Managing Failed Back Surgery Syndrome

Quick answer: Failed back surgery syndrome means back or leg pain that continues, or comes back, after spine surgery. It’s common, and it doesn’t mean the operation was done badly. Exercise programs that start four to six weeks after surgery reduce pain and disability more than no treatment, and a whole-body approach can help with the hips, pelvis and upper back that still load the spine. Work alongside your surgeon, and get urgent care for the warning signs below.

What is Failed Back Surgery Syndrome (FBSS)?

Failed Back Surgery Syndrome (FBSS), a condition often abbreviated as FBSS or chronic low back pain post-surgery, highlights a significant dilemma in spine health management. Despite the advancements in spinal surgery, a considerable number of patients continue to suffer from persistent back pain, leg pain, or even worsening symptoms after undergoing spinal procedures. This prevalent issue underlines the complexities of spinal health and the limitations of traditional surgical interventions such as spinal fusion, laminectomy, or discectomy.

Traditionally, ​managing back pain involves a range of treatments, from invasive techniques like spinal cord stimulation and nerve blocks to conservative measures like NSAIDs and physical therapy. However, these approaches often address only the superficial symptoms, not the underlying biomechanical or neurological issues contributing to pain, leading to cycles of temporary relief followed by recurrent pain.

In contrast, Activ8 Posture introduces a holistic approach, emphasizing posture alignment therapy that delves deep into the root causes of pain. This therapy promotes long-term wellness and functional improvement of the spine and adjacent segments.

Exploring Non-Surgical Options Before More Surgery

Before you consider another surgery, explore every non-invasive option. At Activ8 Posture, we believe in exhausting all holistic avenues before turning to invasive methods. Our posture alignment therapy addresses the whole body, not just the symptoms, offering a foundation for robust health that traditional care often overlooks. This comprehensive approach prepares your body for potential surgeries and aids in more effective rehabilitation, targeting imbalances and structural issues that are commonly neglected.

20%

Approximately 20% of patients who undergo lumbar spinal surgery develop Failed Back Surgery Syndrome (FBSS).

40%

Studies show that up to 40% of spine surgeries may not result in significant pain relief, leading to a continued cycle of discomfort and additional surgeries.​​

1,200,000

Over 1.2 million spine surgeries are performed annually, with a significant percentage of these patients not achieving expected outcomes.

Understanding FBSS: Symptoms and Associated Conditions

FBSS manifests through various symptoms and related conditions, profoundly impacting quality of life. Patients typically report ongoing chronic ​low back pain, nerve pain radiating to the legs, and significant mobility restrictions. Complications like scar tissue (fibrosis) around surgical sites, persistent nerve root compression, and pseudoarthrosis contribute to these symptoms. Moreover, conditions such as spinal stenosis or recurrent disc herniation after an initial surgery might exacerbate or introduce new pain challenges.

Failed Back Surgery Syndrome most commonly arises following surgeries intended to alleviate chronic back pain, such as:

1. Lumbar Laminectomy: Intended for decompressing the spinal canal to relieve nerve pressure, especially in cases of spinal stenosis.
2. Lumbar Fusion: Aims to stabilize the spine by fusing two or more vertebrae together using bone grafts and hardware. This is often performed for severe spinal instability, spondylolisthesis, or severe cases of degenerative disc disease.
3. Discectomy: This involves the removal of a portion of a herniated disc to relieve irritation or compression on nerve roots.
4. Spinal Decompression: Similar to laminectomy, this surgery removes or trims bone spurs or parts of discs or bones that are compressing nerves.

These surgeries carry the risk of FBSS due to a variety of factors, including incomplete removal of the structures compressing spinal nerves, recurrent disc herniation, postoperative scar tissue (epidural fibrosis), and persistent or new spinal instability post-surgery.

Causes and Risk Factors of FBSS

FBSS can arise from multiple factors spanning the pre-surgical phase to post-surgical recovery:

• Pre-surgical Factors: Issues like untreated or unrecognized spinal misalignments, chronic inflammation, or a history of lumbar spine surgery can set the stage for FBSS.
• Surgical Factors: Intraoperative challenges, including inadequate decompression, improper surgical technique, or the surgical approach, can directly lead to FBSS.
• Post-surgical Factors: The development of scar tissue, ongoing degeneration of spinal segments, or the mechanical instability of the spine post-operation often perpetuates pain and dysfunction.

Diagnosing FBSS: How is it Identified?

