What is Spine Surgery Pain?
Spine surgery may not alleviate all pain associated with the condition causing symptoms. After spine surgery, a patient may find themselves still suffering from back pain. To decide the proper treatment plan, many steps need to be taken.
An office visit at a pain specialist for pain after back surgery should include obtaining a history, performing a physical exam, and doing additional studies. The patient may also be asked if they have recently seen the spine surgeon that did their back surgery. Once this information is gathered and a diagnosis is made, then a treatment plan can be created and executed. While treating back pain after spine surgery, the process in finding the best answer to this question usually involves a look at the patient history, a physical, and some additional tests.
Causes of The Condition
Spinal surgery pain is a direct result from surgical intervention to treat a variety of other conditions that affect the back.
To determine the issue, thorough history about recurring back pain and symptoms should be obtained. How did the symptoms return? Was there a fall or some type of accident that brought the symptoms on? Are the symptoms the same as before? If there is no inciting event, and the symptoms are of similar nature prior to the back surgery, then more than likely there is not new pathology with the spine. This, of course, is not always the case, so further information is always needed. The pain physician may also inquire about any radiating “tingling” or “numbness” sensation down the lower extremities. Is there weakness? Does the pain feel “burning”? Serious symptoms could include bowel or bladder incontinence or new weakness.
Treatment for Spinal Surgery Pain
As a general rule, most pain physicians will have the patient re-evaluated by the spine surgeon who did the initial surgery. Special care should be taken to explain to the patient that this does not necessarily mean that they will have to have another back operation. It is an important step in the diagnostic and treatment plan process. If the patient has significant new pathology and is at risk for permanent spinal cord injury, then a second surgery may be needed. If the patient has a diagnosis that is non-surgical, then many different treatment options can be explored. A good spine surgeon and pain specialist will work in concert together, along with the goals and desires of the patient, to determine if a re-operation is best.
Conservative treatment measures such as physical therapy and medications that include non-steroidal anti-inflammatory drugs (NSAIDS) or muscle relaxants may suffice. Chiropractic care and acupuncture are options. Treatment to fix vertebral body fractures can be done by placing cement in the bones through a procedure called vertebroplasty. Facet joint pain can be alleviated by cauterizing the nerves to the joints utilizing a procedure called radio frequency ablation. Minimally invasive procedures can be highly successful in treating this type of pain.
Lastly, if all conservative and minimally invasive avenues are exhausted and the patient’s pain still persists, a spinal cord stimulator (seen here) may be recommended.
Pain after spine surgery can be complex to diagnose and difficult to treat, but hopefully with the right pain specialist and surgeon, you can find the best options for you.