That is an odd way for a surgeon to open a page about spine care, but it is the truth that should govern the specialty. The overwhelming majority of back and neck pain is mechanical — muscles, ligaments, discs and joints protesting against long sitting, poor lifting and weak support musculature — and it responds to structured, patient, non-surgical care. Surgery has a place, and when it is needed it can be transformative. The skill lies in telling the two situations apart.
Dr. Pradyumna Chakraverty manages the full range of spinal complaints at his South Kolkata practice — from the office-goer's stiff neck to disc prolapse with sciatica to spinal fractures from falls and road accidents. His MS in Orthopaedics is from KPC Medical College, Jadavpur, and he serves as an Assistant Professor of Orthopaedics.
Mechanical back and neck pain. The commonest complaint by far, and the one most mistreated — usually with weeks of painkillers and bed rest, both of which are the wrong prescription. The evidence is unambiguous: staying active within pain limits, correcting the way you sit and lift, and progressively strengthening the core recovers these backs. This is unglamorous medicine, and it works.
Disc prolapse and sciatica. When a disc bulges onto a nerve root, pain shoots down the leg — sharper and more electric than the backache itself. Most prolapses shrink and settle over weeks to months without an operation. The minority that need surgery declare themselves clearly: progressive weakness, pain that defeats proper conservative care, or emergency signs. The slipped disc and sciatica page walks through this decision in detail.
Spinal injury. Falls from height and road accidents produce spinal fractures that range from stable injuries needing only a brace to unstable ones threatening the cord. Assessment here is urgent and disciplined; this side of the practice connects to Dr. Chakraverty's trauma work.
The fragile spine. In older patients — particularly post-menopausal women — vertebrae weakened by osteoporosis can fracture under everyday loads. Treating the fracture without treating the bone invites the next one; see osteoporosis treatment.
Diagnosis first: history, neurological examination, and imaging only when it will change the decision. An MRI ordered for every backache mostly discovers harmless age-related changes with alarming names, and frightened patients make poor decisions. When a scan is warranted, Dr. Chakraverty reviews it with you on screen, shows you exactly what is pressing on what, and lays out the options — including the honest odds of improvement without surgery. When surgery is the right answer, the aim is the smallest effective operation: freeing the compressed nerve, stabilising only what is unstable.
See a doctor promptly for leg-radiating pain, numbness or weakness, night pain, pain after a fall, or any change in bladder or bowel control — the last needs emergency attention.
No — most disc prolapses improve with medication, activity modification and physiotherapy. Surgery is for progressive weakness, pain that defeats proper conservative care, or emergencies.
Not usually at the first visit. MRI is for suspected nerve compression, red-flag signs, or pain that fails a proper course of treatment.
Most operations free a compressed nerve (decompression/discectomy); some conditions also need stabilisation with implants (fusion). The diagnosis decides — explained with your scan in front of you.
For most mechanical back pain, yes — graded exercise and core strengthening are the most reliably effective treatment known, prescribed as specific programmes rather than vague advice.
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