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How Can Physical Therapy Help You Avoid Back Surgery

How Can Physical Therapy Help You Avoid Back Surgery?

by Tony Matoska PT, DPT, CMPTLeave a Comment

If you’re one of the many people who’ve been dealing with chronic back pain, you may think surgery is your only option to get better. Research shows that over half of adults will experience chronic lower back pain at some point in their lives. Recent data has shown that the rate of lumbar spinal fusions has increased 170%. Unfortunately, the data also suggests that the re-occurrence or worsening of pain 12 months after a back procedure can range from 30-40%. One study indicates that up to 80,000 patients per year have continued to experience back pain after surgery. Many factors can affect the success of these procedures, including accuracy of the diagnosis, socioeconomic status, psychological factors, smoking habits, and anatomical changes that can occur to the surrounding structures and tissues.

What Causes Back Pain?

Fortunately, research has found that degenerative changes in the spine such as disc herniation and stenosis are widespread in the general population and are often not causes for the patient’s lower back pain.3 In one study, researchers did MRIs for people over 60 years old on their lumbar spine and found that 59% have “abnormal findings,” but less than 20% of those participants had back pain.1 This suggests that there may be over-reliance on medical imaging to diagnose patients, which may be leading to misdiagnosis of the patient’s pain. Guidelines in the research suggest that MRIs should only be performed if medical red flags exist and after conservative care has not provided significant relief.3 The research tells us that back pain can be caused by many things that an MRI may not show. It is recommended to start with conservative treatment first, such as working with a physical therapist to help address your pain and physical limitations.

Conservative Care for Back Pain

It is very accurate that back pain can improve without surgery, but you’re likely asking what your options are instead of surgery. Research strongly suggests that conservative care for non-specific chronic lower back pain and spinal stenosis is as effective as surgical procedures and has fewer complications and financial costs.3,4 Conservative care includes non-steroidal anti-inflammatory medication, injections, lifestyle modifications, minimally invasive procedures, and physical therapy.

Start Here, At Athletico

Treatment for your lower back pain by a physical therapist with Athletico will include a comprehensive evaluation to help determine the contributing factors to your injury and pain. Your assessment will also include education on the anatomy, physiology, and expected outcomes of treatment, hands-on treatment to assist with pain relief and improving mobility, and, if needed, a home exercise program to help you improve at home with your activities of daily living. Many of our providers are certified in manual therapy and are active members of our spine specialty program. If you have questions or want to know more, find an Athletico clinic near you and request a free assessment.

Request a Free Assessment

The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

1. Zhou, Y. and Irwin, S. 2009. Back Pain: How to Avoid Surgery? British Journal of Medical Practitioners, 2 (1): 4-5.
2. Baber, Z., & Erdek, M. (2016). Failed back surgery syndrome: Current perspectives. Journal of Pain Research, Volume 9, 979–987.
3. Peul W C, Bredenoord A L, Jacobs W C H. Avoid surgery as first-line treatment for non-specific low back pain BMJ 2014; 349 :g4214 doi:10.1136/BMJ.g4214
4. Anthony Delitto, Sara R. Piva, Charity G. Moore, et al. Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis: A Randomized Trial. Ann Intern Med.2015;162:465-473. [Epub ahead of print 7 April 2015]. doi:10.7326/M14-1420

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