Not every ache means you need surgery. Most back pain gets better with simple treatment and by keeping gently active. But some signs mean you should get your spine checked. Here are 10 to know.
Go to an emergency department now if you have back or leg pain with:
- loss of bladder or bowel control
- new trouble passing urine, or not being able to pass urine
- numbness around the private parts, inner thighs or buttocks
- new or quickly worsening weakness in the legs
Severe back or neck pain after a fall or accident: keep the person still, do not move them, and call Rescue 1122.
Back pain with a fever or feeling very unwell needs a doctor the same day. If the clinic is closed, go to an emergency department.
See a doctor within days, not weeks, if back pain comes with:
- night sweats
- weight loss you can't explain
- pain that is worse at night
- a past history of cancer or TB
1. Back Pain That Won't Go Away
Back pain that lasts more than three months is called chronic. Most back pain settles within a few weeks. If yours has lasted for months, it is worth getting checked, even though there is often no single clear cause.
Doctors usually try physiotherapy, medicines and keeping gently active first.
Chronic pain alone is not a reason for surgery.
If pain stays, your doctor may suggest an X-ray or MRI to look for a cause that can be treated. Some wear on a scan is normal with age, so the scan is read together with your symptoms.
2. Daily Tasks Are Getting Hard
Back or neck pain may stop you bending to tie your shoes, playing with your kids or enjoying sports.
If pain changes how you live each day, get it checked.
3. Pain That Shoots Down Your Leg or Arm (Sciatica)
Pain that shoots down your arm or leg often means a nerve is pinched. A bulging disc or a bone spur (a small bony growth) may press on it. Sciatica is a sharp pain from your back down your leg. A neck problem can cause pain in your arm.
If leg pain has not settled after a few weeks, or is getting worse, see a doctor. Most people with sciatica get better without an operation. If it does not settle, surgery to take pressure off the nerve often reduces this pain.
4. Numbness or Tingling in Your Hands or Feet
Tingling or numbness in your hands or feet can come from a pressed nerve in the neck or back. A common spine cause is a narrow spinal canal (the tunnel the nerves run through).
It can also come from diabetes, low vitamin B12 or a trapped nerve at the wrist. A doctor can tell which.
If it does not stop, see a doctor. Pressure on a nerve for a long time can cause lasting damage.
5. Weakness in an Arm or Leg
A weak arm or leg can mean nerve signals are not reaching the muscles. You may trip, drop things or feel your grip is weak.
Weakness is more serious than pain, so get checked soon. If weakness comes on suddenly or gets worse quickly, go to an emergency department now.
Sudden weakness, especially with a drooping face or slurred speech, may be a stroke. Call Rescue 1122.
Surgery may help strength return, but this varies from person to person.
Not sure if your pain needs surgery? WhatsApp your X-ray or MRI to +92 300 4890692 to book a consultation. Dr Malik will need to examine you before advising on surgery.
6. Trouble Walking or Standing (Spinal Stenosis)
If you must sit down after walking a short way, or your legs hurt when you stand, you may have spinal stenosis. This means the canal in your lower back has narrowed and presses on the nerves.
Sitting or bending forward usually eases it. If walking gets hard, ask a spine surgeon whether an operation to make room for the nerves (decompression) would help.
7. Bladder or Bowel Problems (Emergency)
Losing control of your bladder or bowel, or new trouble passing urine, can mean the nerves at the bottom of your spine are badly squeezed. This is called cauda equina syndrome. It often comes with numbness around the private parts, inner thighs or buttocks.
Go to an emergency department now. Do not wait for a clinic appointment. Urgent surgery is often needed.
8. A Spine Curve That Is Getting Worse
Scoliosis (a sideways curve) and kyphosis (a forward rounding of the upper back) can get worse over time and cause pain. Severe curves can affect balance and, rarely, breathing.
If the curve keeps growing despite a brace or physiotherapy, surgery may be considered to stop it getting worse.
9. A Slipped or Unstable Spine Bone
If a spine bone slips out of line (spondylolisthesis), it can press on nerves. At first it may not hurt. Over time it can cause back or leg pain.
Many people with a slipped bone on a scan never need an operation. If a slipped bone causes leg pain, numbness or weakness that has not settled with other treatment, an operation to hold it steady may help.
One option is fusion (joining two spine bones so they stop moving).
10. Pain That Stays After Other Treatments
You may have tried medicines, physiotherapy, a back brace or injections.
If pain still limits your life and work after all this, a spine surgeon can check whether an operation would help.
For Most Back Pain, Surgery Is Not the First Step
For most problems that are not emergencies, surgery is considered only after other treatment has been tried. Non-surgical treatment can include:
- Medicines to calm pain, including nerve pain
- Physiotherapy and exercises
- Injections, in some cases
These are usually given a fair try for several weeks before surgery is discussed. This is different if pain is severe, weakness is getting worse or emergency signs appear.
Most people with sciatica get better without an operation. Dr Malik also offers non-surgical pain management. The emergency signs above are different: they need hospital care straight away.
Is spine surgery safe? Can it cause paralysis?
Serious nerve damage is uncommon, but it can happen with any spine operation. Dr Malik will explain your own risks before you decide.
Not Sure If You Need Surgery?
At a consultation, Dr Malik will examine you. He explains the options, risks and costs, including not operating, so you can choose the right next step.
Already been told you need an operation? A second opinion is your right. Bring your reports and Dr Malik will go through your options with you, including non-surgical ones.
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, the implant, the room and the nights in hospital. It is explained to you before you decide.
Dr Malik has more than 20 years of experience in orthopedic surgery. He performs every operation himself.
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.
