Back surgery has changed dramatically. In the past, it was often viewed as the last hope—the final option for people with back and back-related leg pain who were not helped by anything else (see Taking Charge of Your Symptoms and Recovery).

Today, surgery on the spine is seen as the correct and timely approach for a relatively small number of patients with specific diagnoses of leg or back pain. The proper timing of such operations is almost as important as the surgery itself. In most cases, back surgery should be considered only after other treatments have been tried without success and when the person is physically and mentally ready—not just for the operation, but also for the recovery period.

There are times, however, when the surgery is required right away and even when it can be put off for a while, delaying necessary surgery for too long also causes problems. For one thing, the person may develop a pattern of complex pain with feelings of hopelessness and disability. This can greatly interfere with recovery once the surgery finally takes place.