Since many people have some degree of disk bulging or instability without any pain or symptoms, these findings in themselves do not mandate surgery. Pain severity alone is not an indicator for surgery. Some patients with the most severe pain cannot be helped by surgery, while others with only moderate pain but progressive loss of neurologic function are candidates for early surgery. There are indications for doing spinal fusions, but also risk. The patient should discuss this in detail with the surgeon if this course is recommended.
Most back pain is related to spasms of the back muscles.
Usually rest and avoiding activity that increases the pain is the best initial treatment. Exercises should not be the initial form of treatment since this might cause further injury and increase the muscle spasm. If the pain is not controlled by these means, you should seek see a physician before taking stronger pain medication or muscle relaxants. Inherited factors, such as body build, strength of tissues, presence or absence of spine, hip or knee deformities, all play an important role in who is likely to develop back pain. There are, however, factors we can control to reduce potential problems with the back.