The vast majority of back pain resolves without surgery. In fact, responsible surgeons try to avoid operating whenever possible.

But sometimes, surgery is the only way to prevent permanent damage or restore life.

Here is how we decide when it's time to operate.

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The Absolute Emergencies (Surgery TODAY)

There is one condition called Cauda Equina Syndrome that requires immediate surgery. Signs:

• Loss of control over bladder or bowel (incontinence).
• Numbness in the groin/saddle area.
• Severe weakness in both legs.

If you have these, go to the ER. Waiting causes permanent paralysis.

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The "Urgent" Needs (Surgery SOON)

1. Foot Drop: If you cannot lift your toes or ankle, the nerve is dying. Decompressing it quickly increases the chance of recovery.
2. Progressive Weakness: If your arm or leg is getting weaker by the week despite treatment.

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The "Quality of Life" Choice (Elective Surgery)

This is the most common category. Surgery is an option if:

1. You've tried everything else: Physio, meds, and injections for at least 3-6 months with no relief.
2. Pain rules your life: You can't work, sleep, or walk.
3. Structural Instability: Your vertebrae are slipping (spondylolisthesis) and need stabilization.

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When Surgery is NOT the Answer

Surgery is usually not recommended for non-specific muscular back pain without nerve compression.

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Takeaway

Surgery is a tool, not a cure-all.

If you have nerve danger, do it quickly. If it's just pain, take your time and weigh the options.

Not sure? 👉 Get a Second Opinion from Dr. Abhijit Kale.