Two separate studies reported in this week’s New England Journal of Medicine show that surgery is the fastest route to pain relief for two very different conditions: severe sciatica and degenerative spondylolisthesis.

But the studies also show that these conditions do not worsen if surgery is delayed — and that nonsurgical treatments can relieve at least some of the pain.

An editorial titled “Back Surgery: Who Needs It?” accompanies the studies. Editorialist and back pain researcher Richard A. Deyo, MD, MPH, is professor of medicine and director of the center for cost and outcomes research at the University of Washington in Seattle.

“The people who truly need back surgery are those who need it to preserve their ability to function,” Deyo tells WebMD. “But short of that, most back surgery is an elective procedure. It is not urgent. Patients face real choices that are quite reasonable: either surgical or no surgery.”

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