Spinal surgery patients frequently present to me after multiple years of managing their chronic back pain through physical therapy, injections, medications, and alternative treatment methods. Patients arrive at my office already worn out physically and emotionally drained from frustration about their chronic condition. What increases my concern is that irreversible damage has already resulted in many cases, which could have been reduced or prevented through earlier surgical treatment.
I recommend starting with conservative care for initial treatment. I always advocate for non-surgical treatments for most back issues before considering surgery options. Eventually, waiting becomes dangerous because time transforms into the adversary. Many patients unknowingly move past the point where surgery could have been more effective.
Many view surgery as a last resort solution, which should only be considered when all other options fail. Patients sometimes wait too long for essential medical care because fear reinforcement, along with outdated beliefs and inconsistent advice, uphold this damaging mindset. By delaying treatment, they might experience worsening symptoms or extended pain while reducing their chances of complete healing.
Lumbar disc herniations, which doctors could treat with basic microdiscectomy procedures, often develop into complex conditions with nerve damage and muscle weakness. Patients with spinal stenosis have missed their chance for quality life restoration because they did not receive timely decompression surgery. After extended periods of waiting, many individuals start to view disability as their expected way of life.
This situation requires primary care physicians to respond, as it extends beyond individual patient problems. I recognize the difficulty health care professionals face in determining when a back pain issue becomes a candidate for surgical intervention instead of continued conservative management. I advocate for earlier specialist referrals to improve patient outcomes. Once conservative treatments fail to show improvement in the patient’s condition after three to six months or the patient experiences worsening symptoms accompanied by neurological signs such as numbness, tingling, or weakness, referral is necessary.
Sending a patient to a spine specialist does not automatically lead to surgical intervention. Referring them to a spine specialist enables them to receive a complete evaluation and access to various treatment options both surgical and non-surgical. The health care system requires a collaborative approach that emphasizes early diagnosis and informed choices while understanding when surgery presents the optimal solution for healing.
Delaying surgery isn’t always harmless. There are situations where delayed surgery leads to poor outcomes. The true expense extends beyond pain and lost mobility, as it represents a loss of opportunity for improvement.
Gbolahan Okubadejo is an orthopedic surgeon.
