team of specialists to call upon as needed. Our highly trained team strives to deliver excellent care centered on your needs. We partner with all or some of these specialists on a case by case basis:

• Spine surgeons 
• Rehab physicians 
• Pain specialists 
• Radiologists 
• Neurologists 
• Endocrinologists/bone density specialists 
• Infectious diseases specialists 
• Oncologists and radiation oncology physicians 
• Physical/occupational therapists 
• Orthoptists 
• Vascular and thoracic surgeons

If you are suffering from back or neck pain, don’t wait any longer. We can help make evaluation and treatment as stress-free and convenient for you as possible.