I'm Still in Pain After Back Surgery: Now What?

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I'm Still in Pain After Back Surgery: Now What?

It’s normal to expect an improvement in pain symptoms after back surgery. After all, that’s likely the reason you chose surgery to start with. Given the complexity of the spine and nerve tissue, your outcome may not provide the relief you hoped.

It’s disappointing to find that after back surgery to relieve pain you still feel pain. It’s medically known as failed back surgery (FBS) or failed back surgery syndrome, but the name is somewhat misleading.

Your surgeon can successfully complete a procedure, but due to a number of unpredictable factors relating to the complex nature of nerves and the spinal column, pain may remain. 

Estimates tell us that 10%-40% of back surgeries result in FBS. While additional surgery might deliver better results, your chances of success fall with each subsequent procedure. 

At Metro Anesthesia & Pain Management, we look to multimodal approaches to back pain treatment for patients with FBS symptoms. In many cases, these treatments are the same as those that often postpone the need for surgery for other patients. 

The limits of back surgery

Spine surgery accomplishes only two goals. It can remove the physical reasons for nerve compression, such as a herniated disc or bone spur, or it can stabilize a dysfunctional spinal joint, through a procedure called fusion. 

Achieving these goals often brings pain relief, but spine surgery can’t directly target the causes of your pain symptoms. Instead, your surgeon looks to the probable causes of nerve irritation. Nerve tissue doesn’t always respond as expected. Pain signals may continue even when these causes are gone. 

Treatment approaches to turn to after FBS

Because back surgery doesn’t directly treat nerve tissue, alternate treatment approaches that do may prove more successful on chronic pain. Spinal cord stimulation and radiofrequency ablation are two examples. 

Spinal cord stimulators

Spinal cord stimulators use a pacemaker-like generator to send tiny electrical signals into target nerves. These signals scramble the nerve impulses that send pain messages to your brain. Your perception of pain reduces or disappears. 

Operated with a remote control, a spinal cord stimulator can act as a drug-free “pain pump,” delivering relief as needed, on command. 

Radiofrequency ablation

Radiofrequency ablation is a minimally invasive procedure that destroys targeted nerve tissue. It’s ideal when you have chronic pain signals when there’s no longer a physical reason for your pain. The radiofrequency probe creates heat that compromises the nerve tissue and stops pain signals. 

Other nonsurgical options

Other nonsurgical approaches after FBS include physical therapy and occupational rehabilitation. Strengthening support muscles and finding alternatives to problem tasks can reduce the burden on your spine and nerves, reducing or eliminating pain. 

Exercise increases blood circulation, a key to effective natural healing from the body. 

Drug-based therapies include joint injections with corticosteroids, which provide longer-term relief from inflammation, and low-dose ketamine intravenous (IV) infusions, which can also provide long-lasting relief from chronic pain symptoms. 

The ideal plan for you depends on your condition and how long it’s been a problem. At Metro Anesthesia & Pain Management, we review your back pain history and provide a detailed assessment of your current condition to target a personalized treatment plan. 

Call or click to set an appointment with our office in West Des Moines or Des Moines, Iowa. You’ve suffered long enough. Let us help you find an effective solution to your pain. Book your visit today.