Surgery is rarely used in chronic pain cases. If it is used, it's generally the last resort. However, if you have serious neurological complications (such as bowel or bladder dysfunction), along with chronic pain, you may need immediate surgery.
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.
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.