Failed Back Surgery Syndrome (FBSS)

Before and after spine surgery the surgeon and medical staff prepare you for recovery. The recovery process can take a long time and be extremely challenging. Pain after spine surgery is normal, but how to tell if it’s beyond the typical pain during recovery?

What indicates that the surgery failed?

Chiropractor Dr. Alex Jimenez has dealt with this issue throughout his career and discusses symptoms associated with failed back surgery syndrome (FBSS, also known as failed back surgery (FBS) or post-laminectomy syndrome).

 

Back Pain is the most common symptom

Chronic back pain is the most common symptom of failed back surgery.

With FBSS, chronic pain in one patient can be very different from pain in another.

People with FBSS can experience a range of different types of pain based on:

• Spinal disorder
• Spinal procedure
• The underlying cause of failed back surgery syndrome

Types of back and neck pain people with failed back surgery may experience. Some may have one or more types.

Chronic pain:

• Sustained pain that lasts for more than 12 weeks.
• Chronic pain is the opposite of acute pain, which is short-term severe pain.
• Acute pain is expected during spine surgery recovery but should fade during the healing.

Nociceptive pain:

Localized pain can be dull or sharp.

This is the type of pain patients may experience immediately after surgery

Example: The pain felt around where the incision was made.

When most people think of pain, nociceptive pain is the type.

Neuropathic pain (neuropathy):

Nerve-related pain is caused by damage to the nerves or spinal cord.

Neuropathic pain shoots and moves around, thus affecting large areas of the body.

Examples of this type of pain include:

• Numbness
• Burning
• Tingling
• Weakness
• Abnormal sensations (called paresthesia)

Radicular pain (radiculopathy):

A branch of nerve pain (neuropathy) is called radiculopathy, or radicular pain.

Radicular pain radiates from one area to another.

Examples include the:

• Low back
• Down the buttocks
• Legs
• Feet

And then starts all over again, or goes in a different order.

Other symptoms:

The original symptoms return:

When the symptoms that put the patient in the surgery room return, then there is a definite possibility of failed back surgery. New pain presents: meaning pain in a different part of the spine or a different type merits a discussion with your doctor.

Mobility Reduced :

It does take time to recover and that process can affect:

• Endurance
• Flexibility
• Movement

However, if mobility or limitation is different from what was talked about with the surgeon or develops after recovery, then it should be discussed with your doctor.

Example: A limited range of motion in the neck or low back.

Headaches begin to present:

If headaches were not an original part of your medical history, this may point to a nerve problem.

Nerve Symptoms & Quality of Life

Neuropathic pain/ neuropathy or nerve-related pain is the most complex, debilitating, and difficult to treat.

People who experience this type of pain find it lowers their quality of life.

An online survey of 1,000-2000 patients that underwent low back surgery responded and revealed the following:

1. 94% of respondents reported post-surgery low back pain
2. 71.1% dull achiness
3. 69.8% numbness
4. 43.3% cold sensations
5. 35.3% paresthesia (eg, burning, tingling, pricking sensations)

A separate study noted that nerve-related pain suffered by people with FBSS is more life-altering than pain caused by joint and nerve disorders.

Patients with FBSS and neuropathic pain go through higher levels of pain and have less quality of life/physical function compared with people with osteoarthritis, rheumatoid arthritis, and fibromyalgia.

FBS Symptoms Emergency Treatment

After surgery, it can be difficult to tell whether the pain is within the bounds of normal recovery pain.

At follow-up appointments ask questions about the progress of your recovery and about any concerns.

Pain after surgery is normal, but there are some signs and symptoms that merit emergency attention.

If you experience any of the red flag symptoms, call your doctor immediately:

• New weakness
• Difficulty walking
• Electric pain in the lower body
• Fever
• Vomiting
• Unintentional weight loss
• Loss of bowel or bladder function

This can be a sign of a spinal nerve disorder called cauda equina syndrome.

Symptoms of Failed Back Surgery Syndrome Are Different for Every Patient

• Every patient goes through a unique surgical experience and if it fails, patients may experience unique symptoms.
• Because failed back surgery has several possible causes, the symptoms are going to be different for each patient.
• Before you are discharged and even before you go under, ask your surgeon questions about what to expect during the recovery process.
• Educating yourself with possible expectations during recovery, you’ll be best positioned to know when things aren’t going as they should.

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Back Pain Management

 

 

Denise was involved in an auto accident which resulted in low back pain. When she realized she couldn’t sit, walk or sleep for extended periods of time without experiencing painful symptoms, Denise found chiropractic care with Dr. Alex Jimenez in El Paso, TX. Once she received treatment for her auto accident injuries, Denise experienced relief from her symptoms and she was able to perform her everyday activities once again. Thanks to the education and care Dr. Alex Jimenez provided, Denise regained her original health and wellness.

Back pain is common, with roughly nine out of ten adults experiencing it at some time in their life, and five in ten working adults developing it every year. Some estimate around 95 percent of Americans will experience back pain at some time in their lifetime. It’s by far the usual cause of chronic pain, as it is also a significant contributor to missed work and disability. In the United States alone, acute cases of lower back pain are the fifth most common reason for physician visits and cause 40 percent of missed days off work. Furthermore, it is the only leading cause of disability globally.