“I had been in pain for years,” he said, recalling the back pain that eventually took over his life, “In the beginning, it came and went, and I thought I could hack it. Eventually, though, the pain was so bad and so constant, I could hardly get around. I had to do something… So, I had the surgery… but as it turned out, that was just the beginning of my pain.”
This patient, who we’ll call “Dale,” is like many others who come to us seeking relief from back pain without surgery. Many of these people previously had surgery and found that it offered them no back pain relief. For others, like “Dale,” surgery offered temporary relief, but the pain returned, sometimes months after they left the hospital.
“After the surgery, I felt pretty good. My surgeon said everything went great, and I was excited to get through rehab and on with my life… And that’s exactly what happened, until about two months after I came home from the hospital. I woke up one morning, sat up, and felt this burning, pinching sensation right beneath the surgical incision. At first, I thought it was my visible scar, but it felt deeper than that. Like it was right on my spine… That scared me.”
Despite his worries about this new pain, “Dale,” like many patients in similar situations, felt like he’d lived with worse, so he took some over-the-counter pain relievers and got through the day. The next morning, though, the pain was back. Something wasn’t right.
“I read through the paperwork they gave me at the hospital and did some research online. Everything I read said that some pain or discomfort could be expected after surgery, but a ‘sudden onset of pain months after surgery’ was a sign of a problem.”
Over the next few days, the pain continued to worsen. “Dale” tried stretching, tried pain medication, but nothing seemed to help. He began to feel as bad as he had prior to surgery, though he kept telling himself that was impossible. He’d felt better for months. It just didn’t make any sense. Frustrated and hurting, “Dale” struggled for a few more days before finally calling his doctor. After a brief examination, the doctor said his pain was probably caused by scar tissue near the nerve root, and that they would need another surgery to fix the problem.
“Dale” was not in any hurry to go back under the knife. But the pain was intense, and it didn’t seem to be getting any better. Did he really have another option? If his spine surgery scar tissue was causing the pain, he wanted to know, because he did not want to live with this pain anymore. The surgeon, again, recommended surgery. “Dale” said he would think about it.
Wanting to be his own health advocate, he did some reading online, and he came across some information about Failed Back Surgery Syndrome (FBSS). He learned that scar tissue adhering to the spinal nerve root, called epidural fibrosis, is one of the most commonly reported causes of FBSS. He read that as many as one-in-three people struggling with pain caused by failed back surgery have symptoms related to scar tissue near the spine. He also read that epidural fibrosis tends to develop about two to three months after surgery, the time it takes for scars to form and adhere to nerve roots along the spine. The timeframe checked out, but “Dale” was still not ready to agree to another surgery, so he made an appointment for a second opinion.
He learned that traditional surgery is not really a viable option for treating epidural fibrosis. The odds of significant pain relief are not great (about 1 in 3), and the odds of ending up in worse pain are significant (about 1 in 5). The second doctor recommended further diagnostic tests to determine the most likely cause of his back pain before “Dale” even considered another surgery.
“Given the risks and the odds, it seemed like getting more tests to see what was causing my pain would be a better option than another surgery. So, they did an MRI, but it wasn’t conclusive…”
A diagnostic test called an epiduroscopy showed some inflammation as well as scar tissue adhering to the nerve root. Both conditions may cause back pain after surgery. Fortunately, for “Dale,” he did not show any indications of disc degeneration, herniation, or any further signs of failed back surgery.
With this diagnosis, the doctor was able to recommend a long-term treatment for back pain called Spinal Cord Stimulation (SCS). Dale listened to the benefits and decided to take the treatment for a week-long test drive. Thanks to the spinal cord stimulator, Dale experienced a significant decrease in back pain over that week. After a follow-up consultation with his doctor, Dale chose to go ahead with the long-term version of SCS. After receiving the stimulator implant, Dale has continued to experience a significant decrease in pain, and he is enjoying a much better quality of life without having to endure a second back surgery.
“Dale’s” story represents an ever-growing number of people who undergo surgery to relieve back pain, only to end up experiencing new or worsening pain. If you, like “Dale,” are experiencing new or worsening back pain, and you are looking for an alternative
to traditional back surgery, click here or to make an appointment for a consultation and see if you are a candidate for a spinal cord stimulator.