FAQ

About Back Pain

How do I know if my back pain is serious?

Most back pain is not serious. The majority of episodes — even severe ones — are muscular and resolve within 4–6 weeks. What matters is whether you have red flag symptoms: loss of bladder or bowel control, progressive leg weakness, numbness in the groin or inner thighs (saddle area), back pain after significant trauma, fever with back pain, or pain that is completely unrelenting in every position. Any one of these warrants same-day or emergency evaluation — call (516) 743-9450 or go to the ER.

Do I need an MRI right away?

Probably not, if this is a new episode without neurological symptoms. NASS guidelines recommend against routine early MRI for acute low back pain without red flags — a large percentage of adults have disc bulges, mild stenosis, or degenerative changes on MRI regardless of symptoms. Ordering imaging too early frequently produces alarming findings that aren’t causing your pain. MRI becomes appropriate when neurological symptoms are present, when red flags exist, or when 4–6 weeks of proper conservative care hasn’t improved things.

Can back pain go away on its own?

Yes — and it does, for most people. About 60–70% of acute low back pain episodes resolve within 6 weeks. Even disc herniations causing significant sciatica resolve without surgery in 80–90% of cases. Back pain does have a high recurrence rate — building core strength through rehabilitation significantly reduces that risk.

About Herniated Discs

What's the difference between a bulging disc and a herniated disc?

A bulging disc means the disc has expanded symmetrically — the outer ring (annulus) is intact. A herniated disc means the inner gel (nucleus pulposus) has pushed through an actual tear in the annulus. Herniations are more likely to contact a specific nerve root and produce sharp, specific radiating pain. Both can show on MRI, but only herniations directly pressing on nerve roots typically require treatment beyond conservative care.

Will my herniated disc get better without surgery?

Very likely, yes. This is one of the most important things to understand: larger herniations — extrusions and sequestrations where disc material has completely escaped the disc space — actually have the highest rates of spontaneous resorption. The immune system sends macrophages to clean up the extruded material over 6–18 months. This is why Dr. Grewal recommends a structured trial of conservative care for most patients: the biology is often working in your favor.

About Spine Surgery

What's the advantage of minimally invasive surgery?

Less muscle damage, less blood loss, less post-operative pain, shorter hospital stay, and faster return to activity — with comparable or superior outcomes in appropriately selected patients. A 2024 meta-analysis (MDPI Life Sciences) found MIS complication rates of 5.3% versus 14.8% with open surgery. The NASS Quality Outcomes Database study (N=129 matched pairs, JNS:Spine 2021) found higher patient satisfaction at 3 months and fewer reoperations at 12 months with MIS fusion. For lumbar discectomy specifically, a 2024 PRISMA-guided systematic review of 87 studies (3,238 patients) found endoscopic and MIS microdiscectomy produce outcomes equivalent or superior to open techniques with less tissue disruption. Dr. Grewal’s UCSF fellowship training included advanced MIS techniques for both cervical and lumbar pathology.

Am I too old for spine surgery?

Age itself is rarely the deciding factor — physiological health is. Patients in their 70s and 80s routinely have excellent outcomes from minimally invasive spine procedures. What matters is cardiopulmonary fitness, kidney function, bone quality, and individual risk stratification. Dr. Grewal discusses the individual risk-benefit calculation candidly with every patient considering surgery.

Can I get a second opinion before deciding?

Absolutely — and we encourage it. Dr. Grewal provides second opinions on spine surgery recommendations from other providers. Bring your imaging and the operative plan you’ve been given, and we’ll review your case and give you an honest assessment. If surgery is the right answer, we’ll tell you. If it isn’t, we’ll tell you that too.

About Insurance and Billing

What insurance do you accept?

Most major commercial plans, Medicare (Parts A and B), Medicaid, New York State Workers’ Compensation (authorized provider), and No-Fault / Auto Insurance (PIP). Our insurance team verifies your specific benefits before your appointment at no charge. Call (516) 743-9450 to confirm.

Can I be seen after a car accident without paying out of pocket?

Yes. New York’s no-fault law requires your own auto insurance to cover medical expenses after a motor vehicle accident — regardless of who caused it — up to your PIP limit (minimum $50,000). We accept no-fault insurance directly and can see you same-day or next-day. Call (516) 743-9450.