Low back pain is a major cause of disability and chronic pain problems. It is the most common reason for medical consultations. Low back pain also interferes with work performance, quality of life, and usual activities of daily living. Because millions of people have spine problems, surgery of the spinal column is common. Unfortunately for a small percentage of these patients, the surgery does not relieve the pain, or a new problem develops after surgery. Pain following back surgery is called failed back surgery syndrome.
How common is back pain?
Back pain is the most common musculoskeletal condition in the industrialized society. This problem is also the most common cause of disability in people 45 years of age and younger. In our society, 90% of adults will have back pain at some time during their lives. As the primary cause of work related injuries, back pain is the main reason for time off from work, medical and legal expenses, and long-term disability.
How many people develop FBSS in the United States?
Around 20% of Americans who undergo spine surgery each year continue to have some degree of persistent neck, back, arm, and/or leg pain afterwards. When spinal surgery does not achieve the desired results, it is called failed back surgery syndrome.
What are the symptoms of failed back surgery syndrome?
With failed back surgery syndrome, symptoms include a diffuse, dull, and aching pain involving the back and/or legs (or neck and/or arms), depending on the site of surgery. In addition, patients also have sharp, burning, stabbing, and radiating pain into the extremities (radiculopathy).
What causes failed back surgery syndrome?
FBSS can occur after spine surgery, when the procedure does not achieve the desired result, or when some other problem occurs. Also called post-laminectomy syndrome, many causes have been associated with this condition. For many people, the spinal nerve root, which was decompressed by the surgery, simply does not recover from the prior trauma, and continues to send pain signals to the brain. For other patients, the body forms lots of scar tissue, which surrounds nerve roots and causes persistent pain.
What factors contribute to failed back surgery syndrome?
Contributing factors include compressed nerves, herniated disc(s), altered joint mobility, muscle deconditioning, scar tissue formation, and facet or sacroiliac joint degeneration. Many patients suffer post-operative spinal or pelvic ligament instability, which gives rise to sacroiliac joint dysfunction and chronic pain.
How is failed back surgery syndrome diagnosed?
The Colorado pain physician will review your surgery notes, review treatment history, and consider your current health problems. In addition, the doctor will perform a thorough neurological and musculoskeletal examination. Certain diagnostic tests may be ordered, such as radiographs (x-rays), computed tomography (CT scan), and magnetic resonance imaging (MRI scan).
How is failed back surgery syndrome treated?
Treatment of failed back surgery syndrome often begins with medications and physical therapy. The therapist works with the patient to strengthen the back and leg muscles, improve mobility and flexibility, and loosen tight joints. Medications are used to decrease inflammation (ibuprofen, ketoprofen, and naproxen), relax muscles (Baclofen and Flexiril), and target nerve-related pain (Neurontin and amitriptyline).
When medications and physical therapy do not help, the doctor may recommend facet joint injections, facet joint rhizotomy, sacroiliac joint injections, and epidural steroid injections. The treatment regimen depends on the findings from the diagnostic tests and physical exam.
As a last resort treatment, a spinal cord stimulator implant is a great option to obtain relief. The latest implants have over 200 programming options and are great for treating both back and leg pain.
Colorado Clinic offers top pain treatment at seven locations with Double Board Certified providers. Over 25 treatment options are available including both medication management and interventional procedures. Most insurance is accepted, call today to get relief!