Surgery for low
back pain

Is surgery right for low back pain?

Surgery for low back pain is not a one-size-fits-all decision. Most people improve with time, movement, and a well-structured rehabilitation plan. Surgery is usually considered only when symptoms continue to limit daily life, especially when nerve pain or weakness down a leg does not improve with conservative care.

Doctors may discuss surgery if you have:

• Severe leg pain from a disc herniation (soft cushion of tissue between the bones in your spine bulges outwards) or nerve compression that does not improve after a period of active treatment.
• Trouble walking or standing because of spinal cord squeeze.
• Progressive weakness or other neurological changes(numbness, tingling).
• Rare emergencies like new bladder or bowel problems or numbness in the groin, buttocks and genitalia, which require immediate attention.

Even in these situations, surgery is a shared decision. Your doctor will look at your symptoms, your goals, and how your back pain affects your daily life. Many people choose to keep working with physical therapy and education first because these approaches often reduce pain and restore function without surgery^{1 2}.

Common surgical options for low back pain

Below are surgeries you might hear about when speaking with your doctor. These are not recommendations, just explanations to help you understand the terms.

• Lumbar Discectomy

Removes part of a disc that is pressing on a nerve. It can be open discectomy, microdiscectomy (minimally invasive surgery with microscope help) or endoscopic discectomy (minimally invasive surgery which use an arthroscope) Often discussed when leg pain from a disc herniation continues to be severe or limiting [3].

• Lumbar Decompression (Laminectomy)

Removes bone or tissue that narrows the spinal canal and irritates nerves. Typically considered when spinal compression makes walking or standing difficult [4].

• Spinal Fusion

Connects two or more vertebrae to stabilize spine. Used mostly for structural instability or certain deformities. Not generally recommended for non-specific low back pain without clear mechanical instability [5].

• Vertebroplasty or kyphoplasty

Used selectively for certain fragility fractures (broken bones), like in osteoporotic bone (weak and porous bone)

What to expect during recovery

Recovery after spine surgery varies based on the procedure, your health, and how active you were before surgery. Most people benefit from a mix of gentle movement early on and a guided rehabilitation plan as healing progresses.

You can expect:

• Soreness and fatigue for the first days to weeks.
• Limits on lifting and twisting while tissues heal.
• A gradual return to walking and daily activities, often within days for decompression or on the same day for discectomy procedures.
• Physical therapy to rebuild strength and support the spine.

Many people experience meaningful improvement, especially in leg-dominant nerve pain after discectomy or decompression. But recovery is not always linear, and some people continue to have symptoms. A small number may need additional procedures or may not get full relief^{3 4 5}. Risks such as infection, blood clots or bleeding, nerve injury, or persistent pain can occur, although they are not common.

Planning ahead, understanding your limits, and keeping up with rehabilitation can ease the process and help you return to the activities you enjoy.

Can surgery be avoided?

Yes, in many cases. Most people with low back pain recover without surgery when they follow a structured plan that includes education, movement, and progressive exercise.

Physical therapy and exercise-based care help reduce pain, improve mobility, and support long-term resilience. Research shows that many people with disc-related leg pain also improve without surgery over time, and symptoms from spinal compression can often be managed with targeted rehabilitation^{1 2}.

Sword’s digital programs are designed to support consistent movement and adherence, which are key parts of avoiding surgery. In a randomized trial, people using Sword’s digital care program had greater improvements in pain and function than those doing conventional therapy for chronic low back pain⁶.

For many people, trying high-quality conservative care before considering surgery is a helpful way to make an informed decision based on how they respond.

Explore Physical Therapy for Low 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

Support for preparation, recovery, and long-term movement health

Clinical insight

Large clinical trials show that surgery for disc herniation often leads to faster leg-pain relief, but long-term outcomes after one to two years are usually similar to those who continued with non-operative care. This is why shared decision-making is essential, especially when symptoms are improving over time³.