Persistent Post-Surgical Spinal Pain (PPSSP) Solutions

Defining Persistent Post-Surgical Spinal and Back Pain

Persistent Post-surgical spine pain, also known as post-laminectomy syndrome or failed back surgery syndrome (FBSS), is a condition where a patient continues to experience pain after undergoing spine surgery. 

Symptoms typically include chronic pain in the back or legs, similar to pre-surgery pain, and can be accompanied by other symptoms such as numbness, tingling, or weakness. Treatment options for persistent post-surgical spinal pain often involve a combination of physical therapy, pain management techniques (medications, injections), and, in some cases, additional surgery.

What Causes Persistent Post-Surgical Spinal or Back Pain?

This type of chronic pain can arise from various causes, including:

• Incomplete surgery: The initial problem, such as a herniated disc, might not have been fully addressed.
• Nerve damage: Surgery may cause nerve damage or fail to relieve existing nerve compression.
• Scar tissue: Formation of scar tissue around spinal nerves can lead to persistent pain.
• Recurrent disc herniation: Discs can herniate again after surgery.
• Adjacent segment disease: Surgery can place additional stress on adjacent spinal segments, leading to degeneration and pain.
• Infection or inflammation: Post-surgical infection or inflammation can result in ongoing discomfort.
• Wrong surgery: The surgery is performed at the incorrect level or is the incorrect surgery for the type of pain.
• Incorrect Diagnosis: The area where surgery is performed is not responsible for the patient’s pain.

It is important to note that while many cases of back pain or spinal pain improve with rest and self-care, persistent or severe back pain following a surgery should be evaluated by a healthcare professional to determine the underlying cause and appropriate treatment.

What is a Spine Pain Specialist or Back Pain Doctor?

There are multiple reasons why someone might choose to see a back pain specialist or back pain doctor for persistent post-surgical spinal pain.

• Expertise. Back pain specialists, such as orthopaedic surgeons, neurosurgeons, rehabilitation physicians, rheumatologists, or pain management specialists, have specific training and expertise in diagnosing and treating back-related issues. They are familiar with various conditions that cause back pain and can offer specialised treatment options.
• Accurate Diagnoses. Chronic back pain can result from a variety of underlying conditions such as herniated discs, spinal stenosis, arthritis, or muscle strain in addition to complications following a spinal surgery. A back pain specialist can conduct a thorough evaluation, which may include imaging studies like X-rays, MRIs, or CT scans, to accurately diagnose the source of the pain.
• Personalised Treatment Plans. Once the cause of the pain is identified, a specialist can develop a personalised treatment plan tailored to your individual needs. This plan may include a combination of therapies such as physical therapy, medications, injections, minimally invasive procedures, or surgery if necessary.
• Pain Management Therapies and Techniques. Persistent spine or back pain can significantly impact your entire life, affecting your ability to work, perform daily activities, and enjoy leisure time. Post-surgical pain specialists can offer various pain management techniques to help alleviate discomfort and improve function, including medication management, nerve blocks, spinal cord stimulation, or other interventional procedures.
• Prevention and Education. Pain specialists can provide education and guidance on lifestyle modifications, ergonomic principles, exercises, and preventive measures to reduce the risk of future back problems or exacerbations of existing conditions.
• Coordinated Care. In cases where post-surgical spinal pain is complex or involves multiple medical specialties, a pain specialist can coordinate care with other healthcare providers, such as physiotherapists, chiropractors, psychologists, or pain psychologists, to ensure comprehensive management of the condition.

Overall, seeking care from a pain specialist with experience treating post-surgical spinal pain can offer patients with chronic back pain access to specialised expertise, an accurate diagnosis, personalised treatment, and comprehensive management strategies to improve their overall health.

Multidisciplinary Healthcare Teams for Post-Surgical Back Pain Management

Several types of healthcare professionals are involved in the diagnosis, treatment, and management of spine and back pain. These include:

• General Practitioners: General practitioners play a crucial role in coordinating care for individuals with chronic pain. They may initially evaluate the patient, provide treatment, and make referrals to pain specialists or other specialists as needed.

• Spinal Pain Management Specialists: Pain management specialists focus on the evaluation and treatment of chronic pain conditions, including spine and back pain. They may use a multidisciplinary approach that includes medications, injections, physical therapy, and psychological interventions to address pain and restore general comfort.
• Physical Therapists. Physiotherapists are experts in rehabilitative exercises and techniques to improve mobility, strength, and flexibility. They develop individualised treatment plans to address spinal pain and may incorporate modalities such as ultrasound, electrical stimulation, dry needling and taping.
• Occupational Therapists. Occupational therapists focus on helping their clients perform daily activities despite physical limitations or disabilities. They may provide ergonomic assessments, assistive devices, and adaptive strategies to manage back pain and prevent further injury.
• Psychologists and Counsellors. Psychologists and counsellors can help you cope with the emotional and psychological aspects of living with chronic back pain. They may use techniques such as cognitive-behavioural therapy, relaxation training, and stress management to improve coping skills and overall well-being.

