Use caution with surgery

This article is the archived version of a report that appeared in May 2009 Consumer Reports Magazine.

Your doctor might suggest you see a surgeon if back pain is unrelenting and no other treatment seems to work. We conducted a separate survey of almost 1,000 consumers who have had back surgery in the past five years.

Those who had back surgery had tried nine to 10 treatments and described themselves as much more impaired by their pain than people with back problems who did not have surgery. Just 60 percent of the back-surgery respondents were completely or very satisfied with the results, compared with 82 percent of respondents who were satisfied after hip- or knee-replacement surgery in our 2006 survey.

But satisfaction depended on the diagnosis and the type of surgery. Those with degenerative disk disease (arthritis of the spine) were far less likely to be highly satisfied with surgery (54 percent) than those with a herniated disk (73 percent) or spinal stenosis (71 percent).

Alfonso Sanchez, 38, a state senatorial aide from Sacramento, Calif., was highly satisfied with his lumbar discectomy. His back pain turned excruciating when he was canvassing door-to-door in the hills of San Francisco last June. After failing to improve with acupuncture, physical therapy, and chiropractic treatments, Sanchez underwent a microdiscectomy last August. Remarkably, as soon as he woke up from the anesthesia, his pain was gone. He is now back to gardening and riding a bike to work.

But not everyone does so well. More than 50 percent of respondents reported at least one problem with recovery, finding it lengthier and more painful than they had expected. Indeed, 16 percent of back-surgery respondents said that their back pain did not improve, and half of those said it became worse after surgery. The most common regret was that more post-surgery rehabilitation was not planned.

If you're told you need surgery, get a second opinion from another practitioner, preferably one who is not a surgeon. If you decide that surgery is the best approach, ask whether the surgeon is board-certified and find out how many operations he or she has done.

For more guidance, see our free diagnostic tool for back pain at www.ConsumerReportsHealth.org. More detailed information is available to subscribers to that site, including consumer ratings and the medical evidence for 23 back remedies.