This guide explains when surgery is really needed and what to try first. It also explains how to get a second opinion from Dr Imran Salim Malik in Lahore. He explains the options, risks and costs, including not operating.
WhatsApp your MRI report, if you have one, to +92 300 4890692 to book a consultation. Clinic, Monday–Saturday: Omar Hospital & Cardiac Centre, Johar Town, 7–9 PM. Urdu or English, whichever you prefer.
What causes back pain?
Back pain can come from a strain, an injury, wear and tear, poor posture, heavy lifting or sitting too long.
Sometimes a damaged disc or a narrow spinal canal presses on a nerve. This can cause pain, numbness or weakness in the legs.
Try these first
Doctors usually start with non-surgical care. It helps many people avoid surgery, and it has fewer risks than an operation.
| Treatment | How it helps |
|---|---|
| Physiotherapy | Exercises that strengthen the muscles around your spine and help you move better. |
| Medicines | Anti-inflammatory painkillers and muscle relaxants can ease pain and swelling. |
| Steroid injections | An injection near the pinched nerve (epidural) can calm swelling and ease leg pain. The relief may be temporary. |
| Lifestyle changes | Losing extra weight, keeping good posture and avoiding strain on your back all help. |
If the pain still does not go away, surgery may be the next step.
When is spine surgery needed?
Most people do not need surgery. But some do.
Surgery may help when an MRI shows something pressing on a nerve. This could be a slipped (herniated) disc or a narrowed spinal canal (spinal stenosis).
If it is not an emergency, surgery may help when pain, numbness or weakness has not improved after months of treatment. Emergencies are different: see the box below.
A spine surgeon examines you and checks your scans, then advises whether surgery is right for you.
Go to an emergency department now if you have back or leg pain with: loss of bladder or bowel control, new difficulty passing urine, numbness around the private parts, inner thighs or buttocks, or new or quickly worsening weakness in the legs. Do not wait for a clinic appointment.
Severe back or neck pain after a fall or accident: keep the person still, do not move them, and call Rescue 1122. Do the same if they have numbness or weakness after the fall.
See a doctor within days, not weeks, if back pain comes with fever, weight loss you can't explain, pain that is worse at night, or a past history of cancer or TB.
Common types of spine surgery
Your surgeon will choose the one that fits your problem:
- Discectomy: removes the part of a disc that presses on a nerve.
- Laminectomy: removes a small part of spine bone to make room for the nerves.
- Spinal fusion: joins two or more spine bones so that painful movement stops.
- Disc replacement: the damaged disc is taken out and an artificial disc is put in.
Recovery depends on the operation. Removing part of a slipped disc is a smaller operation, and recovery is usually quicker. Fusion takes longer, often several months.
After disc surgery, as a guide:
- Walking: usually very soon after the operation, with help at first.
- Hospital stay: Dr Malik will tell you how long you are likely to stay.
Dr Malik will give you a plan for your own case.
Stop smoking and all tobacco, including naswar and chewing tobacco. It slows bone and wound healing.
Warning signs after spine surgery
Go to the nearest emergency department now, or call Rescue 1122, if you have:
- new or worsening leg weakness, numbness around the private parts or buttocks, new difficulty passing urine, or loss of bladder or bowel control
- chest pain, sudden breathlessness or coughing up blood
Call or WhatsApp +92 300 4890692 the same day if you have:
- a wound that is red, hot, swollen or leaking, or a fever
- pain or swelling in the calf
- clear fluid leaking from the wound, or a bad headache that is worse when sitting up
If you cannot reach the clinic, go to the nearest emergency department.
Can it be done through small cuts?
Some operations are done through small cuts (minimally invasive surgery). For the right patient, this can mean:
- Often less pain after surgery
- Smaller cuts and a smaller wound
- Usually a shorter hospital stay
- Often, getting back to daily life sooner
It is not right for every back problem. Some problems still need open surgery. Dr Malik will choose the method that suits you.
Can spine surgery cause paralysis?
This is the question we hear most. Serious nerve injury is rare. But every operation has some risk. These include infection, bleeding, nerve injury, blood clots, pain that does not fully go away, or the need for a further operation.
Dr Malik will explain the risks for your own case, and what to expect if you wait, before you decide.
How much does it cost?
The consultation fee depends on the hospital you visit. We tell you the exact fee on WhatsApp before you book, so there are no surprises. A follow-up visit within 5 days of your first consultation is free to go through your reports and scans.
The cost of surgery depends on the operation, any screws or rods, the room and the nights in hospital. It is explained to you before you decide.
Who is Dr Imran Salim Malik?
Dr Malik is an orthopedic and trauma surgeon with more than 20 years of experience in orthopedic surgery. He is a consultant at Omar Hospital & Cardiac Centre in Lahore, with a special interest in spine surgery.
He treats slipped discs, spinal fractures, spondylolisthesis (a spine bone slipping forward) and long-term back pain. He talks to each patient and explains the plan. If you need an operation, Dr Malik performs it himself.
For most problems that are not emergencies, he recommends surgery only after other treatment has been tried.
Do you need surgery? Ask yourself
Spine surgery is a big step. Ask yourself:
- Have I tried non-surgical treatments already?
- Is the pain stopping me from walking or working?
- Do I feel numbness or weakness in my legs?
- Has my MRI or X-ray shown a disc or nerve problem?
If you answer yes to most of these, it is time to talk to a spine surgeon about your options.
Not sure if you need surgery? WhatsApp your MRI report and a line about your pain to +92 300 4890692 to book a consultation. Dr Malik will need to examine you before advising on surgery.
How to choose a spine surgeon in Lahore
Here is what you can check:
- Registration with the PMDC and a qualification in orthopedic surgery or neurosurgery. You can check this on the PMDC website.
- Has done both open and smaller-cut (minimally invasive) operations
- Gives clear and honest answers
- Works at a hospital with proper scans, an operating theatre and after-surgery care
- Explains the other options, the risks and the cost before you decide
Already been told you need spine surgery? A second opinion is your right. Bring your reports to your consultation, and Dr Malik will go through your options with you, including non-surgical ones. You can WhatsApp your MRI report when you book.
The bottom line
Most back pain gets better with staying gently active, physiotherapy and simple treatment. Avoid long bed rest. Some people need surgery. A good surgeon explains your choices and lets you decide.
If back pain has not settled with treatment, or you also have leg pain, numbness or weakness, book an assessment with Dr Malik. If leg weakness is new or getting worse fast, do not book: go to emergency now (see the box above).
From the clinics of Dr Imran Salim Malik, orthopaedic and trauma surgeon. MBBS (Allama Iqbal Medical College) · MS (Trauma & Orthopaedics) · PMDC Reg. 39646-P. Every patient is different: Dr Malik will tell you what applies to you.
