Failed back syndrome can feel hopeless. Very often patients come to us out of desperation. They’ve tried prescription medications and they’ve tried one back surgery or multiple back surgeries, only to end up with Failed Back Syndrome. They were on the verge of giving up hope but came across Doctors’ Choice Physical Medicine & Rehabilitation and the Workplace Injury Institute or were referred to us by a family member or friend.
What Is Failed Back Syndrome?
Failed Back Syndrome (FBS) or Failed Back Surgery Syndrome (FBSS) usually involves constant back and or leg pain following a back surgery or series of back surgeries. Failed Back Syndrome is an all too common condition. Many patients expect that back surgery will fix their back problem. That is not that case. You can’t cut away parts of the spine or fuse parts of the spine together and expect it to work normally and be pain free. Spine surgery may give pain relief but studies show that within 18 to 24 months the pain is typically the same for patients the had surgery and those that didn’t. Make sure you have exhausted all types of conservative care before you submit to back surgery. Failed back surgery syndrome is the worst possible outcome of back surgery.
As you may surmise, pain is the major symptom after a back surgery that indicates Failed Back Surgery Syndrome. It can vary from a dull pain that radiates into the hips, buttocks and thighs or it can be a sharp pain in the back and legs.
Pain following surgery may be caused by scar tissue that’s unavoidable with every type of surgery. The surgery may have also resulted in the onset of infection or the inflammation of a joint leading to pain. Many patients continue to need narcotic medications for pain control over one year after surgery. And this can lead to its own set of problems; opioid addition. The reasons for the pain may stem from the surgery or the surgery simply did not resolve the back pain it was designed to correct in the first place.
Categories of Failed Back Surgery
There are essentially three categories of failed back surgery patients. The first involves those patients who had back surgery for the wrong reason in the first place. This may include a patient for instance, who was deemed to have a degenerative disc disease problem with a fusion at the suspected level, and the person did not in fact have symptoms being generated from that level.
The second category of failed back surgery patients, are those whose surgery was in fact indicated, and the procedure was inadequately performed. Or, it was done very well but the desired outcome was not achieved. It is well known, that even if a back surgery is done for the right reasons and technically done perfectly, a patient may still not achieve the desired pain-free outcome.
The third reason that a back surgery can fail is that over time, degeneration may occur in areas around the surgery. For instance, the patient may have an excellent outcome with a fusion performed at L4 – L5, only to have renewed pain in a year or two when the level above or below breaks down.
What We Can Do
Additional treatment for failed back surgery syndrome may include physical/rehabilitation therapy along with chiropractic treatment. This may include stretching and strengthening the back muscles with specific MedX Lumbar Extension machine. Special type electrical stimulation devices, ultrasound and ice and heat may be used. Along with these, therapeutic massage can help break up some scar tissue for relief. Pulsed Electromagnetic Frequency (PEMF)has been helpful in promoting healing as well as Ozone therapy.
Interventional treatments with our pain doctor may also be indicated. These may include trigger point injections, facet blocks, injections of numbing pain medicine around painful hardware, along with intermittent epidural steroid injections.
As a last resort treatment for failed back surgery syndrome, spinal cord stimulation has been shown to provide very good results. Stimulators do not fix the problem that led to fill back surgery syndrome, but if it is something that cannot be corrected with a revision surgery, then at least masking the pain may be the next best possibility.