I had back surgery to remove some damaged discs and fuse my spine at L45. At the time, I was living in Colorado. Now I've moved to California to be with my adult children. The back pain never really went away. My kids have insisted that I see a doctor here for the problem. But the primary care physician doesn't seem to have any answers either. Should I keep looking?

More and more adults in the United States are having back surgery. This comes along with a higher number of patients who don't get better after the first operation. A second surgery may be suggested. But only one out of three patients who have a second surgery report feeling better.

A review of the literature suggests why primary care specialists don't have a quick and ready response for their patients with chronic back pain. There isn't one! There is very little agreement on the best way to treat this problem.

Should the patient try physical therapy? If yes, what works best? If no, what is the next option? Should another surgery be recommended? What kind?

Right now, physicians are advised to use a collaborative multidisciplinary approach to this complex and challenging problem. This means working with other health care professionals such as the physical therapist, pain management specialist, and orthopedic surgeon or neurosurgeon.