Do you know what to it means when you have back pain after surgery? You might have failed back surgery syndrome. That’s right – back surgery failures are so common that there’s a name for it. In this guide, we’ll take a detailed look at all the complex issues that can happen when back surgery fails. You don’t have to live with pain – you have options. Keep reading to find out what they are.

What Causes Pain After Back Surgery?

Epidural Fibrosis

One of the most common causes for pain after back surgery is scar tissue (the medical term for it is epidural fibrosis). Whenever the body is injured, it tries to heal itself. Surgery is a major injury and thus scar tissue will form. Unfortunately, there is no way to control where and how the scar tissue forms and often it can trap a nerve resulting in pain. This is one of the most common reason for pain to develop approximately 6-12 months after surgery.

At first, you’ll probably experience no pain after your surgery. Then, you’ll gradually develop back or leg pain that doesn’t go away. If you have pain right after surgery but it keeps improving, you probably don’t have failed back surgery syndrome. However, if you don’t see improvements by three months after the surgery, your surgery probably wasn’t successful.

Some types of surgeries make epidural fibrosis more likely than others. For example, if you had spinal decompression surgery, your pain probably isn’t caused by scar tissue.

Improper Patient Selection

Sometimes, the cause of your post-surgery pain is that your surgery didn’t successfully treat the issue in the first place. The most important predictor of a having a good surgical outcome is having the proper diagnosis. How can you treat a problem if you don’t know what that problem is in the first place? To properly diagnose the cause of a patient’s pain, it takes a detailed history and physical exam, appropriate imaging, and potentially diagnostic injections to help localize the problem. If your doctor didn’t successfully diagnose the source of pain prior to surgery, there is a low likelihood the surgery will significantly help.

Recurrent Disc Herniation

There is no rule that states once a problem is fixed, it cannot happen again. All too commonly, patients who undergo surgeries such as a discectomy or microdiscectomy can develop a recurrent disc herniation. You’ll see pain relief at first, but then your pain will return suddenly. This is different from pain caused by scar tissue, which tends to build up gradually. This is a natural consequence of having the initial disc herniation in the first place. Once the disc is damaged, it is more likely to happen again even if you have it surgically removed.

Surgical Error

While not common, the surgeon may have committed a technical error during the procedure. For example, a part of your herniated disc might have been missed, or a small piece of bone might have gotten left too close to the nerve. If the nerve root becomes compressed due to one of these problems, you’ll feel pain. It is important to maintain appropriate follow up with your surgeon during the initial recovery phase. If the surgeon determines there is no technical issue with the surgery yet you still have pain, then there are additional options to treat the pain.

Failed Back Surgery Syndrome Treatment Options

What are your failed back surgery syndrome treatment options? Let’s take a look.

1. Stretching to Avoid Scar Tissue Problems

It may sound overly simple, but stretching can sometimes help manage your back pain post-surgery. Prior to initiating an exercise routine, it is important to get approval from the surgeon.

If you stretch out your nerve root while your body is healing and growing scar tissue, your epidural fibrosis probably won’t cause pain. Keep in mind that scar tissue growing after surgery is normal. It makes sense to take this step to keep it from growing in a painful way.

Most of your scar tissue grows in the six to 12 week period after surgery, so that’s the time when it’s most important to stretch. Some medical professionals believe that keeping the nerve flexible while you heal will keep the scar tissue from growing where it can hurt you.

For example, you can do stretches that involve pumping your ankle while stretching your hamstrings. This helps move the nerve in your lower back, keeping the scar tissue from adhering to the nerve.

2. Managing Pain Due to Scar Tissue

Sometimes, despite your best efforts, the scar tissue still forms around the nerve and causes pain after back surgery. You’ll need a physical exam and the right kinds of diagnostic imaging to see whether or not that’s the case.

If this is your issue, you have a couple of treatment options to choose from. You can use medications to manage the pain, combined with stretches to keep the issue to a minimum. Sometimes stretches can help free your nerve after the scar tissue has already started growing. There are more advanced treatment options including injection therapy, epidural adhesiolysis, or neuromodulation.

3. Repeat Surgery

If your pain happens years after the surgery was completed, scar tissue isn’t the problem. Instead, the issue might be that your nerve has become compressed by a herniated disc or new bone growth. If that’s the case, you may need a discectomy or decompression surgery.

Do You Have Failed Back Surgery Syndrome?

Pain after back surgery can start to happen weeks, months, or years after the surgery. No matter when it starts or what the cause is, you should seek out failed back surgery syndrome treatment options right away.

You don’t need to live with pain. Back pain can become debilitating and negatively impact your quality of life. Instead, book an appointment with a medical professional who can help you figure out the cause of your pain and the right course of action.

Ready to get started on your personalized pain management plan? Book an appointment with us today!