Failed back surgery syndrome, or FBSS, is a complex and often misunderstood condition that affects between 10 and 40% of patients who undergo spinal surgery. Despite the best efforts of skilled surgeons, not all spinal surgeries lead to the desired outcomes, leaving some patients in persistent or even worsening pain. Understanding the signs of failed back surgery syndrome, and the available treatment options is crucial for managing the condition.
What is Failed Back Surgery Syndrome?
Failed back surgery syndrome refers to the continuation or recurrence of pain following spinal surgery. It’s important to note that FBSS is not a specific diagnosis, but rather a generalized term used to describe a range of symptoms experienced by patients whose spinal surgeries did not achieve the intended results.
Common Symptoms of Failed Back Surgery
Recognizing the symptoms of failed back surgery is the first step toward seeking appropriate care. Symptoms vary widely depending on the patient and the type of surgery performed, but some of the most common signs include:
- Persistent pain: The most prevalent symptom of FBSS is ongoing pain that can be as severe, or even worse, than the pain experienced before surgery. Pain can be localized to the surgical site, or radiate to other areas, such as the legs, buttocks, or back.
- Limited mobility: Many patients with FBSS experience reduced mobility, stiffness, or difficulty performing daily activities. This can be due to lingering pain, muscle weakness, or nerve damage.
- Neurological symptoms: Some patients may experience numbness, tingling, or weakness in the limbs, indicating potential nerve damage. In severe cases, this can lead to more serious complications, such as loss of bladder or bowel control.
- Emotional distress: Chronic pain and limited mobility can take a toll on mental health, leading to feelings of depression, anxiety, or frustration.
Failed Back Surgery Syndrome Treatment
Treating failed back surgery syndrome requires a tailored approach to the individual needs of the patient. The primary goal is to alleviate pain, improve function, and enhance the patient’s quality of life. Common treatment options include:
- Medication: Pain management often begins with medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or neuropathic pain medications. In some cases, stronger pain relievers like opioids may be prescribed, but these are usually considered a last resort due to the risk of dependency.
- Physical therapy: Physical therapy helps patients regain strength, improve flexibility, and reduce pain through targeted exercises. A physical therapist can also teach patients techniques to manage pain and prevent further injury.
- Injections and nerve blocks: For patients who do not respond to medications or physical therapy, injections such as epidural steroid injections or nerve blocks may provide temporary pain relief. These treatments can help reduce inflammation and interrupt pain signals.
- Spinal cord stimulation: In some cases, spinal cord stimulation (SCS) may be recommended as a treatment for failed back surgery. This involves implanting a device that delivers electrical impulses to the spinal cord, which can help reduce pain by altering the way pain signals are perceived by the brain.
- Surgery: Although less common, additional surgery may be considered in certain cases where there is a clear structural issue, such as a herniated disc or spinal instability. However, repeat surgeries carry their own risks and are not always successful.
Pain Management for Failed Back Surgery Syndrome
Pain management for failed back surgery focuses on a comprehensive approach that addresses both the physical and emotional aspects of the condition. Patients may adopt a combination of medications, physical therapy, and interventional procedures to manage pain effectively. Healthy habits like regular exercise, eating whole foods, managing weight, and quitting smoking can also improve overall outcomes. Access to counseling or support groups helps patients cope with the emotional challenges of living with chronic pain. Lastly, continuous monitoring and follow-up care with a patient’s healthcare provider ensures that the treatment plan is effective. It’s important to consult with a physician to determine the best step forward.
Find Relief with the Pain Institute of Middle Tennessee
The Pain Institute of Middle Tennessee works with patients to develop a comprehensive pain management plan to help alleviate symptoms associated with FBSS. If you or a loved one currently suffers from chronic pain after back surgery, we recommend scheduling a consultation to speak with our specialists.