If you don't have neurological complications, it's typical to try several months of non-surgical treatments, such as physical therapy and medications, before trying surgery. It's also difficult to treat chronic pain with surgery because often, there's no identifiable cause of pain. The surgeon can't operate without knowing what he or she needs to fix.
But if non-surgical treatments don't work and if you have an identifiable cause of your chronic pain that can be addressed via surgery, your doctor may recommend surgery. The precise procedure is dependent on the cause of your pain, and the surgeon will make the best recommendation.
For example, if you have a herniated disc pressing on your sciatic nerve and causing chronic sciatica, the surgeon may do a discectomy, where he or she removes part of the disc in order to take pressure off the nerve. Before agreeing to surgery, it's a good idea to get a second opinion from another surgeon. You should also ask as many questions as you need so that you understand the risks, benefits, recovery process, and general procedure. The final decision to have surgery rests with you, so make sure you understand all your options.