Is Back Surgery Necessary?
Causes of Back Pain
The second most common complaint your family doctor hears is about low back pain, and it is not always easy to diagnose the cause. The pain might be dull, sharp, burning or an ache.
Back pain will usually resolve within three months with conservative treatments. These treatments include: anti-inflammatory medications, physical therapy and ice or heat.
I have had two back surgeries due to osteoporosis from long term prednisone use that treated systemic lupus. I actually need a third surgery, but I do not want to go through another long surgery that takes a long time to fully recover. That is certainly not the case for everyone, as some people do quite well after surgery.
Back problems may occur for a multitude of reasons, such as: a sprain, fracture or an accident. Diseases causing back pain includes fibromyalgia, spinal stenosis, various auto-immune diseases or arthritis.
Osteoarthritis may cause bone spurs, which sometimes causes pain. Hinge joints on the back of the spinal column that narrow the space where nerves are located will cause nerve pain.
Bulging or ruptured (herniated) spinal disks may or may not cause pain, but pain will occur with pressure on a spinal nerve, which also affects its function.
Can Back Problems be Prevented?
There are several lifestyle choices and ways to help prevent back problems, including:
- Regular physical exercise eases muscular tension and reduces inflammation.
- Stay within ten pounds of your ideal weight. Extra weight, especially in your midsection, can shift your center of gravity and cause back pain.
- Stop smoking as it restricts the flow of blood to the spinal discs.
- Sleep in a good position. If you sleep on your side pull your knees up slightly, or if you sleep on your back put a pillow under your knees and one under your back. Sleeping on your stomach is hard on your back, so you might put a pillow under your hips.
- Good posture is important. A straight back chair is ideal or one with low back support. Stand with you head up, stomach pulled in and shoulder straight.
- Lift objects with your knees bent, without bending over and use your leg muscles, while holding the object close to your body. Never twist your body when lifting.
- Avoid high heels as they shift your center of gravity, so a 1” heel is ideal.
- Skinny jeans are a problem as they interfere with sitting, bending or even walking.
- Fat wallets in the back pocket may cause can cause discomfort, especially if you are sitting for an extended period of time.
- A handbag or a briefcase can be a problem, so the perfect design is similar to a messenger bag that has a strap on the opposite shoulder. Lighten your purse, and switch hands occasionally while walking.
- While back supports are readily available, but they do not help prevent back pain.
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When is Back Surgery Appropriate?
There are some back problems where surgery is the only recourse to relieve pain and sometimes movement.
These conditions include:
- Spinal stenosis, which is a narrowing of the spinal column putting pressure on the spinal cord and nerves
- A ruptured (herniated) disk when one or more disks of the spine are damaged
- Vertebral fractures that are caused from an injury to the bones in the spine
- Degenerative disk disease or damage, which occurs more often with aging
- Rare causes include infection, a tumor or cauda equina syndrome (a nerve root problem)
Minimally invasive back surgeries are used more commonly today, however, major back surgeries are still done frequently.
There are several newer techniques used over the past few years, but some major surgeries remain the same. The various surgeries include:
- A discectomy treats a pinched nerve, removes a bone spur or the herniated portion of a disk and treats sciatica, which radiates pain through the limbs.
- A foraminotomy procedure enlarges the tunnel in the back where the nerve root exits the spinal canal, to keep bulging disks or thickened joints from pressing on the nerve.
- A kyphoplasty treats the removal of the bone overlying the spinal canal to relieve a compression fracture. This is an outpatient procedure.
- A nucleoplasty (plasma disk decompression) is a laser surgery using laser surgery that uses radiofrequency energy. This surgery treats a mildly herniated disk.
- A laminectomy enlarges the spinal canal by removing the bone overlying the spinal canal to relieve nerve pressure due to spinal stenosis.
- A spinal fusion connects two or more bones permanently, which adds stability for a spinal fracture.
- An artificial disk is implanted between two vertebrae due to degeneration or an injured disk
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Recovery From Back Surgery
Patients are hospitalized for 1-4 days depending on which type of surgery and a patient's general health. There are typically stitches or staples on the incisions. The pain following back surgery can be significant, but it is treated while in the hospital. If you are on pain medications at home, do not drive.
Rehabilitation after most back surgeries is the best way to regain strength, but it will take at least 4-6 weeks for the back surgery to heal. It can take months following some major surgeries to regain your previous activity level, particularly if you are elderly.
There are some obvious times when you should call your doctor or for more severe problems call 911. Some of those times include:
- The wound is leaking fluid or blood
- Stitches start coming out
- You have a high temperature
- You have increasing pain, weakness and numbness in your back, legs or buttocks
- A severe headache
- Sudden shortness of breath
- You can’t move your legs
Major back surgeries require good rehabilitation, and there are many things you must not do, like try to pick something up off the floor. All did not go smoothly when I had two 8 hour back surgeries only a few months apart, and recovery was difficult. Ultimately, I got my life back, but the recovery was difficult.
I know others who had a smooth recovery after back surgery and recover relatiely quickly. It never hurts to get a second opinion before proceeding wilh any surgery.
Back Pain Question
Have You Ever Experiences Back Pain?
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Pamela Oglesby