When Should I Worry About Back Pain?

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano

When Should I Worry About Back Pain—And Is Surgery the Only Answer?

Back pain is common—but not always harmless. If you’ve been told you might need back surgery, you may feel like there’s no other choice. But here’s what most people aren’t told:

Surgery is not always the only option—even when it’s been recommended.

At Pain Experts, we’ve seen many patients told they “needed surgery” when what they really needed was a deeper diagnostic evaluation and a smarter strategy.

We’re not anti-surgery. But we’re very selective about when it’s actually necessary—because once surgery is done, it can’t be undone.

When Should You Worry About Back Pain—And When Should You Act?

Let’s be honest: Some back pain should not be ignored. If you experience any of the following, you need a skilled, timely evaluation:

• Pain that lasts longer than 6 weeks

• Pain that radiates to your leg or groin

• Numbness, tingling, or weakness

• Pain that disrupts sleep

• Loss of mobility or stability

• Unexplained changes in bladder or bowel control

• Previous back surgery with recurring symptoms

These symptoms may reflect disc herniation, nerve impingement, spinal stenosis, or instability—but that doesn’t always mean you need surgery.

When Is Surgery Truly Urgent?

There are rare but serious red flags that do require immediate surgical evaluation:

• Cauda equina syndrome: sudden loss of bowel or bladder control

• Progressive leg weakness: especially if worsening over days

• Spinal fracture: especially in trauma or advanced osteoporosis

• Severe spinal instability: leading to rapid neurologic decline

• Failed back surgery syndrome with hardware complications

If none of those apply to you, you may be a candidate for regenerative options—even if you’ve been told otherwise.

Let’s analyze your case first. Because when should I worry about back pain? The answer is: when it starts changing the way you move, live, and lead—and especially before making a decision you can’t undo.

Regenerative Treatments May Still Be an Option

Orthobiologic treatments such as platelet-rich plasma (PRP) and focused shockwave therapy can:

• Support ligament and muscle repair

• Calm nerve inflammation

• Rebuild the stabilizers of the spine (especially the multifidus)

• Restore function without altering anatomy

At Pain Experts, we use fluoroscopic and ultrasound-guided techniques to identify what’s actually causing your pain—and whether non-surgical interventions can correct it.

We’ve helped many patients avoid or delay surgery, including those already told it was their “only option.”

Let’s Analyze Your Case—Before You Commit to Surgery

If you’ve been told you’re a surgical candidate, don’t rush.

Let’s review your case. Understand the “why” behind the recommendation. Let’s determine whether regenerative treatments may be right for you. Because once you’ve had surgery, there’s no going back.

Dallas + Plano | Concierge-quality care.

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