Is Spine Surgery the Answer to your Back Pain?

Corey Wallach, MD, is a fellowship-trained spine surgeon, board-certified in orthopaedic surgery. He serves as the medical director of the Inova Spine Program at Inova Alexandria Hospital and Inova Mount Vernon Hospital.

Back pain is an interesting beast. It’s incredibly common: As many as 90% of people will experience back pain in their lifetimes, and it’s the number one reason people go to the doctor. Yet as common as it is, there are a lot of misconceptions about back pain and spine surgery.

What should you believe? Here are some of the common myths I’ve heard from patients — along with the facts.

Myth: Spine surgery doesn’t relieve back pain.

Fact: Spine surgery can be really effective — but only when you have a problem that surgery is good at fixing. That sounds obvious, but it’s an important point. Some conditions, such as spinal stenosis, often benefit from surgery. More commonly, though, back problems are better treated with conservative measures such as time, medications and physical therapy.

Myth: An X-ray is the best way to diagnose back pain.

Fact: Imaging tools like X-rays and MRIs can be useful, but they aren’t our only tool for diagnosing the cause of back pain.

In fact, it’s common for abnormal spots to show up on X-ray or MRI, especially as we age. Those imaging abnormalities are often harmless — and unrelated to the pain you’re feeling. It’s a mistake to assume that if we see something funny on an X-ray, it must be the source of your pain.

That’s why it’s so important to see a spine specialist who can determine where the pain is actually coming from.

Myth: Spine surgeons will always recommend surgery. (They’re surgeons, after all!)

Fact: Experienced spine surgeons recognize that surgery isn’t always the best answer. In fact, most people with back pain don’t need surgery. In the Inova Spine Program, we always explore nonsurgical options before recommending surgery.

For people who have signs of neurological impairment —disabling pain, progressive weakness, loss of sensation or loss of fine motor skills — we often recommend surgery sooner rather than later to prevent the problem from getting worse. But if you have a condition that will get better without surgery, that’s what we’ll recommend.

Myth: Back surgery is complicated and recovery is often painful.

Fact: All surgery comes with some risks. But surgical advancements have definitely changed back surgery for the better. We use a number of minimally invasive procedures, which allow us to repair spine problems more precisely, with smaller incisions and often a shorter recovery time.

Many of my surgical patients go home the day of surgery and are able to return to work and regular activities within two or three weeks. Recently, one of my patients sent me a photo of himself on the hockey rink, scoring a goal — just two months after a lumbar fusion surgery. Another patient completed a 100-mile bike ride a mere three months after I operated on him. Our goal with surgery is to help you feel better, move better and return to the hobbies and activities you love. We want you to reach that point as soon as possible.

Myth: Neurosurgeons are best for spine surgery…Or are orthopaedic surgeons better?

Fact: The fields of neurosurgery and orthopaedic surgery overlap a lot. If you’re having surgery for back pain or nerve dysfunction, one type of surgeon isn’t necessarily better than another. What is important is that you see a surgeon who has completed a spine surgery fellowship, which provides specific training in treating the spine.

Experiencing back pain? The Inova Spine Program can help. Our interdisciplinary specialists are experts in diagnosing and treating back pain, with surgical and nonsurgical options. There is no one-size-fits-all plan to relieve back or neck pain, so we work with each patient to create a customized treatment plan. Read more about the Inova Spine Program or call 703-776-4700 to find out how we can help.