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Failed Back Surgery Syndrome

Failed back surgery syndrome, or FBSS, is any persistent or recurrent pain after spinal surgery. Pain symptoms may come immediately following surgery; some patients have described the pain to have never left, or even worsened post-surgery. Other patients experience pain weeks, months, or even years after surgery. Learn about why it happens, the symptoms patients experience, and treatment options.

What causes failed back surgery syndrome?

Post-operative pain is normal after any surgery, but pain should fade or disappear completely a week or two after surgery. If the pain does not lessen, or if it becomes worse, a patient may be suffering from failed back surgery syndrome. 

FBSS is most commonly seen in those who have undergone spinal fusion surgery. In these cases, the spine does not fully fuse together after surgery, and the healing process remains incomplete. Over time, patients may experience their pre-surgery pain or develop new back pain. Sometimes failed back surgery syndrome is the cause of treating a single spinal level when the pain originates from several different levels. 

The best doctors for failed back surgery syndrome will undergo multiple diagnostic tests to determine a clear cause of the back pain. They will also make sure that the diagnostic findings match the symptoms experienced by their patient. Healthcare professionals should also recognize the risk factors in a patient before the surgery. High-risk factors in a patient include:

  • Psychological issues like anxiety and depression
  • Habits that negatively affect health, like smoking
  • Pre-existing medical conditions
  • Multiple prior back surgeries
  • Specific lower back diagnoses (spinal stenosis, lumbar disc herniation) 
  • Altered joint mobility and scar tissue (fibrosis)

What are the symptoms of failed back surgery syndrome?

The most obvious symptom of failed back surgery syndrome is pain after the spinal surgery. Pain can appear immediately post-surgery, or even a few weeks, months, or years later. Some patients describe the pain as being localized to their back or their leg, while others experience pain moving from their back to their leg, or from their leg to their back. The pain may feel similar to the pain felt pre-surgery, or it may feel completely different. 

Other motor and sensory symptoms can be present, including numbness and weakness in the legs, which may restrict mobility and therefore cause an inability to recuperate and recover properly. Some patients may also experience heightened anxiety, depression, and sleeplessness. 

What are the treatment options for failed back surgery syndrome? 

A team approach is best for patients who experience failed back surgery syndrome.

Physical therapy is critical for patients recovering from any type of spinal surgery. Ongoing physical therapy helps decrease pain, reduce inflammation, address joint stiffness, and increase mobility. Therapists can also help patients learn to do everyday activities more safely, like sitting up or down and lifting and carrying with proper technique. 

Non-steroidal anti-inflammatory drugs, or NSAIDs, can help reduce pain and inflammation. Common over-the-counter NSAIDs include aspirin and ibuprofen. If pain becomes excruciating, doctors may prescribe stronger NSAIDs. 

Nerve blocks, transcutaneous electrical nerve stimulation (TENS), microcurrent electrical neuromuscular stimulators, membrane stabilizers, and spinal cord stimulation are also other viable treatment options for those suffering from failed back surgery syndrome. 

If pain persists despite ongoing treatment, patients may require additional surgery. 

The Pain Institute of Middle Tennessee can help patients experiencing failed back surgery syndrome. Schedule an appointment with one of our physicians today.