How Do I Know If I Need Back Surgery? – San Diego, CA
What Doctors Look For Before Recommending Surgery
If you’ve been told you may need back surgery, one of the most common questions is:
👉 “How do I actually know if surgery is necessary?”
Many patients hear:
- “You have a herniated disc”
- “There’s degeneration”
- “You may need surgery”
But that alone does NOT automatically mean surgery is required.
The truth is:
👉 Some patients do need surgery
👉 Many others may still have non-surgical options
The key is understanding how that decision is actually made.
At The Spinal Decompression & Chiropractic Center of San Diego, Dr. Cassidy Boelk, DC focuses on helping patients determine whether they may be candidates for Non-Surgical Spinal Decompression (NSSD) before moving forward with surgery.
Real Patient Experience – Unsure About Surgery
“For the first time in 10 years, I am totally pain free. My sciatica is gone and I have no more back pain! I've tried other chiropractic procedures, acupuncture, pain killing drugs, and other type therapies that just did not work. I was one step before back surgery, until I discovered Dr. Boelk's therapy and his procedure, and it's a miracle! My office visits were always so relaxing and comfortable, there was never any pain involved with the therapy. Dr. Boelk and Patty are so welcoming and warm and ready to explain everything that's going on. They both take such good care of you! Thank you Dr. Boelk and Patty!”
— Toni H., San Diego, CA
Summary: After years of unsuccessful treatment and being close to surgery, Toni was able to avoid surgery and become pain free through non-surgical care.
What Actually Determines If Surgery Is Needed?
Surgery is typically considered when certain criteria are present.
These may include:
- progressive weakness in the leg or arm
- significant nerve compression
- loss of function
- worsening neurological symptoms
- lack of improvement with appropriate conservative care
- structural instability
In more urgent cases, such as:
- loss of bowel or bladder control
- severe neurological compromise
👉 surgery may be necessary right away.
But many patients do NOT fall into these categories.
Why Many Patients Are Told They Need Surgery Too Early
One of the biggest issues we see is this:
Patients are often told they need surgery based primarily on:
- MRI findings
- disc abnormalities
- degeneration
But here’s the problem:
👉 Many people have disc issues on MRI with NO pain
👉 Not all disc findings are the source of symptoms
This is why:
- imaging alone is not enough
- symptoms must match findings
- movement and function must be evaluated
Real Patient Experience – Severe Sciatica Before Surgery Recommendation
“Dr. Boelk has been a life saver. Have had constant lower back and sciatica pain for over 8 plus months, no pills helped and on track for multiple shots but with the treatment given I have found relief and down to zero pain. As a firefighter that relies on his body to help others and the results I have experienced it's totally worth looking into what Dr. Boelk can do for you.”
— Joshua T., San Diego, CA
Summary: After months of severe sciatica and heading toward injections and more aggressive care, Joshua experienced full relief without surgery.
What Should Be Evaluated Before Surgery Is Recommended?
A proper evaluation should include:
1. Symptom Pattern
- Where is the pain?
- Does it travel?
- What makes it worse?
2. Functional Limitations
- Can you sit?
- walk?
- sleep?
- perform daily activities?
3. Movement Assessment
- How does your body respond to movement?
- Are certain positions relieving or aggravating symptoms?
4. Imaging (When Needed)
- MRI or X-ray findings
- disc involvement
- nerve compression
5. Response to Prior Treatment
- what have you tried?
- what worked or didn’t work?
👉 All of these factors matter—not just imaging.
Real Patient Experience – Severe Functional Limitation
“I had really bad back problems to the point I couldn’t sleep, also had pain radiating along the sciatic nerve which ran down one leg from the lower back—caused by an accident.
I came in and talked to Dr. Cassidy about my back problems. He evaluated me and mentioned I was a good candidate for this treatment. After the first 2 decompression sessions my sciatic pain was gone and we were able to work on the root of the problem. I did a total of 24 sessions, after which I was able to start rehabilitation training to strengthen my core.
The office is super nice and the staff’s customer service is above and beyond.
Back and neck issues are horrible to live with—trust me, I know firsthand. I gained weight, took pain killers, went into depression, and had major anxiety. I’m over it now—feeling better, walking, sleeping well, and starting to have a better social life as well.
The experience for me has been nothing but excellent. Dr. Cassidy Boelk is hands down amazing—super glad I came here.”
— Abel T., San Diego, CA
Summary: Despite severe symptoms affecting sleep, mobility, and mental health, Abel improved significantly with treatment and avoided surgery.
What Role Does Non-Surgical Treatment Play?
Non-surgical treatment may be appropriate when:
- symptoms are stable
- there is no severe neurological loss
- the condition responds to decompression
- the disc and nerve can be offloaded
At our office, this is done through:
👉 DRX9000 Non-Surgical Spinal Decompression
👉 combined with targeted rehabilitation
With:
- 7 DRX9000 units
- over 100,000 treatments performed
- fully customized protocols
Dr. Boelk is a:
- Certified Spinal Decompression Doctor
- Certified Pain-Free Performance Specialist
- Founder of the Spinal Decompression Training Academy
Real Patient Experience – Failed Other Approaches
“Had terrible low back pain last year, had gone with a traditional chiropractor but didn’t feel it was doing much. Went to this place and after talking to Dr Boelk decided to try spinal decompression therapy. After 3 session my pain was almost completely gone.
The staff is very professional and friendly. A big plus is how you get to go at your appointment time instead of waiting.
I would say the only negative is that is not covered by insurance so you have to pay out of pocket but it you can afford it is 100% worth it.”
— Edgar R., San Diego, CA
Summary: After limited improvement with traditional care, Edgar experienced rapid relief once beginning decompression treatment.
Not Everyone Can Avoid Surgery
This is critical.
Some patients:
- truly require surgery
- are not candidates for decompression
- need additional intervention
Real Patient Experience – When Surgery Is the Right Choice
“I found this terrific practice on social media. I followed up and did my own research so I decided to pay them a visit. The place is clean, well organized and run by a very efficient receptionist. I met with the doctor and after a honest and forthright conversation, we both determined that surgery was my only option to correct my back issues. I will return as a customer when the time is right.”
— Jeff J., Tucson, AZ
Summary: Jeff was evaluated and advised that surgery was the most appropriate path, highlighting the importance of proper patient selection.
So… How Do You Know?
The answer is not guessing.
👉 It comes down to a proper evaluation.
Schedule a No-Charge Consultation – San Diego, CA
If you’ve been told you may need back surgery but want to understand whether non-surgical options may still be appropriate…
the first step is determining:
- what is actually causing your symptoms
- whether disc or nerve pressure is involved
- whether you are a candidate for treatment
- and whether non-surgical care may be appropriate
A no-charge consultation is available for this purpose.
The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Rd Suite 300
San Diego, CA 92123
📞 Office: 619-298-0800
📱 Call/Text: 619-884-8298
🌐 www.SanDiegoBackCare.com
✔ 24/7 answering service
✔ Hablamos Español
Please note:
All consultations are scheduled on a first-come, first-served basis to ensure adequate time for a proper evaluation.