Q: How long do you try to treat back pain without surgery before you send someone for a surgical evaluation? How much time would you give a patient whose primary symptom is pain, and how much time would you spend on physical therapy and injections before you send somebody maybe for surgery if the pain just doesn’t get better?
A: A lot depends on what treatments someone has already tried, but I like to give patients about four to six weeks of physical therapy and maybe a month or two in total of conservative care before we think about surgery. That means injection therapy, medication — obviously if patients show weakness we might need to send them sooner, almost right away. I try to prioritize medicine and physical therapy before injections, because a lot of times these things get better on their own. But if patients have already tried these things, or they’re in a tremendous amount of pain, we do everything at the same time. So generally I would say medications and physical therapy for about four to six weeks, and maybe a month or two after that with procedures, sometimes even three months, but after that point I would start to get the surgeon involved. And we have the surgeon right here at the Spine Center.
– Dr. Mike Mizrahi, Rehabilitation Medicine Specialist
This question was answered during the episode of Spine Time called “Back Pain: When is surgery the answer, and when isn’t it?” A video of that episode, held on June 10, 2020, is available here on YouTube. To sign up for future episodes of Spine Time, where you can ask questions of our spine specialists, subscribe here.