When you first developed chronic back pain, you probably tried a variety of conservative treatments in a bid to attain relief. You may have even noticed some short-lived improvement with over-the-counter pain relievers, chiropractic care, physical therapy, or epidural steroid injections.
But when your back pain persisted or gradually worsened, you found yourself considering a more invasive treatment solution: spine surgery. It’s a common story, as back surgery is often viewed as a “final option” for pain that hasn’t responded to conservative care measures.
So, what should you do if you’ve had back surgery, but you’re still in pain? Fellowship-trained neurosurgeon Jose Valerio, MD, wants you to know that no matter how complex or frustrating your case may seem, you still have options.
Read on as Dr. Valerio explains the unpredictable phenomenon known as failed back surgery syndrome (FBSS), and explores next steps to help you find the best possible therapeutic plan for long-term pain control.
Defining failed back surgery
Chronic back pain is a complex problem, and many people view spine surgery as a curative solution. Unfortunately, that’s not always the case. In fact, experts estimate that 20-40% of people who’ve had one or more spine surgeries to treat chronic back pain continue to suffer persistent pain and limited function.
Back surgery is said to have failed when a patient never attains symptom relief, or when they experience recurrent symptoms down the road after an initial period of relief. A patient may feel as though they got better for a while but then started to get worse again, or they may feel like their pain never improved or even became more severe.
Sometimes, continuing or recurrent back pain after surgery may radiate into a patient’s legs, causing other neurological symptoms, such as numbness, tingling, or weakness.
Contributing factors to failed back surgery
Failed back surgery can be caused by a multitude of factors, each of which falls into two general categories:
The existence of certain conditions or circumstances before back surgery can decrease the likelihood of a successful outcome. These factors include smoking, obesity, and the presence of a mental health disorder, such as depression or anxiety. They also include situations that delay surgical care, such as litigation or workman’s compensation.
Problematic conditions and circumstances that can lead to pain after back surgery include the formation of nerve-trapping scar tissue near the surgical site as well as altered biomechanics that lead to unbalanced load burdens, joint pain, and muscle spasms. Furthermore, continued progression of degenerative changes within the spine can also be a factor, among others.
In some cases, failed back surgery stems from an inaccurate diagnosis of the underlying cause of pain. In other cases, it’s caused by a lack of adherence to post-operative physical therapy and rehabilitation. In many cases, more than one factor is involved.
Moving toward long-term pain relief
Whether you continue having pain after back surgery, or it reemerges sometime later, the most important next step is to work with a skilled expert to get to the bottom of your symptoms. As a fellowship-trained neurosurgeon who specializes in complex cases of failed back surgery, you’re in excellent hands with Dr. Valerio.
No matter what your initial condition and surgical intervention happened to be, the question becomes whether your new or persistent pain is related to the surgery itself, or whether it’s a product of new or continuing spinal changes or degeneration.
Identifying the root cause and contributing factors of your problem is key to developing a responsive, multidisciplinary treatment plan that effectively addresses your symptoms and helps you find long-term pain relief. Depending on your case, this may include:
- Targeted physical therapy exercises to help restore function
- Interventional procedures to address new problems
- Chronic pain management (neuromodulation and/or medication)
- Mental health management to treat depression or anxiety
- Further surgical intervention for new or continuing degeneration
For most people living with pain following back surgery, a mix of treatments and therapies is the best way to address symptoms in a comprehensive way. No matter what your personal treatment plan looks like, it has one overriding goal: to help you recover and enjoy an active, pain-free life once again.
If you’re ready to overcome post-surgical back pain, the team at Jose Valerio, MD, can help. To learn more, book an appointment over the phone today.