Failed back surgery syndrome is the term used to describe recurring or persistent pain in the back or legs following a lumbar spine surgery. Often, surgery is used to fix an anatomical problem, such as a herniated disc pushing on a nerve. Unfortunately, even in the hands of the most skilled surgeon, some patients will continue to have pain after the anatomical problem has been repaired. The exact number of patients who continue to have pain is not clear; however, more extensive surgeries and multiple operations appear to increase the risk of this syndrome.

 

There are many reasons why patients may continue to have pain. Low back pain is often from more than one source. For example, there could be pain from a herniated disc, or pain from arthritis in the small joints, known as facet joints. After repair of one problem, pain may persist from the other. There can be a problem related to the surgery itself, such as a complication of hardware that was inserted or an infection. Continued degeneration of the discs and joints of the spine can also cause pain. Epidural fibrosis (also known as scar tissue formation) and arachnoiditis (also known as nerve inflammation) may also cause pain.

The best treatment is prevention. Non-operative therapy should be the first step in treating low back pain, unless there is a clear anatomical problem that requires surgical intervention. Patients should be aware that even with a skilled surgeon, there is no guarantee of complete pain resolution from a low back surgery.

If a person develops FBSS, it is important to have a multidisciplinary approach to treatment of this complex problem. If there are no problems requiring surgical intervention, then multidisciplinary care involving physical therapy, medications and spinal injections should be pursued. Not only should physical therapy include treatments for pain (like deep heat), but also muscular training exercises and how to build up strength to decrease pain. FBSS therapy may also include spinal injections, such as injections around the nerves, discs or small joints in the back or neck. Epidural steroid injections are the most common, but there are several other injections that may be helpful for treatment or facilitating diagnosis.

There are some patients that do not respond to less invasive techniques, but they may benefit from more intensive treatments, including spinal cord stimulation or pain pump implantation. Spinal cord stimulation is frequently used for the leg pain associated with FBSS. A small lead is placed in the epidural space around the spinal cord and masks pain by producing a tingling or tapping sensation in the place where pain is felt. Before having the device implanted permanently, a screening trial is performed. A temporary lead is placed where the patient feels pain and they are able to test their response to the device. Once it is properly implanted it is able to be turned on and off, and able to be adjusted. Another treatment is pain pump implantation, also known as intrathecal drug delivery system implantation. This pump will place medication directly into the fluid around the spinal cord, which requires a much smaller dose of medication than when taken orally. Because the medication does not circulate throughout the body and a much smaller dose is used, the frequency of side effects is less. Though morphine is the most commonly used medication in these pumps, some other opioid and non-opioid medications can be used successfully.

 

Failed Back Surgery Syndrome - How to Treat It

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The Failed Back Syndrome: Etiology and Therapy $189.15 No Synopsis Available

End Your Carpal Tunnel Pain Without Surgery: A Daily 15-Minute Program To Prevent & Treat Repetitive Strain Injury Of The Arm Wrist And Hand $10.19 This helpful guide tells how to prevent and treat Carpal Tunnel Syndrome in just fifteen minutes a day. This proven twelve-step routine of adjustments stretches and exercises can eliminate CTS pain without surgery. Illustrated and indexed.

Treat Your Back Without Surgery (Paperback) $28.46 Description not available.

When To Bypass Back Surgery $7.99 My book describes the significance and difference of low back pain among a child, adult, or elder. It guides the nonmedical reader how to evaluate low back pain, how it should be treated, and it emphasizes a conservative nonsurgical treatment. I wrote a chapter about the anatomy of the lower spine, so the lector will have a better understanding of the medical condition; a chapter about sciatic pain, central and lateral hemiated discs, spinal stenosis, sacroiliac strain, and coccygodynia; one about and when surgery is indicated and how to go about a consultation and "second opinion"; I talk about physical therapy and its multiple modalities; as well as manipulation, acupuncture, and trigger points injections. I have a small chapter of the most common surgical procedures and also about painkillers and analgesics. I describe my own exercise program for the treatment of low back pain. Finally, there is a chapter that I call Useful Resources, a Web page where the reader can obtain serious professional information about the subject. I feel that this small book could be useful to the average reader, to these days of "medical propaganda" when we are paying for unnecessary surgery and tests, which are very costly and sometimes with catastrophic results.

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