A new study has suggested that before considering a surgery for back pain, you should try physical therapy as it is both less risky and less costly.

The study, done by the University of Pittsburgh, has found that that surgery and physical therapy were equally useful in the case of lumbar spinal stenosis. It is a common condition in older people that makes walking painful.

The study has also raised questions regarding the financial incentives. It has found that surgery is very expensive for insurers, an average of $24,000 in 2010, as compared to a Medicare cost of $1,440 for a dozen therapy visits.

The study also found that the co-payments for physical therapy can make it the more expensive option for insured patients, which was sufficient to discourage some patients.

The lead author, Tony Delitto, chair of Pitt's physical therapy department, said the primary message for patients is that they should exhaust the nonsurgical options, including physical therapy, before they consent to surgery.

The study was published in Monday's issue of Annals of Internal Medicine. Along with it, there was an editorial that reached a similar conclusion, but added that the preference of the patient should weigh heavily in the decision.

William C. Welch, a member of the study team, a spine surgeon, and two other prominent spine surgeons in Philadelphia - Alexander Vaccaro and F. Todd Wetzel said that they have always encouraged the patients to try physical therapy first.

Wetzel said, “This is pretty much the way I've always talked to [patients] about it. I'm definitely on the conservative side compared to many of my colleagues”.

Welch said the surgeons have a moral and ethical obligation to do the least intervention to afford them the best results.

In the previous studies, it was found that patients felt well faster with surgery, but the difference between surgical and nonsurgical treatments have diminished over time.

The study has come up as the latest one to question whether Americans are undergoing back surgeries in cases when they could have been avoided.