The decision to have lumbar spine surgery for chronic back pain is not an easy one to make. Usually patients are at their wits end with daily, disabling pain that has not responded to considerable conservative treatment.
The hope with back surgery performed for degenerative disc disease is that it will alleviate the bulk of an individual’s discomfort. However, all too often one of two things happens.
The first is that the back surgery fails because it was done for the wrong reason. It’s not always the surgeon’s fault, as it can be very difficult to delineate the exact source of a patient’s back pain.
The second reason is that the back surgery only worked partially. Meaning that only 30 to 50% of the individual’s pain is resolved, leaving the individual with continued back pain that bothers the person on a daily basis. The third potential outcome is that the correct surgery was performed but the surgery did not take, which means a revision is necessary. This review is only covering those indications where there is no reason for another back surgery.
So what to do when another surgery is not indicated and continued back pain exists after low back surgery? The question does not have a simple answer, and here are some options for pain relief.
The first option is for over-the-counter pain medicines such as anti-inflammatories and Tylenol. I know this sounds very basic, but these medications work very well for a lot of individuals suffering from mild to moderate pain. On those days when the back pain is not severe, potentially narcotics can be avoided and these medicines will suffice.
For those times when the pain is excruciating, short-term narcotics are beneficial. For long-term usage, opiates are discouraged as the risks starts out with the benefits. These risks include tolerance, addiction, difficulty concentrating, hormone abnormalities, and chronic constipation.
Additional medications that may help include neurogenic modulation ones such as Lyrica and Neurontin. These may help a lot if there is a leg pain component involved.
Chiropractic treatment may offer temporary relief for back pain after failed surgery. Manipulations can help along with electrical stimulation, physical rehabilitation exercises and cryotherapy. A TENS Unit can offer relief by emitting slight electrical impulses through the skin, which can change the way the brain perceives pain signals.
Spinal decompression therapy may provide pain relief to those individuals who have continued back pain after surgery. If the person has spinal instrumentation in place, decompression therapy is not indicated.
Physical therapy treatment may offer relief by strengthening up one’s core, and additional ultrasound, electrical stimulation, and massage can offer substantial relief.
Interventional pain management continues to improve every year with new and improved options. Here is a list of those available:
- Trigger Point Injections
- Injections around painful hardware
- Caudal Epidural Injections – have been shown to provide relief for both back and leg pain after failed back surgery
- Facet Injections & Medial Branch Blocks
- Radiofrequency Ablation
- Spinal Cord Stimulator Implants – may help as a last resort for masking the pain. They don’t fix the problem, but there is a good chance they can make life more tolerable.
Pain clinics in Los Angeles and Santa Monica areas treat those with failed back surgery often. It may take a combination of treatments to alleviate the pain. The California Pain Network connects those in pain with pain management Santa Monica and Los Angeles trust. Simply fill out the form on the page or call (310) 626-1526 for help today!