Health Update: Health Update: Health Wellness, Back surgery rarely the answer. Here’s what to know – What Experts Say– What Experts Say.
The number of times this week I have heard people talk excitedly about their upcoming back surgery has left me genuinely disheartened. Not because surgery never has a place – but because it highlights just how misunderstood non-surgical healing for back pain still is.
No matter how much education I share, or how much research exists showing that back surgery is not the guaranteed fix people think it is – so many folks still give up far too quickly and default to the knife.
So here I am again… speaking from a place shaped by my clinical (and personal) experiences, actual evidence, and thousands of patient stories… to say this loud and clear: back surgery is rarely the only option, and certainly not the best first one.
Each year in the United States, tens of thousands of adults undergo back surgery in an effort to relieve their pain. But even with the modern surgical techniques we have today – long-term success is far from guaranteed. A 2023 systematic review published in the Journal of Pain Research found that roughly 15 percent of patients continue to experience ongoing or recurring pain after spine surgery – a condition commonly referred to as “failed back surgery syndrome.”
Similar reviews published over the past several years in peer-reviewed spine and pain journals tell a similar story. The rate of persistent pain after surgery can range anywhere from 5 to 30 percent, depending on the type of procedure and the patient population studied.
Let’s not forget about re-operation rates. A 2022 nationwide cohort study published in Scientific Reports examined outcomes following common lumbar spine surgeries and found that approximately 14 to 18 percent of patients required another back surgery within five years. And for those who had already undergone a prior spinal operation, the likelihood of needing yet another surgery was even higher. What this tells us is that once someone enters the surgical pathway, it can become increasingly difficult to step off it.
While these percentages aren’t particularly huge, they are certainly enough to give me pause – especially when you consider the very real risks associated with back surgery. Infection, blood clots, nerve damage, adverse reactions to anesthesia, and incomplete pain relief are not rare complications. Not to mention what I’ve seen in real life and clinical practice that rarely makes the research studies. Once surgery is performed, it cannot be undone, and that is something people don’t think about enough.
For all of these reasons, exploring non-surgical care becomes critically important. And I do not mean trying a little bit of everything without a clear plan. Many people tell me they have already tried physical therapy, chiropractic care, massage, acupuncture, injections, or exercise and that none of it worked. But when we look closer, most have spent years cherry-picking treatments with no real strategy. They are often repeating the same generalized approaches, layering too many things at once, or relying solely on passive care to solve what is an active, mechanical back problem.
For example, passive treatments such as massage, acupuncture, and chiropractic care can be extremely effective at calming pain and reducing inflammation. But pain relief alone does not equal healing. Without pairing these approaches with precise, corrective movement and tissue-specific loading strategies, the relief is usually temporary – and confusing for people.
Modern, regenerative, non-surgical therapies also need more attention. A few years ago, I discovered the power of non-invasive regenerative shockwave and electromagnetic therapies for stimulating blood flow, cellular repair, and tissue regeneration in damaged muscles, tendons, ligaments, and inflamed nerves. These treatments don’t just mask pain.
They work by encouraging the body’s own healing response, improving tissue quality and reducing inflammation so that real recovery can occur. When used strategically and combined with the right movement-based care, they’ve been a game-changer in my office by helping people significantly reduce symptoms, avoid injections and surgery, and do the real work required for long-term healing.
But technology alone is not the answer. Roughly eighty percent of back pain is mechanical in nature. It develops slowly over time due to how we move, sit, train, work, and recover. Even when pain appears suddenly, the underlying issue has usually been building for years. No amount of surgery, injections, or generalized exercise will correct poor movement patterns or faulty spinal mechanics. Until those are addressed, pain has a tendency to return. But sadly, this very real explanation of how back pain really works is simply not “sexy”.
I continue to passionately share this perspective after more than twenty-three years of working with people suffering from back pain and sciatica. For the first decade of my career, I practiced as a generalist in traditional physical therapy settings. I followed physician prescriptions, relied heavily on insurance-driven care models, and used many of the same passive treatments patients often tell me failed them. At the time, I truly believed I was doing everything right.
It was not until I pursued advanced specialty training and learned how to properly assess and classify back pain that everything changed. That shift allowed me to help people not only get out of pain, but keep it gone and avoid surgery altogether. The difference between a specialist and a generalist is profound, and it’s worth doing your research before you say you’ve truly tried “everything”.
If you are dealing with persistent back pain and feel as though surgery is being presented as your only option – please pause. Especially if you have already tried traditional physical therapy and were told nothing more can be done. There are specialists who focus exclusively on these problems and who understand how to combine movement science with modern regenerative healing techniques.
Before you say yes to back surgery – make sure you have truly exhausted every conservative option available. Healing naturally is not only possible, but actually the best and longest lasting option when done correctly and with an expert’s guidance.
Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Back Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a seat in her upcoming Masterclass: Put an End to Back Pain and Sciatica for Good – visit www.cjphysicaltherapy.com or call 603-380-7902.