Why Most Back Pain Doesn't Need Surgery

Back pain is one of the most common reasons people visit their GP — and one of the most common reasons they're referred for surgery. But research consistently shows that for the vast majority of back pain cases, conservative treatment is equally effective, with far fewer risks. As a physiotherapist, I've helped hundreds of patients avoid unnecessary surgery while achieving full, lasting recovery. Here's what you need to know.

**When surgery is and isn't necessary.** Surgery is genuinely indicated in a minority of cases — severe disc herniations causing leg paralysis, cauda equina syndrome, or significant structural instability, for example. But for the most common presentations — non-specific lower back pain, disc bulges causing sciatica, facet joint pain — research shows conservative management produces equivalent outcomes. **What physiotherapy offers:** - **Manual therapy** — joint mobilisation and soft tissue techniques to restore mobility and reduce pain - **Therapeutic exercise** — progressive, targeted strengthening to stabilise the spine and address the root cause - **Education** — understanding your pain reduces fear, improves outcomes, and prevents recurrence - **Movement retraining** — correcting the movement patterns that perpetuate pain **The key message:** Pain does not equal damage. Acute back pain is your nervous system being protective, not necessarily a sign of serious structural injury. With the right treatment and education, most people make a full recovery.