Surgery Likely Better Than Exercise for Back Pain

The results of a four-year study on severe back pain show that spine surgery produces more and faster pain relief and greater improvement in function than exercise, physical therapy and analgesic drugs.

The study, known as the Spine Patient Outcomes Research Trial (SPORT), was published in the medical journal Spine. The results of the first two years of the research had already found that spine surgery works better than non-surgical techniques for patients who have herniated lumbar (lower back) discs. The next two years have confirmed those findings.

Estimates are that as many as 80 percent of Americans will be afflicted by back pain sometime in their lives. The annual cost to society of treating back conditions is approximately $100 billion, and evidence suggests that surgery may not only produce superior outcomes but be the more cost-effective approach.

The investigation looked at 1,244 patients at 13 U.S. spine clinics, each patient having suffered at least six weeks from a herniated disc in the lumbar spine that caused back pain, leg pain and other symptoms. Patients were assigned to either a back-surgery group that received standard open discectomy, or to a non-surgical group that was treated with active physical therapy, counseling with home exercise instruction, and non-steroidal anti-inflammatory drugs. ames Bean, president of the American Association of Neurological Surgeons, said of the findings, "They've held up for four years - and I think it's a well-done paper. I agree with everything that was concluded."

Even though the results supported the effectiveness of surgery, the study authors hastened to note that all patients in the project improved. It was found that anyone willing to apply themselves to a regimen of physical therapy, home exercises and analgesic drugs was bound to make progress - even though spine-surgery patients made greater progress.

 In addition, non-surgical interventions were found to get patients back to work just as fast as using surgery. "Return to work," the authors say, "appears to be independent of treatment received and does not follow improvements in pain, function, or satisfaction with treatment."