Back Pain: What to Try Before You See a Surgeon

May 12, 2026 · Dr. Carl Heath, D.C. · Founder & Clinical Director

Most people who end up on a surgical waiting list for back pain were never told what the research actually says: conservative care resolves the majority of musculoskeletal back pain cases when applied correctly and early enough.
Surgery addresses structural pathology. A disc that has herniated severely enough to cause neurological deficit, a vertebra that has fractured, stenosis that has progressed beyond what conservative intervention can manage — those are surgical indications. The problem is that many patients reach a surgical consultation before they have completed an adequate trial of evidence-based conservative care. The two categories of problem require two different conversations.
Back pain in North DFW is one of the most common complaints a chiropractic provider encounters, and also one of the most underrated in terms of proper sequencing. A complete conservative care plan involves spinal assessment and joint mobility work, soft tissue intervention for the musculature contributing to the pain pattern, movement retraining to address the mechanical habits driving it, and where indicated adjunctive tools like Western anatomical dry needling to address hypertonic tissue that is not responding to manual therapy alone.
What it does not involve is passive treatment repeated indefinitely without reassessment. Each visit should move the clinical picture forward. When it does not, that is important diagnostic information, not a reason to add more sessions of the same thing.
There are clear indicators that escalate a back pain case beyond conservative management. Progressive neurological symptoms like weakness in the lower extremity, loss of bladder or bowel control, saddle anesthesia require immediate evaluation. Significant and unremitting night pain without a postural component, unexplained weight loss alongside spine pain, or a history of cancer all warrant medical referral before or alongside conservative care.
A qualified chiropractic provider does not manage these presentations in isolation. They identify them, communicate findings clearly, and coordinate with the appropriate specialist. That is what an outcomes-first clinical standard looks like in practice.
For a typical musculoskeletal back pain presentation in a patient without red flag findings, a well-structured conservative care plan produces measurable outcomes within four to six visits. If it does not, that finding is meaningful. It either refines the diagnosis or confirms that additional imaging or specialist evaluation is appropriate. Your MyoMedics provider assesses your back pain at your location across North DFW — Frisco, Prosper, McKinney, and Celina. No waiting room. No commute. A full clinical assessment, not a rushed adjustment. MyoMedics — at your location. On your schedule. Zero waiting rooms.