It seems unfair. You opt for spine surgery to manage your back pain, but weeks after you should be on the mend your pain lingers (or is getting worse!). Even with cutting-edge spinal surgery techniques and technologies, some patients can experience lingering back pain after surgery. Spine surgery pain is also referred to as post laminectomy syndrome or failed back surgery pain. Here’s what it is—and what to do about it.
What Is Spine Surgery Pain?
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Lower back pain is a very common condition experienced by millions of people in the United States. Approximately 85% of the adult population suffers from some form of back pain during their lifetime.
Spinal surgery is also becoming more common to address this pain or other issues. Lumbar fusion procedures have risen over 62% in the past decade, and lumbar surgeries in general increased from 54% to 78% in the past decade, too.
With the increase in surgical procedures and advances in technology, you’d think that spine surgery would be the answer for your back pain. That’s not always the case. Many patients experience significant pain relief from spine surgery, but a growing body of research has shown that not everyone finds relief.
For lumbar disc herniation, patients receiving discectomies reported successful pain relief almost 85% of the time. Spinal fusion success rates were significantly lower, with only ten to 40% of patients adequately pain-free. That means, at a minimum, 15% of patients are still suffering, and as many as 90% have spine surgery pain.
If you need more than one spine surgery? Success rates for all procedures plummet. Typical symptoms associated with failed back surgery include:
- Dull, persistent ache in the back or legs
- Sharp pain in the limbs
- Abnormal sensations in the limbs
- Stabbing pain in the back or limbs
Symptoms range from mild and annoying to completely debilitating.
Why Do I Still Have Pain After Spinal Surgery?
The International Association for the Study of Pain defines failed back surgery as “lumbar/cervical pain of an unknown origin that either persists despite surgical intervention or appears after surgical intervention.”
But why do you still have spine surgery pain? There are a few possible reasons for pain after spine surgery.
Another disc has herniated
Disc herniation is not only one of the most common causes for back pain, it’s also one of the most common reasons you might have pain, even after surgery. In some cases, removing disc material to repair a herniation can lead to weakness in other parts of the spine. This weakness may cause another herniation and a return of pain after spine surgery.
Fibrosis (scar tissue) forms
Scarring in the epidural region after surgery is common. An estimated 20 to 36% of pain after spine surgery can be traced directly to the build-up of scar tissue, post-surgery. This build-up of scar tissue can cause compression in the spine, loss of mobility, and pain after surgery.
The muscles of the spine became weak
In the months or years leading up to your surgery, chances are good that the supportive muscles in your back and abdomen took a hit. After all, it is very challenging to focus on exercise when you are in pain.
Unfortunately, this loss of muscle tone begins a vicious cycle that can result in pain after spine surgery. All types of spinal surgeries can potentially change how your weight is placed on the spine. This change, combined with existing muscle weakness, can lead to more muscular instability and more spinal pain.
There are a few other causes of spinal surgery pain, including:
- Lifestyle factors, such as smoking, that increase healing times
- Spinal stenosis that develops as muscles weaken
- Errors that occur in surgery
- Post-operative infection stalls healing and causes more pain
It is also possible that additional spinal conditions can develop, unrelated to the initial surgery. It’s important to talk to your doctor to pinpoint the exact cause of your pain after spine surgery.
Spine Surgery Pain Treatments That Can Help
The first step to treating your pain after spine surgery is to identify the cause of the pain. In some cases, you might just need a longer time to heal. Our bodies are as individual as we are, so it might take longer for your post-operative pain to subside.
If you are well out of your recovery period and still experiencing pain after spine surgery, then it’s crucial to pinpoint the cause. In general, barring additional surgeries for specific cases, treatments for spine surgery pain might include the following.
Over-the-counter or prescription medications are often used in conjunction with other treatments. This helps manage pain levels to give additional treatments time to work.
Typical medications for spine surgery pain might include the following:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Muscle relaxants
- Antidepressant and anti-convulsant medications
It’s important to note that opioids are generally not recommended for chronic pain. Talk to your doctor to see what might work for you.
Physical therapy is the gold standard when it comes to treating post laminectomy syndrome and failed back surgery pain. The physical and psychological benefits of guided exercise speed healing and improve patient quality of life.
Physical therapists teach patients how to better use their bodies and prescribe specific strengthening and mobility exercises. They also provide pain relief during sessions in the form of:
- Cold and hot compresses
- Electrical stimulation
A complete physical therapy program can help to reduce spine surgery pain and decrease the chances of re-injury (or further surgery).
If physical therapy and medications fail to provide adequate pain relief, your doctor might recommend more interventional treatments such as:
Even though they are referred to as “interventional,” these techniques are minimally invasive and can be highly effective for treating chronic spinal pain.
Complementary therapies are offered at the same time as other treatments. They can provide not only pain relief but also emotional and stress support for patients.
These treatments can include:
Most patients who suffer from spine pain after surgery find that a combination of treatments provide the best chance for relief.
If you are feeling spine surgery pain long after you should have recovered, you don’t have to suffer. A pain specialist can create a treatment plan to help you get your life back.
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