Failed back surgery syndrome
Persistent spinal pain after surgery, managed through non-surgical pain-modulation and rehabilitation rather than repeat surgery as a first step.
What it is
Failed back surgery syndrome (also termed persistent spinal pain syndrome) refers to lumbar spinal pain that persists despite spinal surgery, or that develops or recurs after surgery performed for pain in the same location. Common contributors include recurrent disc herniation, residual nerve compression, scar tissue (fibrosis), altered spinal mechanics, and psychological factors such as anxiety or depression that amplify pain perception. It is managed through non-surgical pain-modulation and rehabilitation rather than repeat surgery as a first step.
Common symptoms & concerns
- Persistent, dull, aching back or leg pain not associated with normal post-operative healing
- Sharp, pricking, or stabbing sensations in the extremities alongside the dull baseline pain
- Onset immediately after surgery, or developing weeks to years later
- Muscular deconditioning, sleep disruption, or mood symptoms in more complex presentations
Assessment & care
Assessment approach
Assessment reviews the pattern and timing of your pain against your surgical history, so treatment addresses the actual contributor — recurrent disc herniation, nerve compression, scar tissue, or mechanical change — rather than treating the pain-site alone.
In-scope care
In-scope care includes nerve blocks, MET, and physiotherapy for pain, with a functional-medicine inflammatory workup available to rule out correctable contributors. Nerve blocks address the immediate pain signal while physiotherapy rebuilds load tolerance, sequenced so rehabilitation begins once acute pain is controlled.
Treatments used
Related questions
Not necessarily. Non-surgical pain-modulation and rehabilitation approaches are typically tried first, and repeat surgery is considered separately by the surgical team only where clinically indicated.
It can begin immediately after surgery or develop weeks to years later, which is why the pattern and timing of pain are part of the assessment.
Options include nerve blocks, manual/exercise therapy (MET), and physiotherapy for pain, sometimes alongside a functional-medicine inflammatory workup to identify correctable contributors.