3 Treatment Strategies For Failed Back Surgery Syndrome

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Significant back pain is a common cause for chronic pain and long-term disability. In some cases, back surgery does not solve the problem and may have made matters worse. If you had back surgery without success, there may be more you can do to reduce pain.

Reevaluate The Problem

Ideally, you will have a second opinion regarding the initial diagnosis for back pain. Some cases of back pain were misdiagnosed, leading to surgery that did not fix the real problem. For example, problems with the sacroiliac joint are often misdiagnosed as back pain. This means some people have undergone surgery to fuse vertebrae or repair discs, only to find out their sacroiliac joints were hypo- or hypermobile. Having a second opinion can be crucial for evaluating your original imaging tests and medical records. Your new surgeon will likely want updated imaging tests to see what was done to fix the problem and determine if the original surgery could have possibly caused new damage, explaining new or ongoing pain. Other problems that might occur are the formation of excessive scar tissue that can lead to stiffness of the back and surrounding muscles.

Integrate Physical Therapy

Physical therapy is a useful tool in failed back surgery syndrome because your current pain may be caused by other changes in biomechanics. In addition to the pain caused directly by your back problem, you likely lie, sit, and stand differently due to pain or physical limitations. Unfortunately, these changes in posture and gait will likely add to the problem. Your physical therapist can develop a set of exercises that might help you regain strength to normalize your posture. Additionally, finding new ways of doing ordinary activities can help with pain or at least prevent exacerbation of pain. Physical therapists frequently recommend devices, such as back braces or other supports, which can make it easier to maintain better posture. Sometimes the compression from these devices also helps with pain.

Improve Pain Management

Pain management is critical for failed back surgery syndrome and a neurosurgeon may be able to offer options beyond pills. For example, a pain pump is a common method of delivering effective pain control, while reducing the abuse potential associated with oral opiates. Inserting a pain pump requires a surgical procedure to determine the exact nerves responsible for the pain and place the electrodes. The dispensing of medication is controlled by a device outside of the body, which is programmed by your doctors. Generally, people with pain pumps need less pain medication than if they used the same medication orally. Since the medication is dispensed directly at the nerves, a lower dose is more effective.

For some people, their back pain remains unresolved even after surgery. Seeking a second opinion can give you new options to minimize pain from a failed back surgery. 


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