Is surgery right for back pain?
Surgery is rarely the first step for back pain. Most people recover with time, movement, and personalized rehabilitation. Still, there are situations where surgery may be considered — usually when specific structural problems are confirmed on imaging and symptoms persist despite months of active care.
Doctors may discuss surgery if you have:
- Persistent nerve pain (such as sciatica) that hasn’t improved with comprehensive non-surgical treatment.
- Narrow spinal canal causing leg pain or difficulty walking.
- Progressive weakness, numbness, or loss of bladder or bowel control — these require urgent evaluation.
- Structural issues like fractures(broken bones), tumors, or infections that threaten spinal stability.
For most back pain that isn’t tied to one clear structural problem (sometimes called non-specific back pain), surgery isn’t helpful and can sometimes lead to ongoing pain. Shared decision-making with your doctor or spine specialist is essential, weighing imaging results, symptom patterns, goals, and personal preferences 1 2 3.
Did you know?
- More than 90% of people with back pain recover without surgery, often through active movement and education 2.
- A simple walking and education program reduced the risk of back pain recurrence by nearly 30% and doubled the number of pain-free days compared with usual care 9.
- In a large clinical trial, a digital exercise-based program matched the outcomes of high-intensity in-person therapy — showing that many people can recover fully at home 8.
Common surgical options for back pain
Here are some of the procedures that may be discussed for certain back conditions:
- Discectomy – Removes a small portion of a herniated disc pressing on a nerve root. Used mainly for persistent pain with clear nerve compression by vertebral disc on MRI.
- Laminectomy (decompression surgery) – Removes part of the bone or tissue that’s narrowing the spinal canal, helping relieve pressure on nerves.
- Spinal fusion – Permanently connects two or more vertebrae to stabilize the spine. Usually reserved for cases with structural instability or severe deformity, not for general low-back pain.
- Vertebroplasty or kyphoplasty – Used selectively for certain fragility fractures (broken bones), like in osteoporotic bones.
Each has specific indications and risks. These surgeries aim to reduce nerve pressure or improve spinal stability — not to “fix” routine back pain 1 3 4.
What to expect during recovery
Recovery depends on the type of surgery, your overall health, and your activity level before the procedure. Typical experiences include:
- Early recovery (first few days to weeks): Pain and stiffness around the incision are common. Gentle movement is encouraged to prevent stiffness and blood clots.
- Rehabilitation phase (weeks to months): Physical therapy focuses on restoring strength, flexibility, and posture. Most patients can iniciate light walking at the day of the surgery. Mobility work usually begins within days after surgery.
- Return to activity: Many people resume normal daily activities in 6–12 weeks after smaller procedures (like microdiscectomy). More complex surgeries like fusion can take several months for full recovery.
Potential risks include infection, bleeding, nerve injury, incomplete symptom relief, or the need for reoperation. Not everyone experiences full pain relief, especially when the pain source isn’t clearly structural 3 5. Preparation, realistic expectations, and early movement are key to better outcomes.
Can surgery be avoided?
In most cases, yes. Active, conservative care — especially exercise-based rehabilitation — helps the majority of people recover without surgery.
- Exercise and education reduce pain and disability and improve confidence in movement 1 2 6.
- Staying active and working with a licensed physical therapist or digital care team can shorten recovery and prevent recurrence.
- Even when imaging shows disc or joint changes, research shows that structured rehabilitation is often just as effective as surgery for many chronic back pain cases 2 7.
In Sword Health’s digital program, participants with chronic low back pain achieved the same functional gains as those in traditional in-person physical therapy — with higher engagement and fewer dropouts 8.
[Physical therapy for back pain]
How Sword can support you before and after surgery
Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers physical therapy programs designed to support you at different points along that journey.
Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.
- Care that adapts as your body and recovery needs change
- Licensed physical therapists guiding your care at every stage
- Non-invasive, evidence-based physical therapy programs
Clinical insight
