How Tiger Woods won the back surgery lottery

But he warns typical middle-aged patients. "Once they have that merger, it cannot be undone," Dr. said. Atlas. "And it is likely that they will undergo surgery later," due to the instability that causes fusion.

"If your goal is healed, that's not what this is going to offer," he said.

Another option, for those who are willing to be patient, is intensive physical therapy. Large clinical studies have shown that those who follow the path as a group are indistinguishable from those who have undergone surgery.

But, Dr. Mirza, said it must be the right form of physical therapy, strengthen muscles in the back, improve flexibility. It is also unlikely that Woods would have returned to the top of his sport with physiotherapy alone.

"There is a tendency towards rehabilitation to involve passive treatments," he explained, such as ultrasound or traction or massage or dry needle. They have not been shown to help.

Rehabilitation must also be accompanied by behavioral therapy to teach patients not to be afraid of their back pain. "Many patients are terrified that they will make it worse," Dr. said. Mirza. So they are deconditioned, which actually makes things worse.

Suppose you don't have time for all that physical therapy and counseling. You just want surgery to relieve the pain.

The problem is that you still need three to six months of physical therapy. After an initial period of near-immobility as the new bone in the cage heals in your back, patients must work on strength and conditioning.