Back Pain? 7 Questions to Ask Before Surgery

If you have chronic back trouble, choosing surgery can be fraught with tension.

Unlike with no-brainer operations—such as an appendix removal—there is not a 100% certainty that surgery will cure the problem that’s causing your back pain.

If your doctor is recommending a surgical treatment for pain, here are 7 important questions to ask before you go under the knife.

What you need to know:

If your doctor cannot identify the cause of your back pain, then how can you expect him or her to know what kind of operation to perform?

Jeffrey Goldstein, MD, director of Spine Service at the New York University Hospital for Joint Diseases, advises patients to make sure that their doctor has found a well-defined source of pain that shows up on an MRI or some other test.

What you need to know:

Some back problems respond better to surgery than others.

Operations to address herniated disks and spinal stenosis (a narrowing of the spinal canal generally caused by osteoarthritis) are routinely more successful than other kinds of surgeries.

Degenerative disk disease caused by ordinary aging is unlikely to be repaired through surgery.

What you need to know:

A surgeon should say, “The results of surgery are X and the results of conservative treatments are Y,” says Richard Guyer, MD, a past president of the North American Spine Society.

A good doctor should be up front with you about the likelihood that a surgery will help your back pain.

However, Dr. Guyer cautions that not all surgeons will offer this information, so it’s up to you to ask for it.

What you need to know:

Before you decide to go under the knife, make sure you have explored all your options.

Because the spine is a very complicated place to operate, with a lot of potential for things to go wrong, surgery should not be entered into lightly.

Some orthopedists will recommend that patients try everything else first and opt for surgery only when the pain has become unbearable. When Dr. Guyer suffered a ruptured disk he decided not to have surgery and to use exercise and medication instead.

What you need to know:

Because surgery is not a guaranteed cure for back pain, you should be certain it is the right choice for your particular condition.

Orthopedists themselves will tell you that they often take different approaches than their peers. Some rush to surgery sooner, some favor conservative approaches. A doctor should welcome your interest in seeking a second opinion, but some will bristle.

No matter how they answer this question, it’s really more of a courtesy that you are sharing your plans with them. You have the right to make the right choice for you.

What you need to know:

You should choose a surgeon who routinely performs the procedure, so that you have the best chance of success with it.

Like anything in life, in surgery, practice makes perfect.

What you need to know:

How long your recovery is likely to take and what kind of participation is expected of you.

If physical therapy will be critical to your postoperative success, you need to be prepared to commit the time to it so that your surgery is worthwhile.

Talk to your doctor about what you can reasonably expect post-surgery and how much involvement you can reasonably commit to.