When Should You Consider Surgery for Back Pain?

Back pain is one of the most common reasons people seek healthcare—whether from a chiropractor, physiotherapist, GP, or specialist. Thankfully, the vast majority of back pain cases can be successfully managed with conservative care such as manual therapy, exercise rehabilitation, and lifestyle changes. But when is it time to consider surgery?

At Epoch Health, we believe in empowering our patients with knowledge, so here’s a guide to help you understand when surgery might be necessary—and when it’s not.

Red Flags: When You Need Urgent Medical Attention

If you're experiencing any of the following symptoms, it's important to seek immediate care, as these may indicate a serious condition requiring urgent surgical assessment:

• Loss of bowel or bladder control

• Progressive leg weakness or numbness

• Severe, unrelenting pain at rest or at night

• Sudden onset of difficulty walking or standing

• Signs of spinal cord compression (e.g. cauda equina syndrome)

When Surgery May Be Considered

Surgery isn’t the first option—but it can be the right one in certain circumstances. Here are common criteria for when surgery might be appropriate:

1. You’ve Tried Conservative Treatment Without Relief

If you’ve completed at least 6–12 weeks of appropriate care (chiropractic, physiotherapy, massage, medication, or injections) and your pain hasn’t improved, it may be time to explore surgical options.

2. There’s a Clear Structural Cause

Imaging (MRI or CT) may reveal conditions that correlate with your symptoms, such as:

• A herniated disc compressing a nerve

• Spinal stenosis causing leg pain or numbness

• Spondylolisthesis (vertebra slipping out of place)

• Severe disc degeneration with disabling back pain

3. Neurological Symptoms Are Getting Worse

If you’re noticing increasing numbness, tingling, or muscle weakness—especially in the legs—it may indicate ongoing nerve damage that surgery could help prevent.

4. Pain Is Limiting Your Life

If your pain is so severe that it affects your ability to walk, work, sleep, or enjoy daily activities, surgery may offer a pathway back to function and comfort.

When Surgery May Not Be Necessary

In many cases, back pain can improve with the right approach—without surgery. Surgery might not be suitable if:

• Your pain is mainly muscular or postural

• Imaging findings don’t clearly explain your symptoms

• You haven’t explored rehab and holistic care options

Our Approach at Epoch Health

Our chiropractors and allied health professionals are trained to assess the root cause of your back pain, provide evidence-based care, and refer you to specialists when necessary. We work collaboratively with GPs, orthopaedic surgeons, and pain specialists to ensure you receive the most appropriate pathway for recovery.

Next Steps

If you're unsure whether surgery is the right path for your back pain, book a consult at Epoch Health. We'll help guide you through a personalised plan—whether that's hands-on treatment, rehabilitation, or a referral to a trusted specialist.

You don’t have to face back pain alone—let us help you move better, feel better, and live better.