What’s the #1 predictor of getting back surgery for back pain?

If you have back pain, the possibility that you might need surgery is something that might worry you. It’s something that worries many of my patients. So, what are the chances you are going to get a risky and expensive surgery? Let’s look at the predictors in a large study that was done a few years ago…


You might think it should be one or more of the following that predict the need for surgery:
– Pain severity
– Pain location or the fact that pain radiates
– How long you’ve had your pain
– Associated weakness or changes in your reflexes
– MRI findings of disc herniations, ‘pinched’ nerves, ‘degenerative joint or disc disease’ (AKA simple arthritis)


If you thought any of these were top predictors of whether someone got back surgery or not in the study, you thought WRONG!


The top predictor in the study was …………………… ZIP CODE!




You read that right. The top predictor involved how many spinal surgeons were in a region. It had nothing to do with the individual patients and their symptoms. Surgeons like to do surgery, I guess.


Another top predictor of getting a back surgery was if the surgeon owned the MRI machine. That increased odds of surgery by 34%!



The fact is that the vast majority of people who have back pain DON’T NEED AN MRI! This is actually a strong recommendation to physicians by their own medical associations… that they don’t routinely refer out for imaging for back pain. Yet, a large number of people are still getting referrals from their physicians for MRIs for simple back pain.


Here’s the problem… Studies show MRI findings of things like arthritis and disc bulges are very often NOT associated with any pain at all. The studies are showing that these things are mostly just associated with aging and very often don’t cause pain.


Take a look at the chart above. It’s from a study of 3000 people and NONE OF THEM HAD BACK PAIN. You can see that 52% of the 30 year olds had ‘degeneration’ and 40% had at least one disc bulge. Remember that these are people without back pain. So, when you see a surgeon and he says, ‘We might as well do an MRI…’ (while also profiting from billing to use his very own MRI), you will likely have something to point at as a ‘positive finding.’ You could have surgery to fix that part, but what if it really wasn’t what was causing your pain? What if you were like the majority of us who have these findings on an MRI anyway, whether or not you have pain?


Why not try seeing a GOOD physical therapist (not just going to a ‘PT mill’ where they pump patients in and out of the clinic as fast as they can)? Research shows PT is actually quite effective at treating back pain and getting people back to the things they want to do. All this while also being much cheaper, less painful, and quicker than recovering from a surgery and also without the risks of infection, nerve damage, and even death.


Yeah… not dying from an unnecessary surgery is a good thing in my book.


If you have back pain keeping you from living your life to its fullest, start by clicking here to download our free Back Pain Guide for some easy tips. If you are ready, feel free to contact us for a FREE phone consult, as well. Just email us and we will figure out the best time to chat about how to get you back to doing the things you love!


In health

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