Can Physical Therapy Replace Surgery for Back Pain?

If you’ve ever been told by a doctor that surgery is an option to fix your back pain, you likely got goosebumps. Talk about spine-chilling! Surgery sounds so major and final. Sure, people have done it for years and it can help some people, but most people are scared to even consider it. And they have every right to be. Between crippling pain and life-altering surgery, you feel like you have no good options. Surgery is a last resort but if there was another option it would be more appealing. The best news is that for most people, the most effective solution is already out there. In fact, the solution to the question, how do you relieve back pain without surgery, may be the very best way to get better. Physical therapy.

The Evidence: Physical Therapy Vs Surgery For Back Pain

If you’re in pain and want relief, the obvious question is “what is the best way to fix my back pain?” For years the conventional wisdom and patient thinking was that surgery was the most aggressive, and therefore best, solution. But is that really true? Recent studies show a resounding “no!” For instance, a group of patients with lumbar spinal stenosis were treated with surgery, while a matched cohort were put into a physical therapy program. They followed both groups for 2 years. The results? Not only did the physical therapy group show the same reduction in pain and functional gains, but PT matched up with the surgical group!

The results of similar studies, this time in patients with degenerative disc disease, were almost identical. They found that while surgery may provide better short-term relief, long-term outcomes are no better than PT. Also of concern with surgery are potential complications, such as infection, nerve damage, and a mysterious, but entirely real, condition known as “failed back surgery syndrome” in which the pain returns and often intensifies after surgery. It’s a reminder that the best way to find out how to relieve back pain without surgery may be the most conservative option.

The Best Candidates for a Conservative Approach

The big question now is this. If surgery is not a guaranteed “fix” for back pain, what is? While there are many causes of back pain, there are several that are well-known, well-understood, and respond particularly well to non-surgical treatment. The important thing is to know the difference and to use the right treatment approaches.

• Herniated Discs: A spinal disc is made of a soft, gelatinous center with a tougher outer layer. When the inner part pushes through the outer layer, you have a herniated disc. Symptoms can be severe and may include nerve-related symptoms like sciatica. With guidance and proper care, most people with herniated discs will find the bulge gets smaller or, in some cases, completely disappears over time.
• Sciatica: A painful condition involving nerve pain that radiates from the lower back all the way down the leg. It is most often caused by a herniated disc or spinal stenosis that presses on the sciatic nerve. The good news is physical therapy can help to treat the underlying cause and in many cases resolve the pain.
• Spondylolisthesis: Sometimes a vertebra will actually slip forward over the vertebra below it. This creates an instability in the spine, which is usually the source of the pain. Specific exercises to strengthen the core and stabilize the spine can provide tremendous relief.

These are just some of the problems that can be treated without surgery.

How Do You Relieve Back Pain Without Surgery?

You know you don’t want surgery. But what is the answer? How do you get off the pain meds? We tell every patient the same thing, you want a customized plan, not a “cookie cutter” approach. At Carter Physiotherapy, we combine time-tested strategies to attack your pain at its source.

Our approach to relieving back pain without surgery always begins with a Mechanical Diagnosis. It’s a process where we take you through specific movements and evaluate how your symptoms respond. This information allows us to classify your problem and sometimes identify a “directional preference,” a movement that will centralize your pain. We call this a positive centralization or “window of correction.” It is a clear sign that we can mechanically resolve your problem and is a key element in our clinical reasoning.

Next, we perform Hands-on Manual Therapy. Our clinicians are trained in advanced techniques to move stiff joints, stretch tight muscles, and reduce the pressure on your nerves. This is more than just a massage. It’s a targeted treatment to restore motion and provide immediate relief so you can begin to exercise without limitation or excessive pain.

Our final component is Core Stabilization. We teach you how to properly engage and use your core muscles. The core is a series of deep muscles that surround and support the spine. By properly engaging these muscles you’ll gain functional strength and the stability you need to prevent re-injury in the future.

A Word About Surgery

For the record, it’s important to note that we are not suggesting a no-surgery approach is a miracle cure for back pain. Physical therapy is not going to work for everything, and in some cases surgery is a very necessary, and even life-saving treatment. We strongly believe in a conservative-first approach, but there are a few red flag conditions in which surgery is the only answer:

Surgery is always a last resort. Unfortunately, there are a few conditions that qualify as absolute indications for surgery. That is, no matter what, surgery is the best option. The vast majority of back pain does not fall into this category. But it’s important to recognize the few exceptions.

• Cauda Equina Syndrome: This is a serious condition in which the nerve roots at the end of the spinal cord are compressed. It can lead to loss of bowel or bladder control and is a surgical emergency. Surgery must be done quickly to avoid permanent nerve damage.
• Progressive Neurological Deficit: This means the nerve problem is getting worse. A classic example is if you start to develop weakness in the foot and that weakness leads to a “foot drop.”

If you have any of the above red flag conditions, we can still help you to get back on track as long as you know surgery is the best course of action.

Related Topics:

• 10 Best Physical Therapy Techniques for Back Pain Relief
• Dry Needling for Lower Back Pain Relief
• Manual Therapy for Lower Back Pain
• At-Home Exercises for Back Pain
• Lower Back Pain When Squatting

Final Thoughts

If you’re in pain, surgery is a very real option. But it’s not the only way. In fact, for most people it’s not even the best way. The solution to the problem, how do you relieve back pain without surgery, is often the most conservative one. Physical therapy that targets the source of your problem and teaches you how to prevent it in the future is the only way to fix back pain for good. It’s not a guaranteed fix, but what in life is? The good news is there is a treatment out there that is safe and effective, with no risk of serious complications.

Find out how you can relieve back pain without surgery at Carter Physiotherapy.