Things to consider about back pain treatment
By Mayo Clinic staffBoth a noninvasive, nonsurgical approach and a surgical or other more-invasive approach can be appropriate treatment for chronic low back pain. It's possible that either approach will lead both to reduced or eliminated pain, and — just as important — to a higher level of functioning than you've been experiencing with your back pain. However, a noninvasive, nonsurgical approach is the far more frequent course of action. Which approach is best depends a lot on your specific diagnosis, personal situation, how much pain you're in, how long you've been in pain, your feeling about your pain, and work and lifestyle factors.
Whichever approach you opt for, it's understandable that you want to deal with your pain and move forward. You'll want to discuss fully with your doctor your personal situation, whether noninvasive approaches you may have been following are heading in the right direction, or whether you're a suitable candidate for a more-invasive approach. You'll also want your doctor to carefully explain more-invasive approaches so that you understand exactly what's involved in the procedure and what to expect afterward.
Many treatments and devices available for low back pain are unproved. Ask your doctor about any products that you're unsure of before spending money on them.
Here are some questions to consider as you and your doctor discuss your treatment options:
What's your current level of pain? Is your pain slight or moderate, or are you in severe pain? Are you in pain all of the time, or does your back pain come and go? And even more important than having some level of pain, how has low back pain affected your ability to function at work, at home and in your leisure activities?
Have you given noninvasive, nonsurgical treatments a fair chance? How long have you had low back pain? How much of a recurring problem is it? Have you tried an array of noninvasive treatments, and what kind of effect have these approaches had? Have you given enough time for these noninvasive treatments to work?
Is surgery a good option for you? Do you have some sort of degeneration or instability that surgery can address? Even if you do, is it of such a nature and severity that it's time for surgery? After all, some degeneration in the back is common by middle age — and most people continue to work with conservative approaches to improve their function and reduce their pain.
What's the likely effect on your lifestyle depending on which option you choose? If you avoid a more-aggressive approach, are you able to control your pain so that you can function the way you need to and want to most of the time? If you do take a more-aggressive approach, are you prepared for the weeks of recovery that may be involved and for adjustments in how you sit, stand, walk and move, in the case of spinal fusion?
Is your doctor's experience and training having undue influence on your treatment decision? Make sure you and your doctor decide on the treatment that's right for you, not just the treatment that your doctor is trained in or has the most experience with.
Some additional thoughts
Remember, whichever approach you take, there's a chance that you'll benefit markedly from that approach but also a chance that you'll be dealing with additional low back pain. And the approach you take requires commitment on your part. A noninvasive, nonsurgical approach demands careful attention to strengthening your back and being aware of situations or poor mechanics that may injure your back in the future. A more-invasive approach requires you to make adjustments after your therapy, and you may face additional treatment in the future.