The diagnosis of FBSS is complex and involves an array of diagnostic tools, such as MRI, CT scans, and comprehensive physical examinations. These assessments help differentiate FBSS from other neuropathic pains or musculoskeletal conditions, such as sacroiliac joint dysfunction or lumbar spinal stenosis, ensuring targeted treatment planning.

Treatment for FBSS: Traditional vs. Whole-Body Approach

While traditional “pain management” treatments often rely on repeat surgical interventions or long-term use of pain medication, including opioids, epidural steroid injections, and non-steroidal anti-inflammatory drugs (NSAIDs), these can lead to additional health risks without resolving the fundamental issues. Conversely, a whole-body approach, particularly posture therapy offered by Activ8 Posture, focuses on correcting spinal alignment, enhancing muscle balance, and reducing nerve impingement through non-invasive and sustainable methods.

Activ8 Posture’s Approach to Healing: Addressing the Root Causes

Activ8 Posture prioritizes a comprehensive understanding of each patient’s unique spinal structure and pain etiology. By focusing on corrective posture therapy, Activ8 targets the underlying dysfunctions—be it lumbar disc herniation, muscle imbalances, or neurologic impairments—that contribute to FBSS. This method not only provides pain relief but also aims to restore the body’s natural biomechanical functionality, reducing the likelihood of recurrence.

Supporting Examples: Limitations of Surgery and Spotlighting the Root Cause

While surgical methods are beneficial for structural repairs like correcting herniated discs or spinal stenosis, they often overlook the interconnected nature of musculoskeletal health. For instance, unresolved issues in hip mobility or thoracic kyphosis can impose undue stress on the lower back region, which surgery alone may not rectify. Addressing these broader biomechanical issues through posture therapy can significantly enhance treatment outcomes.

How Activ8 Posture Fits In After Surgery

Through real-life success stories, Activ8 Posture demonstrates the effectiveness of a non-surgical approach in managing and alleviating lower back pain. By strengthening the spine’s support structure and improving overall posture, patients can achieve lasting relief without dependence on medications or invasive procedures.

No Matter Your Age or Previous Experience, You Can Move More Comfortably!

Key Takeaways

Pain that continues after back surgery is more common than many people expect, and it is not the end of the road. In trials, structured exercise starting about four to six weeks after surgery has helped people recover better than no treatment.

The strongest plans combine your surgeon’s guidance, pain management where needed, and progressive strength and movement work, with any new or worsening symptoms checked by your doctor.

When to Get Medical Care Right Away

After spine surgery, contact your surgeon or seek urgent care if you have:

• Fever, or redness, swelling or drainage at the incision
• New or worsening numbness or weakness in a leg
• Numbness in the groin or saddle area, or new bladder or bowel changes — this needs emergency care
• Sudden severe pain that is different from what you had before

Frequently Asked Questions

What is the best treatment for Failed Back Surgery Syndrome?

For those grappling with the complexities of FBSS, posture alignment therapy stands out as a leading treatment option that looks for the cause of pain holistically. By focusing on correcting the underlying biomechanical imbalances that often contribute to chronic pain, this non-invasive approach offers sustainable relief while looking to avoid the need for further surgeries or dependency on pain medicine.

How common is Failed Back Surgery Syndrome?

FBSS is unfortunately quite prevalent, impacting an estimated 20-40% of patients who undergo spinal surgery. This underscores the challenges of traditional surgical interventions in effectively resolving spinal pain long-term.

Can posture therapy help if surgery didn’t work?

In most cases, the answer is yes. Posture therapy dives deeper into the structural and functional issues that surgery and other modalities may not address, such as misalignments and muscle imbalances. This approach not only alleviates pain but also enhances overall bodily function and quality of life.

What are the risks of additional surgeries for back pain?

Opting for additional surgeries can lead to heightened risks, including increased chances of infection, nerve damage, and the potential for developing FBSS. Each subsequent surgery may also lessen the likelihood of ​long-term pain relief and functional recovery.

How do I know if posture therapy is right for me?

Determining the suitability of posture therapy involves a thorough evaluation by a skilled posture therapist. This assessment will consider your specific symptoms, surgical history, and overall health to tailor a therapy plan that addresses your unique needs effectively.

Sources

• Oosterhuis T, Costa LOP, Maher CG, et al. Rehabilitation after lumbar disc surgery. Cochrane Database Syst Rev 2014;(3):CD003007. doi:10.1002/14651858.CD003007.pub3