Man suffering from lower back pain
Orthopedics & Spine

How to decide whether back surgery is the right route for you


August 16, 2020

You may have considered back surgery to manage your pain. Here’s what you need to know.


Most people experience back pain at some point in their lives. Often the discomfort is temporary, but for about 20 percent of adults who have an aching back, the condition will become chronic, according to the National Institute of Neurological Disorders. Back pain can range from a mild annoyance to a severe issue that impedes mobility or affects daily life. If you’re someone experiencing chronic back pain, you may have wondered if spinal surgery is a potential solution.

We asked Aaron Yang, M.D., of Vanderbilt’s Spine Center, to outline some of the factors to consider regarding back pain treatment and surgical intervention.


Talk to your doctor.

Don’t be afraid to discuss the option of back surgery with your physician, Yang said. Yang is a nonsurgical specialist, but he works closely with surgeons at Vanderbilt. Talking is the first step in determining if a patient should undergo a procedure, and whether surgery might resolve the issue. “That doesn’t mean a surgeon is going to operate on you right away,” Yang explained.

Finding out if surgery and the operating room are a means to treat back pain should be the initial conversation starter.  “Sometimes patients don’t have something that a surgeon can actually target,” Yang said. Plus, even if back surgery is an option, a surgeon must factor in a patient’s other health conditions and the outcomes the patient expects following a potential procedure, he added.


Assess your expectations of surgery.

It’s important to have realistic expectations if your condition expects surgery and whether you want to take that approach. Yang recommends considering your functional goals rather than focusing on just the aspect of pain relief.

Maybe you’ve had difficulty doing certain activities you were able to do in the recent past, like gardening or completing work tasks. Consider your current limitations regarding daily living and determine realistic goals to increase functionality. Reduction in back pain is important, Yang added, but a patient’s objective with surgery shouldn’t be to become pain-free or to partake in extreme physical activity.


Avoid comparisons.

Keep in mind that each surgery and outcome will vary. “As with any medical treatment, people are going to ask other people about what their experiences are,” Yang said. “I tell every patient that every person is different — especially for treatments involving the back.”


Take your time with a decision.

Yang says there’s not necessarily a rush to jump into back surgery, even if it’s an option. “I try to encourage patients to think of it in the greater context,” Yang said. “Can they live with this, or are they at a point where they feel like they just have to have surgery because it’s impacting them that much?”

Yang includes it’s often OK to take conservative approaches to treat your back pain and attain functional goals before considering surgery. Many people have a fear that if they don’t have surgery, their condition won’t improve or it will worsen. Numbness or weakness may also prompt patients to seek surgery sooner. But if a person has tolerable pain without neurological symptoms, they can — and should — take their time and explore the options.

Adult rising from bed and stretching to prevent back pain

The Vanderbilt Spine Center treats patients from across the Southeast for back pain, sciatica, whiplash and other conditions of the spine, offering a full range of treatments including non-surgical options. If surgery is necessary, the Vanderbilt Spine Center team provides an extraordinary level of experience and expertise for each patient’s needs. For more information, click here or call 615-875-5100.

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Aaron Yang, M.D., is assistant professor of physical medicine and rehabilitation at Vanderbilt University Medical Center and his practice focuses on non-surgical approaches for neck and low back pain. He is currently a co-investigator of a wearable device to prevent back injury and provides clinical expertise and input on how this device translates to patient clinical care.