Back surgery is often performed with one goal in mind: reducing your pain and helping you get back to the activities you enjoy. While many people experience significant relief, some continue to have pain after surgery or develop new symptoms months or even years later.
If that sounds familiar, you're not alone. Anywhere from 10-40% struggle with pain even after surgery.
Persistent pain after back surgery is common enough that it has its own name: failed back surgery syndrome (FBSS), sometimes called persistent spinal pain syndrome (PSPS). Importantly, this doesn't necessarily mean your surgery "failed." It simply means pain continues despite surgical treatment.
At Spine Group Beverly Hills, Dr. John Regan and our team can identify the source of your ongoing pain and explore treatment options that may help improve your quality of life.
In the meantime, here are the most common causes of pain after back surgery and what we can do about them.
Scar tissue is a normal part of healing. However, in some cases, it can develop around your spinal nerves, contributing to ongoing irritation, inflammation, or nerve pain.
This is called epidural fibrosis, and it’s one of the most common causes of pain after back surgery.
Symptoms may include:
Post-surgery epidural fibrosis can affect as many as 30% of people who have a lumbar laminectomy.
Even after a successful surgery, a disc can sometimes herniate again in the same place. When this happens, the disc may once again compress nearby nerves and lead to symptoms similar to those experienced before surgery, including sciatica, leg pain, and weakness.
When one section of your spine is surgically stabilized, the neighboring spinal segments sometimes experience increased stress.
This additional wear and tear can contribute to degeneration above or below the surgical site. This can result in new pain months or years after the original procedure.
Certain factors can increase your risk of developing adjacent segment disease after back surgery. This includes diabetes, having a high body mass index (BMI), and spinopelvic sagittal imbalance.
If a nerve was compressed for a long time before surgery, it may take months to heal, and in some cases, it may not fully recover.
Even when surgery successfully removes the pressure, damaged nerves can continue sending pain signals long afterward.
Back pain isn't always caused by a single problem. Sometimes a person may have multiple pain generators, such as facet joint arthritis, sacroiliac (SI) joint dysfunction, muscle-related pain, and nerve pain.
If one source is corrected surgically but another remains untreated, pain may persist.
The good news is that surgery isn't your only option. Depending on the cause of your symptoms, treatment may include:
Dr. Regan first identifies what's causing your pain before recommending the next step. For some people, that may include spinal cord stimulation.
A spinal cord stimulator uses mild electrical signals to change the way pain signals travel between your spinal cord and brain. While it doesn't correct the underlying structural issue in your back, it can help interrupt pain signals before they reach your brain. As a result, many people experience relief from back pain, leg pain, and overall pain related to FBSS.
If you've already had back surgery but continue to struggle with chronic pain, it may be time to seek a second opinion from Dr. Regan. A fresh set of expert eyes can help determine whether your symptoms are related to scar tissue, nerve damage, recurrent disc problems, or another underlying issue.
You may benefit from a second opinion if:
In many cases, a comprehensive evaluation with our team can uncover treatment options you may not have previously considered.
If you're struggling with pain after back surgery, don't assume you simply have to live with it.
Schedule a consultation to learn what's causing your symptoms and what treatment options may help you find relief.
You can also reach us via phone at 424-238-3281.
