Hello,
Thank you for your query at DoctorSpring.com. I understand what you are going through.
Back surgery is required only if there is a compression of the nerve in the MRI or if there is any spinal instability. Spinal instability can be evaluated from flexion extension X-Rays of the spine.
A hairline fracture of the spinal vertebrae does not need stabilisation. If the fall on the hard concrete or the car crash would have caused spinal instability, then the same should have been seen on the MRI in the form of a wedge compression fracture of more than 50% or spondylolisthesis(forward displacement of vertebra).
In your case, there seems to be no indication for surgery as your doctor appears to have ruled those out those abnormalities.
Your doctor does seem to have your best interests in mind as surgery does not seem to be a good option for you.
However, if the pain is progressively worsening then you might need a repeat MRI/CT to look for progression of the problem.
If this MRI too does not have any major abnormality, then your backache has to be termed as a mechanical backache and should be treated conservatively. Treatment options for this are:
-Bed rest
-Analgesic and muscle relaxants drugs
-Physical therapy and back strengthening exercises
-Spinal epidural steroid injections
-Complementary rehabilitation therapies like Acupuncture etc.
Although it looks like you have tried most of these, I would like to know the details of the analgesics you have been on as well as the specific physical therapy you have received so far. This will help me opine on further management for you as there are plenty of options for both analgesics and physical therapies and if some haven't worked for you, there are always better options.
I hope this was helpful.
Feel free to discuss further.
Thank you.