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Bridging the Gap Between Pain Management and Spine Surgery

The idea of going under the knife is frightening no matter what the condition being treated, but when it’s a question of whether to have spine surgery, things get even scarier. Though spine surgery techniques have come a long way over the years and these operations are performed every day, there is also a lot to be said for caution: surgery always comes with risks, and in some cases there are more benefits to a conservative approach that involves therapy and pain management. Since every situation is different, it’s important that you discuss your options thoroughly with your physician so that you have a good understanding of all of your choices. They should be able to tell you whether one protocol is better than the other, whether it’s worth it to opt for pain management first, and how you can tell when it’s time to move forward with surgery.


The first thing you need to know is what pain management entails. For those who are looking for a quick fix and fast elimination of pain, this approach may not be appropriate, as it does require a time commitment and a lot of patience. Management of chronic back pain usually involves learning about what is likely causing or exacerbating your pain so that you can make lifestyle changes; engaging in physical conditioning and strengthening to get muscles into balance; and peer counseling. Many patients also take medication for their back pain and neck pain.


Studies have shown that there is only marginal difference in the outcomes seen between patients who have chosen pain management over surgery. One study showed that four years after patients were first seen, almost one in four of those who had opted for the conservative approach had ended up having surgery, while the same number of those who had opted for fusion surgery ended up having an additional surgery again. This means that the choice rests more on the individual patient’s concerns and preferences than on outcomes. So what makes a patient with neck or back pain a candidate for pain management versus spine surgery?


From our experience, the patients who are better suited to pain management have the following things in common:


  • They tend to be fearful and have difficulty coping with any type of risk. Not only does surgery frighten them, but it offers them no improvement in this area, where the counseling provided in a pain management program does.
  • They are not confident that surgery will help them or are overly confident about the outcomes of surgery
  • They are either afraid of surgery or too hopeful about the outcomes of surgery
  • They are already addicted to pain medication. This not only impacts their surgical outcome, but makes them more likely to continue to rely on medication afterwards. A pain management counseling program is more likely to help them deal with their dependency.


Helping you decide what protocol is the most appropriate for your situation is what the professionals at Central Texas Spine Institute is all about. Contact us today to schedule an appointment and take your first steps towards relieving your back pain.