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Surgery may be an option to treat cases of chronic back pain when:
there is an identifiable cause, such as a ruptured hernia,
the symptoms have not responded to other forms of treatment, and
the symptoms are getting progressively worse.
The type of surgery that will be recommended will depend on the cause of your back pain. Some surgical options are listed below.
Discectomy - where the part of the herniated disc that is pressing on your nerve is removed.
Fusion surgery - if a vertebra has slipped out of place, it may be possible to fuse it into place using metal rods.
Injections - a variety of injections are available that a surgeon can make into your back in order to help relieve the pain.
As with all surgical procedures, spinal surgery carries some risks. For example, following surgery, there is a 10% chance of infection. If this occurs, further surgery may be required to clean out the infection, although some cases can be treated with antibiotics.
In the case of fusion surgery, there is a 1-2% chance of the vertebrae failing to fuse into place. If this occurs, further surgery will be required.
There is a very low risk that your spinal cord will be damaged during surgery. The chances of this happening are estimated to be six in 1,000 (0.6%). In the rare situation that the spinal cord is damaged during surgery, it could result in problems ranging from some muscle weakness to total paralysis. Your bladder and bowel control may also be affected.
Before having back surgery, your surgeon will be able to fully discuss the risks and benefits of the procedure with you.
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Complementary therapies
Some people with back pain choose to use complementary therapies alongside more conventional treatments, while others choose to use them as stand-alone treatments
Complementary therapies such as chiropractic, osteopathy, shiatsu and acupuncture may help to ease your back pain, and encourage you to feel relaxed.
An osteopath is a health professional who specialises in treating the skeleton and muscles, and chiropractor treats joint, muscle and bone problems, focusing on the spine.
Shiatsu is a traditional Japanese technique that is often described as 'finger pressure' therapy. It is a form of massage that works by applying pressure to energy lines in your body. A shiatsu therapist will use their fingers, thumbs and elbows to carry out the treatment.
Acupuncture is a form of traditional Chinese medicine which involves the insertion of very fine needles at key points in the body. This can help encourage the body to release its natural form of painkillers, known as endorphins. It can also help to stimulate nerve and muscle tissue.
For many complementary therapies, clinical studies have not produced conclusive evidence as to their safety and effectiveness. Therefore, if you are considering using a complementary therapy, you should carefully weigh up any benefits and potential risks and discuss it with your GP if you are uncertain.
The transcutaneous electrical nerve stimulation (TENS) machine is an increasingly popular treatment method for people with long-term back pain. The machine delivers small electric pulses to your body through electrodes that are placed on your skin.
It is thought that these pulses work in two ways. A low electric pulse can encourage your body to produce more endorphins - the body's own painkilling chemical. A high electric pulse can also block pain signals going from your back to your brain.
Many medical studies have been carried out on the use of TENS but the results have been conflicting. Some studies suggest that the machines are of little use, while other studies suggest that they may be able to help certain people.
You should only use a TENS machine under the direction of your GP or other healthcare professional.
The following people should avoid using a TENS machine:
pregnant women - unless specifically advised to by their doctor,
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