My mother had the worst back x-rays.

Twice, at different MD offices I have heard them say to her:

“Mrs xxxxx, I look at your x-rays and I honestly do not know how you walked in here without help ! “

As a young boss in the 1980s I had employees who injured their backs at work, were slow to heal, and elected for back surgeries.
None ever were able to really recover or be free from pain.

I have had a now deceased family member who had 2 back operations that afterwards she did not feel were successes.

My mother, a doctor’s daughter who had 4 MD grandchildren,
never had back surgery.

She was no stranger to hospitals, had several complicated operations, such as having a fiber threaded up from the leg to the head to pull a clot loose from deep in her brain.

I witnessed two different Hospice MDs do legally required exams on her and both remarked:

“That is a really bad back, it curves in all directions.”

What worked best for my mother was the very special pain reliever
Tramadol.

Tramadol is one of the most complicated drugs.
When you swallow it, the drug is changed six different times before it leaves your body.
It is like taking one pill that contains 7 different “time release” drugs.
Not all 7 drugs are pain relievers.

Tramadol can lower blood sugar level,
even to dangerous levels in some people at relatively low Tramadol doses,
because people’s blood sugar levels vary a lot, and vary by time of day.

Tramadol is generally accepted as the opioid-class drug least likely to cause addiction.

Despite that, many criminal drug smuggling rings use Tramadol to “cut” other drugs to dilute them before sale.

What award winning MD and long time medical school professor
really has studied back problems
and speaks the truth as he sees it?

This one:

https://uncpress.org/book/9781469642253/stabbed-in-the-back/

If you give back doctors 100 of randomly mixed up x-rays of patient backs to read:

50 of which are patients complaining of severe back pain
50 of which are patients with no back pain, but needed an xray for another reason

can the back doctors correctly identify the xrays with back pain?

The book above has the answer.