Spine-related health issues are a growing concern globally, driven by aging populations, sedentary lifestyles, and obesity rates, particularly in Western industrialized nations. While spine surgery remains a crucial intervention for severe cases, lifestyle modifications-including anti-inflammatory diets, smoking cessation, and physical activity-offer significant potential to prevent spinal conditions and improve surgical outcomes. Inflammation and pro-inflammatory cytokines are implicated in degenerative spinal diseases, and addressing these through diet and exercise could reduce the need for surgical intervention. Moreover, smoking cessation and perioperative nutritional optimization have shown promise in enhancing post-surgical recovery. Despite the demonstrated benefits, barriers exist in integrating these strategies into current practice, including patient adherence challenges and systemic biases toward surgical solutions. This paper advocates for a balanced, patient-centered approach to spine health that combines lifestyle interventions with surgical care, and poses the question: Are we doing enough?