Surgical Considerations for Back Pain
Wondering if surgery is an option for your back pain?
The myBackPain assessment identifies whether your presentation has features that warrant surgical assessment — or whether conservative management has the better evidence for your specific situation.
When surgery is clearly indicated
- Cauda equina syndrome — emergency decompression surgery. Not optional — go to A&E immediately.
- Progressive neurological deficit — worsening leg weakness or foot drop despite conservative management
- Significant structural instability — high-grade spondylolisthesis, fracture with instability
- Tumour or infection — requiring surgical decompression or debridement
Common procedures and their evidence
When surgery is less likely to help
- Non-specific back pain without a clear structural cause
- Back pain with significant central sensitisation or psychological factors not yet addressed
- Disc degeneration alone without significant nerve involvement or instability
- Before adequate conservative management has been properly tried
Surgery for the right indication, at the right time, in the right patient produces good results. Surgery as a response to pain that has not responded to conservative management — without a clear structural target — frequently does not improve outcomes and carries real risks. A spinal surgeon who recommends conservative management first is not withholding treatment — they are applying the evidence correctly.
Find out which treatment is most appropriate for your specific back pain
The myBackPain assessment identifies the most likely cause of your pain — and guides you toward the treatment approaches with the best evidence for your specific presentation.