When should you get surgery for your back, shoulder, knee, hip, etc. pain?

As a corrective exercise trainer and an orthopedic massage therapist, I talk with a lot of people with chronic pain. People often ask me if I think there’s ever a good time to get surgery. Sometimes it’s about back pain. Sometimes it’s knee pain. Could be hip pain, wrist pain, shoulder pain, etc. Whatever it is, the pain lingers, and it’s frustrating.

When is the right time to get surgery?

I don’t think that’s a question someone else can answer for you. It really requires you to educate yourself on a number of issues and a number of variables.

I’m not a doctor, but if you read to the end of this brief post, you’ll find there is at least one very well-known orthopedic surgeon who agrees with that general statement.

I don’t think it’s controversial to say that the time to do a surgery is when you are personally convinced there is no other way to improve your body yourself.  From my own personal and professional experience, a person can spend months, years, and an entire lifetime discovering new exercises that challenge and improve the body in unexpected ways. I have personally had some pain issues linger/recur over a period of nearly two decades before I figured them out by finally learning the right combination of exercises for my body. I’ve had small issues arise during my life that took me years of frustrating observation and experimentation to understand. Would a surgery have “solved” the problems? Maybe…

I have personally had some pain issues linger/recur over a period of nearly two decades before I figured them out by finally learning the right combination of exercises for my body.

But surgeries can and very clearly do fail to deliver relief. In addition, surgeries always have the possibility of introducing a lot of other issues as side effects in addition to failing to improve body mechanics in the short and long run.

For a really clear example of this, you can watch this video of one of our clients. Jigna had severe back pain for 3 years before getting back surgery. After the back surgery, she got a little improvement in the leg pain, but her overall quality of life did not improve that much. The back pain still persisted for another 8 years before she found her way to train with us here at Upright Health.

What are some risks of surgery for joint pain?

It’s important to keep in mind that surgeries are not without risk. Again, I’m not a doctor, but these are things that I’ve observed with clients I’ve trained.

Even when surgeries succeed in their primary pain relief objective, there’s the risk of moving the problem elsewhere. There are plenty of stories of people who get hip surgery to relieve hip pain who then end up with back problems or knee problems due to compensations that started to show up in the recovery process.

If a surgery fails, you still have given up months or years of rehab, you still have the original problem, and you may have extra problems on top of that.

On the other hand, if careful and gradual exercise fails, it doesn’t necessarily mean that the problem can’t be solved with more time and more creative approaches. Maybe it takes you months. Maybe it takes you years. Maybe you screw up and injure yourself a bit. At least you know any new problems that develop can be solved by gradually retraining your body. A muscle strain can recover. A bone that’s been shaved down is unlikely to recover by any means you have control over. A muscle that’s been removed will never grow back.

So is there a right time for surgery for back pain? For shoulder pain?

I’m not a doctor and don’t claim to know exact cut-offs (and from everything I’ve read, there are no strong evidence-based cut-offs for most joint surgeries). I would simply invite you to weigh your desires and the real risks involved. I know I’m glad that I’ve learned so much about what hurts my body and what helps my body. And I’ve gradually recovered from a life of relentlessly incapacitating body-wide pain.

My shoulders used to frustrate me. My hands and wrists would go numb, cold, and achy just typing at a keyboard. My knees were wobbly, weak, and pinchy. My feet burned with a bizarre numb sensation all the way up into my calves. My hips snapped, popped, and ached from just shifting around in a chair or getting into a bathtub. My back – the one that started it all – hurt for a solid two years before I figured out how to relax my back muscles and get some relief.

Perspective from an orthopedic surgeon on joint surgeries

I mentioned previously that a well-known orthopedic surgeon seems to agree with my general statement above. Here’s a salient quote from Nicholas DiNubile, MD, an orthopedic surgeon (from his book Framework):

“…anyone contemplating surgery needs to realize that when it comes to getting the information they need, and then making good decisions based on that information, the responsibility falls squarely on their own shoulders. Some people find it more comforting to fall into a childlike role, relying on the highly trained authority figure to know what’s best. But it’s your body and your health, and the issues are rarely so clear cut that an “objective” professional can make the right choice for you…nobody but you can make the judgments about what you really want.”

Final Thoughts on pain and surgery

Solutions for your body can take a long time to figure out, but if you can solve your pain problems without surgery (or drugs), that seems to be the least risky option.

When is it time to give up? Only you can make the choice about when you think you’ve really tried everything. 

I’ve been working on solving my body’s chronic aches and pains since 1998. I’ve been learning about and working with the musculoskeletal system full-time since 2007. Every week, I still learn at least one new permutation of an exercise or a completely new exercise that I’ve never thought of before. Many weeks I’m learning more than three new exercises. That’s after 10 years of dedicated professional engagement in the world of massage/bodywork, corrective exercise, and strength training.

If you think you’ve reached the limit of what you can do to improve your body, I invite you to consider that there’s a huge realm of things to try that you may not even yet be aware exist! And that means you still have some things you can try…if you’re willing. 

Pain sucks. Life shouldn’t.


About the Author

Matt Hsu is a trainer and orthopedic massage therapist. He fought a long battle with chronic pain all over his body and won. He blends the principles he learned in his journey, empirical observations with clients, and relevant research to help others get their lives back.