Your back is hurting. Youve tried ice, heat, massage, anti-inflammatory medications-even a short stint of physical therapy. Is it time to consider surgery? That depends, says R. Douglas Orr, MD, a staff physician in the Center for Spine Health and the Department of Orthopaedic Surgery at Cleveland Clinic. "Realistically, if your only symptom is back pain, you probably shouldnt be thinking about surgery until youve had pain for at least a year. And you should be doing the whole array of nonsurgical treatments during that time," Dr. Orr says.