Before Back Surgery: What Three Important Studies Say About Nonsurgical Spinal Decompression

A patient-focused review from Charles Street Family Chiropractic

If 94% Still Report Back Pain After Surgery, Patients Deserve to Know That Beforehand

Lumbar spine surgery is invasive, irreversible, and carries recognized risks. In some situations it is medically necessary and can be extremely important. But when surgery is elective, patients deserve a clear understanding of what the published research says about persistent symptoms afterward.

The number that should stop every elective-surgery patient in their tracks is 94%.

In a large 2017 Journal of Pain Research study of 1,842 people who had undergone lumbar spine surgery, 94% reported some degree of residual low-back pain. That does not mean 94% had severe pain, nor does it mean 94% of the operations were surgical failures. But for an invasive procedure that many patients understandably hope will eliminate their back pain, the persistence of any low-back pain in such a large proportion of respondents is difficult to dismiss.

The same study found that 20.6% met the researchers’ criteria for failed back surgery syndrome —roughly one out of every five patients. Residual numbness was reported by 69.8%, cold sensations by 43.3%, and paresthesia such as tingling or abnormal sensations by 35.3%.

For a patient considering elective surgery, those numbers deserve serious attention.

The question should not simply be, “Can someone operate on my spine?” It should also be, “Have I exhausted reasonable nonsurgical options before taking an irreversible step?”

Study #1: Inoue Shows the Problem After Lumbar Surgery

Inoue and colleagues examined the prevalence and burden of persistent symptoms after lumbar spine surgery. The study involved 1,842 respondents and found that 20.6% met criteria for failed back surgery syndrome. Persistent symptoms were associated with reduced satisfaction and quality of life.

The 94% residual low-back-pain figure is especially striking. Again, the study measured residual pain across a range of severity. Nevertheless, if the purpose of an elective operation is substantially to address a patient’s painful lumbar condition, a finding that the overwhelming majority of surveyed postoperative patients still reported some degree of low-back pain is clinically important information for informed decision-making.

Study #2: Connolly Looks at Nonsurgical Decompression—and the MRI

The next piece of the story comes from Connolly and colleagues. In a 2025 case series, 13 patients with lumbar intervertebral-disc lesions received 20 sessions of nonsurgical spinal decompression.

Following treatment, the investigators reported an 80% improvement in pain, a 50% improvement in disability, and approximately a 75% improvement in function and activities of daily living.

But what makes the Connolly study particularly interesting is that the investigators did not stop at asking whether the patients felt better.

They also obtained and evaluated pre- and post-treatment MRI studies. The researchers reported increases in disc height and anterior-posterior spinal-canal dimensions, and 77% of the patients demonstrated notable changes or reduction in the disc herniation.

The study was small and was a case series rather than a randomized trial, so its findings should not be overstated. But it adds something important to the decompression discussion: the clinical improvements occurred alongside measurable imaging changes.

Study #3: Military Medicine Expands the Picture to 267 Patients

A 2025 retrospective study published in Military Medicine examined 267 patients treated at seven clinics. Patients generally received at least 20 nonsurgical spinal-decompression treatments over approximately six to eight weeks.

The patient population included lumbar disc lesions, radiculopathy or myelopathy, sciatica, spondylosis and other low-back conditions.

Average pain scores decreased from approximately 6.9 before treatment to 2.5 afterward.

Approximately 90.5% of patients with available pain data experienced a reduction in pain. The researchers also reported improvement in neurological findings among patients who had abnormalities documented before treatment: 60.9% improvement in abnormal reflex findings, 74.8% improvement in affected myotomes or muscle weakness, and 77.6% improvement in affected dermatomes or sensation.

That matters because a disc problem is not simply about a pain score. When a lumbar disc is affecting a nerve, strength, sensation and reflexes can also matter.

Put the Three Studies Together

These studies answer different questions, but together they create a useful clinical conversation.

·         Inoue documents how common persistent symptoms can be after lumbar surgery, including residual low-back pain reported by 94% of respondents and failed back surgery syndrome criteria met by 20.6%.

·         Connolly reports substantial improvements in pain, disability and daily function after nonsurgical spinal decompression, accompanied by measurable MRI changes in a small case series.

·         The Military Medicine study reports pain reduction and improvement in neurological findings in a much larger, seven-clinic retrospective population.

For patients considering elective lumbar surgery, the message is straightforward: conservative treatment should be treated as a necessity, not an alternative.

An operation changes anatomy permanently. Nonsurgical spinal decompression does not involve an incision, anesthesia, implanted hardware, or removal of spinal tissue. When a patient is an appropriate candidate and there is no urgent surgical indication, it is reasonable to investigate a nonsurgical option before proceeding to an invasive procedure.

There Are Times When Surgery Is Necessary

This is not an argument against every spinal operation. Progressive neurological loss, cauda equina syndrome and certain serious structural conditions may require urgent or necessary surgical management.

But those circumstances are very different from an elective operation for a patient with a disc herniation, disc protrusion, degenerative disc condition or sciatica who has time to consider conservative care.

If surgery is not an emergency, why rush past a reasonable nonsurgical option?

Why We Recommend Considering Nonsurgical Spinal Decompression

At Charles Street Family Chiropractic in Beacon Hill, we evaluate patients with lumbar disc conditions to determine whether they may be appropriate candidates for nonsurgical spinal decompression.

No treatment can guarantee a particular outcome, and decompression is not appropriate for everyone. But the research reviewed here gives patients good reason to ask more questions before choosing elective surgery.

Reduced pain.

Improved disability.

Improved neurological findings.

Improved activities of daily living.

Measurable MRI changes.

Those findings deserve consideration—particularly when placed beside research showing how frequently symptoms can persist after lumbar surgery.

Before elective back surgery, ask one more question:

“Am I a candidate for nonsurgical spinal decompression?”

Because once surgery is performed, you cannot undo it.

Charles Street Family Chiropractic
Boston Spine, Disc & Car Crash Specialists
Beacon Hill, Boston
617-720-1992

References

Inoue S, Kamiya M, Nishihara M, et al. Prevalence, characteristics, and burden of failed back surgery syndrome: the influence of various residual symptoms on patient satisfaction and quality of life as assessed by a nationwide Internet survey in Japan. Journal of Pain Research. 2017;10:811–823. doi:10.2147/JPR.S129295.

Connolly JA, Luginsland LA, Welsh S, et al. Clinical and Imaging Outcomes of Non-Surgical Spinal Decompression for Lumbar Intervertebral Disc Lesions: A Case Series. Journal of Contemporary Chiropractic. 2025;8:81–87.

Schueren S, Luginsland LA, Ariza Medina G, Schilaty ND. Retrospective Chart Review of Nonsurgical Spinal Decompression as a Therapeutic Modality for Low Back Pain. Military Medicine. 2025;190(Suppl 2):134–140.