Physical Therapy vs. Surgery for Back Pain: Which Is Best for Eliminating Pain?

You’ve been suffering from back pain for far too long.

It’s time to find a solution.

You’re curious about the difference between physical therapy vs. surgery for back pain, but have questions and no idea where to begin.

If you’re struggling with back pain and wonder which treatment approach is right for you, you have come to the right place.

Here we explain the pros and cons of physical therapy vs. surgery for back pain so that you can make an informed choice.

• Is Physical Therapy Worth it for Back Pain?
• 6 Benefits of Physical Therapy for Back Pain
• 3 Physical Therapy Exercises for Back Pain
• When to Consider Surgery for Back Pain
• What Type of Back Pain Requires Surgery?
• Important Considerations for Back Surgery
• Other Conservative Options to Consider if You’re Not Ready to Commit to Surgery
• Back Surgery vs. Physical Therapy: The Bottom Line
• The Licensed Physical Therapists at PRO~PT Can Help Alleviate Your Back Pain

If you are wondering, “Can physical therapy help back pain?” the answer is a resounding, “Yes!” 

Physical therapy is often recommended for back pain, and it is well worth your time to schedule an appointment with a licensed physical therapist.

And it is best to seek help as soon as possible — especially if the pain is severe.

Your physical therapist will evaluate the way you:

• Move when you walk; and 
• How you get up when you are sitting or lying down

They will then be able to recommend physical therapy exercises that can help to diminish your back pain.

Another of the benefits of physical therapy for back pain is that physical therapists don’t just treat your pain—they look for the root cause of your discomfort. 

By suggesting stretching and exercises that are specifically geared to your bottom-line issue, they can work wonders when it comes to restoring your mobility and range of motion.

Individuals with a degenerative disease or poor posture have an increased likelihood of falling. 

Your physical therapist will create a customized plan to improve your balance and coordination, which greatly reduces your chances of taking a fall.

Physical therapy is not a one-size-fits-all approach to healthcare.

Another one of the benefits of physical therapy for back pain is that your physical therapist has the opportunity to get to know you and your needs. 

Your physical therapist will consider the best approach to your care by evaluating factors such as your…

• Age
• Body type
• Lifestyle
• Level of physical activity
• Overall health
• Range of motion

Some back pain is due to repetitive movements, such as athletic activities or job duties. 

A physical therapist has the training it takes to work with you on exercises and stretches that can help you feel better and avoid the possibility of a future back injury. 

As one of the most proactive methods of resolving back pain, physical therapy may be just what the doctor ordered to eliminate your need for back surgery.

The stretches that result in an increased range of motion can help ease, and in some cases, even eliminate your pain.

Chances are, your physical therapist will recommend exercises to help reduce your back pain. 

Below are a few common physical therapy exercises for back pain.

As with many forms of exercise, these should not be performed unless you are under the care of a licensed physical therapist. 

To do bird dogs, follow these instructions:

Begin on your hands and knees with both of your shoulders hips-width apart. 

Keeping your back straight with your ab muscles tight, lift your right leg. 

Extend your leg straight out behind you and hold for five seconds before returning to the starting position. 

Do 8 to 12 repetitions for each leg.

To do bridges, follow these instructions:

Start on your back with your knees bent and your feet flat on the floor. 

Raise your hips while keeping your back in a straight line with your shoulders and knees.

Maintain this bridge position for six seconds. 

Do 8 to 12 repetitions.

To do press-up back extensions, follow these instructions:

Begin on your stomach with your elbows underneath your shoulders and your hands flat on the ground. 

While pushing down on your hands, lift your shoulders away from the floor. 

Hold for 5 seconds. 

Do 8 to 12 repetitions.

Unless you are experiencing a neurological or medical emergency, it is always best to try a conservative solution, such as physical therapy, before jumping into a surgical procedure.

If you have worked on your back pain with a physical therapist, and have not had success in alleviating your pain, it may be time to consider surgery.

The type of pain that requires surgery will vary from person to person. 

As we mentioned earlier, unless you are experiencing a neurological medical emergency, you never want to have back surgery without first going to a physical therapist. 

1. Microdiscectomy:  Microdiscectomy is probably the most common surgery performed by spine surgeons. During the surgery, the herniated or protruding portion of the intervertebral disc is removed to relieve the compression of the traversing spinal nerve root.
2. Laminectomy: During a laminectomy, part or all of the vertebral bone (lamina) is removed. This helps relieve the pressure on the spinal cord or nerve roots that may have been caused by a herniated disk, injury, spinal stenosis, or tumors. A laminectomy is considered to be a last resort, only after other medical treatments have not produced the desired results.
3. Spinal Fusion: Spinal fusion permanently connects two or more vertebrae in the spine.

Choosing to have back surgery is a decision that should not be taken lightly. 

Back surgery should always be a last resort—only when all other options have been exhausted. 

One of the largest misconceptions regarding back surgery is that patients will become pain-free following the surgery.

Depending on the type of surgery you have, it may not fix everything you expect it to be, so it’s important to have clear expectations for what your life will look like following your surgery.

It’s also important to note that positive findings on an MRI are not always indicative of pain, so they should not be seen as a life sentence for never-ending back pain.

Why is this?

MRIs are not great at identifying the level that the pain is originating from. For example, your MRI may show that you have a herniated disk at L4, but that may not be the source of your pain.

Research has shown that imaging findings of spinal degeneration are present in high percentages of asymptomatic individuals—and that those findings increase with age.  

The fact is that many imaging-based degenerative findings are simply a normal part of aging and are not associated with pain.

Occasionally, there are instances when physical therapy doesn’t work for back pain on its own, and you will want to combine it with other pain relief methods. 

Here are a few options that you can do in conjunction with physical therapy, or on your own.

Injections include procedures such as … 

• Nerve blocks
• Epidural steroid injections
• Nerve ablations

While injections are common for back pain and may eliminate or reduce your pain for a time, they are not intended as long-term solutions.

At PRO~PT, we’ve found that injections and physical therapy combined usually produce a better outcome than injections alone, both in terms of speed of recovery and pain relief.

When used in conjunction with physical therapy, these medications may be helpful when it comes to reducing back pain:

• Anti-inflammatory medications
• Analgesics
• Muscle relaxants
• Other medications

However, since these medications often come with unwanted side effects, they are not recommended for prolonged use.

Some alternative treatments that have proven to be effective at reducing back pain when used with physical therapy include: 

• Acupuncture
• Dry needling
• Electrical nerve stimulation 
• Cupping
• Myofascial release
• Massage therapy

Ultimately, outside of if you’re dealing with a medical emergency, physical therapy should be the first line of defense against back pain.

And even if surgery is eventually needed, physical therapy is a valuable tool both before and after any surgical procedure.

Physical therapy can:

• Help you identify the level of surgery needed, which will improve the success rate of your surgery.
• Help the success of the surgery and recovery by outlining a 6-8 week program of physical therapy. 

PRO~PT has had the pleasure of serving the Central Valley since 2001.

Whether you are trying to avoid surgery—or are recovering from it—our professional physical therapists can provide you with the personalized care you deserve. 

Not only do we treat back pain, but we also specialize in…

• Orthopedic injuries
• Sports-related injuries
• Spine conditions
• Post-surgical care
• Balance and fall prevention
• Other specialties

Our goal is to return our patients to their best quality of life. 

Request an appointment today.