Persistent Pain after Back Surgery


 

Following back surgery—even a successful one—some patients experience persistent or new pain, and there are a variety of reasons for this. The pain could be caused by failed back syndrome, which refers to the failure to achieve complete symptom resolution—not failure of the goals of the original surgery—which may have included decompression and stabilization. The formation of scar tissue after back surgery is another possible reason for pain normal healing process. Although scar tissue pain is unusual, epidural fibrosis, which is the formation of scar tissue near the nerve root, can result in pressure and pain. Symptoms associated with epidural fibrosis appear six to 12 weeks after surgery, with sensations such as burning pain or a constant pain that remains unchanged regardless of position.

Issues that could lead to pain after surgery are a missed fragment of the disc or bone is still pinching the nerve, the operation was done at the wrong level of the spine, or dissection of the nerve root may have caused further trauma, as it becomes inflamed and leads to temporary pain. Back pain after surgery may also be caused due to improper preoperative patient selection. In a decompression surgery, such as a laminectomy or discectomy, patients who have not noticed any improvement approximately three months afterward are unlikely to receive substantial benefit from the surgery.

The doctor will conduct a physical exam and diagnostic imaging, such as magnetic resonance imaging (MRI) and computed tomography (CT) scans, to determine the cause.

Treatment for these painful conditions may include spinal cord stimulation, which is approved by the U.S. Food and Drug Administration for those who have not had success with other chronic pain treatments. The implanted device delivers mild electrical pulses to the spine, causing a tingling sensation in chronic pain site.

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