Is surgery right for upper back pain?
Most people with upper or mid-back pain recover without needing surgery. In many cases, pain comes from stiff joints, muscle tension, or mild disc irritation that responds well to movement and guided exercise.
Surgery may be considered only when imaging shows a clear structural problem, such as a thoracic disc herniation, spinal cord compression (myelopathy), or an unstable or fracture-related deformity (caused by broken bone), and when conservative care has not improved symptoms. Other reasons might include infection, tumor, or significant nerve injury that affects strength or walking1 2.
Even in these situations, surgery is not an automatic next step. Decisions depend on your symptoms, daily function, imaging findings, and overall health. Shared decision-making with your doctor and a spine specialist is essential to balance potential benefits and risks1 2.
Common surgical options for upper back pain
When surgery is needed, it is usually for a specific cause—not for general “upper back pain.” Common procedures include:
- Thoracic discectomy or decompression: Removes part of a herniated disc or bone pressing on a nerve or the spinal cord. Approaches may be from the front (anterior), side (lateral), or back (posterior), depending on where the disc sits3.
- Spinal fusion: Stabilizes the spine by joining two or more vertebrae after a fracture, tumor removal, or severe joint wear3.
- Vertebral augmentation (kyphoplasty or vertebroplasty): Minimally invasive surgery used to treat painful broken vertebra, often caused by osteoporosis. It involves inflating a balloon inside the bone and then injecting bone cement to stabilize it and relieve pain4.
Each procedure carries its own recovery demands and potential risks. Your surgical team will tailor the plan to your exact diagnosis and health profile3 4.
What to expect during recovery
Recovery after upper back surgery varies widely based on the type of procedure and your health before surgery. In general:
- Early phase (first few weeks): Pain and stiffness are common. You’ll be encouraged to walk and move safely soon after surgery to reduce complications.
- Rehabilitation phase (weeks 4–12): Guided physical therapy focuses on restoring posture, mobility, and gradual strengthening of back and shoulder muscles.
- Long-term phase (3–12 months): Many people regain most of their function, but some experience lingering fatigue or stiffness, especially after fusion.
Potential risks include bleeding, incomplete pain relief, nerve irritation, and in rare cases, recurrent symptoms that may need another procedure. Having a plan for gradual activity and a supportive rehab program improves confidence and recovery5 6.
Did you know?
About two-thirds of herniated discs shrink naturally without surgery as the body reabsorbs the material8. This explains why so many people recover fully with active, non-surgical care.
Can surgery be avoided?
Yes—most people with upper back pain improve without surgery. Exercise-based rehabilitation and education are the strongest evidence-based starting points for recovery. Physical therapy helps restore thoracic mobility, strengthen postural muscles, and ease stiffness that limits breathing or sitting comfort.
Research shows that digital physical therapy can be as effective as in-person care for chronic back pain, with similar improvements in pain and disability and even higher adherence rates. In a 2023 randomized-controlled trial, Sword Health’s digital care program achieved equivalent recovery to conventional physiotherapy for chronic low back pain, while improving satisfaction and reducing dropout rates7.
Starting with guided movement, self-management education, and gradual load progression often prevents the need for injections or surgery altogether7.
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
Did you know?
Thoracic spine surgery is rare—it accounts for less than 1% of all spinal operations3. People who begin active physical therapy early are far less likely to need imaging or surgery later. Sword’s digital programs have shown strong pain relief and functional recovery comparable to in-person care7.
Clinical insight
