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The pain of failed back surgery syndrome occurs due to a buildup of scar tissue around the spinal nerve roots after the surgery. This is often accompanied with persistent muscle spasm and tissue pain. In addition, joints or nerves may become irritated during the surgical procedure. The pain following back surgery can be reduced, but chronic pain following back surgery is categorized as FBSS. Common causes of FBSS include:

. Pain from another region of the spine
. Failure of the spine to fuse
. New or recurrent disc herniation
. Nerve compression
. Failed spinal implant

The pain after a laminectomy or other back surgery may subside as the patient continues to heal. However, during this time, the patient may notice pain in the neck or back, which can radiate into the limps. Patients with FBSS often describe aching, throbbing, persistent pain that is worse with certain activities.

Certain conditions raise the patient’s risk for developing pain after back surgery. These include:

. Diabetes
. Systemic lupus erythematous
. Peripheral vascular disease
. Depression and/or anxiety

The treatment for failed back surgery syndrome depends on the underlying cause, as well as the severity of the pain. Treatment options include:

Medications - Both non-narcotic and narcotic pain medicines are used for pain following back surgery. In addition, the doctor may prescribe antidepressants, such as amitriptyline.

Physical therapy - To reduce pain and improve function, the doctor will start you in a physical therapy program. The therapist uses exercise, massage, and stretching techniques to increase flexibility and relieve pain.

Epidural steroid injection (ESI) - To reduce inflammation, the doctor can inject a corticosteroid into the epidural space outside the spinal cord. Sometimes an anesthetic is added for immediate pain relief. ESI has an 80-90% success rate, based on current clinical reports.

Facet joint injections (FJIs) - Usually given in a series of three, these injections involve insertion of tiny needles into the facet joints of the spine. The doctor injects an anesthetic, with or without a corticosteroid, into the joint space and near the spinal nerves. FCI is proven to offer both short- and long-term pain relief for patients with back pain.

Intrathecal pain pump - To deliver pain medicine directly into the spinal fluid to bypass the gastrointestinal tract, the doctor can implant a small unit into the patient’s torso.

Spinal cord stimulation (SCS) - This device is implanted in the abdomen region or buttocks. A wire with electrodes is attached near the affected nerves. The generator sends electrical pulses to the nerves, which interfere with pain signals. SCS is only considered when a patient with FBSS fails on other treatment measures.