A: It depends on your diagnosis. For some conditions, such as infections or fractures, surgery may be the only treatment option. For most other conditions, like herniated discs or sciatica, conservative care treatment, including medications and physical therapy, is the first treatment option. If physical therapy and injections do not work, patients may need a spinal injection. At Texas Back Institute surgery is always a last resort. At each step along the way, we reevaluate the patient and the effects of the spine pain on function and lifestyle. Once the patient gets to an acceptable level of pain and function, we slow down and hopefully the patient continues to get better.