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Back and neck pain
Spinal degenerative disease and related disorders
When is an operation necessary?
The simple answer here is very infrequently, particularly when we consider how many people suffer from spinal pain. On the other hand, some people reading this booklet may have reached the point where they are wondering if an operation could help them. Even then, surgery is rarely essential, but it may be an option to consider. It is only essential in certain rare circumstances.
Multiple nerve compression
Surgery is seldom performed for lower back pain or neck pain alone. It is occasionally needed when a single nerve is trapped (see below). When, however, there is significant compression of several nerves, with resultant disturbance of major functions - particularly control of the bladder, bowels or sexual function - then an operation is essential to prevent long-term disability. Such circumstances arise when the spinal cord is compressed in the neck or the cauda equina is compressed in the lumbar spine.
Persisting acute pain
Most episodes of acute spinal pain, with or without limb pain, resolve naturally. Sometimes, however, pain can persist at quite an intense level, sufficient to prevent the person from carrying out any normal activity. Although there is no immediate threat of serious physical disability, surgery may be performed to decompress the nerve in order to relieve such severe symptoms.
Recurrent pain
Many people suffer recurrent episodes of pain, particularly if they have not had expert physiotherapy tuition, and sometimes in spite of such assistance. In such circumstances surgery is entirely optional but is a reasonable course to consider. A person may decide to have surgery if the pain is sufficiently intense or has been present for too long. In making a decision the individual needs to balance the negative effect of the pain on work, recreation and normal daily activities against the potential drawbacks of surgery. The alternative to surgery is continued conservative treatment and expectant management. Such an approach will eventually lead to a resolution of the problem but usually after several months.
Surgery is seldom performed for lower back pain or neck pain alone. It is occasionally needed when a single nerve is trapped (see below). When, however, there is significant compression of several nerves, with resultant disturbance of major functions - particularly control of the bladder, bowels or sexual function - then an operation is essential to prevent long-term disability. Such circumstances arise when the spinal cord is compressed in the neck or the cauda equina is compressed in the lumbar spine.
Persisting acute pain
Most episodes of acute spinal pain, with or without limb pain, resolve naturally. Sometimes, however, pain can persist at quite an intense level, sufficient to prevent the person from carrying out any normal activity. Although there is no immediate threat of serious physical disability, surgery may be performed to decompress the nerve in order to relieve such severe symptoms.
Recurrent pain
Many people suffer recurrent episodes of pain, particularly if they have not had expert physiotherapy tuition, and sometimes in spite of such assistance. In such circumstances surgery is entirely optional but is a reasonable course to consider. A person may decide to have surgery if the pain is sufficiently intense or has been present for too long. In making a decision the individual needs to balance the negative effect of the pain on work, recreation and normal daily activities against the potential drawbacks of surgery. The alternative to surgery is continued conservative treatment and expectant management. Such an approach will eventually lead to a resolution of the problem but usually after several months.
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Page 11 of 19
Contents
- Introduction
- What causes spinal pain?
- Why do I experience different types of pain?
- What other symptoms can develop?
- How common are spinal problems?
- Could it be something serious?
- What will happen if the pain is not treated?
- What do the various words used by doctors mean?
- What tests can be performed?
- How is spinal pain treated?
- When is an operation necessary?
- What do you recommend, doctor?
- Who should perform my operation?
- What are the drawbacks of surgery?
- What is the recovery period?
- What is surgery fails?
- What advances are likely in the future?
- Conclusions
- Other organisations that may be able to help