Collaboration among these healthcare professionals is often necessary to provide comprehensive care for patients with post-surgical back pain, addressing both the physical and psychosocial aspects of the condition.

How Does a Pain Specialist Treat Persistent Post-Surgical Spinal Pain?

A back pain specialist employs a variety of approaches to treat persistent post-surgical spinal pain, depending on the underlying cause, severity, and individual patient factors. 

Here are some common methods used by back pain specialists to manage chronic back pain:

1. Medication Management. Pain specialists may prescribe medications to alleviate pain, reduce inflammation, and improve function. Commonly prescribed medications include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, opioids (for short-term use only in severe cases), antidepressants, and anticonvulsants.
2. Physical Therapy. Physical therapy plays a crucial role in the management of pain following a spinal surgery. A physical therapist will design an individualised exercise program to improve strength, flexibility, and posture, as well as provide manual therapy techniques to reduce pain and improve mobility.
3. Interventional Procedures. Pain doctors may perform various interventional procedures to alleviate pain and improve function. These may include epidural steroid injections, facet joint injections, nerve blocks, radiofrequency ablation, spinal cord stimulation and peripheral field/ peripheral nerve stimulation.
4. Lifestyle Changes. Managing persistent pain post-surgery may include recommendations for maintaining a healthy weight, adopting ergonomic principles in daily activities, improving posture, quitting smoking (if applicable), and incorporating stress management techniques.
5. Psychological Treatment. Seeing a psychologist or counsellor to provide psychological support and interventions such as cognitive-behavioural therapy can help cope with pain, stress, and anxiety.

By employing a multidisciplinary approach that addresses the physical, psychological, and social aspects of post-surgical spinal pain, Dr. Mittal and her collaborative team of specialists can help patients effectively manage their symptoms, improve function, and enhance overall quality of life.

What Does a Treatment Plan for Post-Surgical Spine or Back Pain Involve?

Any treatment plan for back pain or spine pain typically involves a comprehensive approach that addresses the underlying cause of the pain, alleviates symptoms, improves function, and prevents future episodes. 

Here are the key components of a treatment plan for post-surgical back pain:

• Medical Evaluation. The first step in developing a treatment plan is a thorough medical evaluation, which may include a review of the surgical plan, your medical history, a physical examination, and diagnostic tests such as X-rays, MRI, or CT scans to determine the cause of the pain.
• Pain Management. Pain management is a crucial aspect of the treatment plan and may involve various strategies, including medication management. Commonly prescribed medications for back pain include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, opioids (for short-term use in severe cases), antidepressants, and anticonvulsants.
• Physical Therapy. Physical therapy plays a key role in treating spine and back pain by improving strength, flexibility, posture, and mobility. A physiotherapist designs an individualised exercise program tailored to your needs, which may include stretching exercises, strengthening exercises, aerobic conditioning, and manual therapy techniques such as massage or spinal manipulation.
• Interventional Procedures. Depending on the cause and severity of your pain, interventional procedures may be recommended to alleviate symptoms and improve function. These procedures may include epidural steroid injections, facet joint injections, nerve blocks, radiofrequency ablation, spinal cord stimulation, or minimally invasive surgical procedures such as microdiscectomy or decompression.
• Lifestyle Modifications. Positive changes to your routine can be essential for managing persistent pain and preventing the need for future interventions. This may include maintaining a healthy weight, adopting ergonomic principles in daily activities, improving posture, quitting smoking (if applicable), and incorporating stress management techniques such as relaxation exercises or mindfulness meditation.
• Education and Self-Management Strategies. Patient education is a critical component of the treatment plan, empowering patients to actively participate in their care and make informed decisions about their health. Pain doctors provide information on the condition, treatment options, and strategies for self-management, including proper body mechanics, activity modification, and resources for further support and education.
• Psychological Support. Support may be provided by collaborating with psychologists or counsellors to address issues such as pain-related anxiety, depression, or stress through interventions such as cognitive-behavioural therapy or relaxation techniques.
• Follow-Up and Monitoring. Regular follow-up appointments with your team are essential to monitor the progress of the treatment plan, adjust medications or therapies as needed, and address any new or worsening symptoms. Patients are encouraged to communicate openly and report any changes in their condition or response to treatment.

By incorporating these components into a comprehensive treatment plan, Dr. Mittal can effectively manage your post-surgical spine and back pain, improve function, and enhance the overall quality of life for patients.

The Challenges of Post-Surgical Spine Pain

Living with persistent back pain or spinal pain after a major surgery presents numerous problems or issues that can significantly impact a person’s physical, emotional, and social well-being. 

Some of these challenges include:

• Persistent Discomfort. Spine and back pain often leads to persistent discomfort, ranging from mild to severe, which can interfere with daily activities such as walking, sitting, standing, and sleeping. This constant pain can affect all parts of your life and make it difficult to concentrate or enjoy leisure activities.
• Limited Mobility. Spine and back pain may restrict mobility and range of motion, making it challenging to perform tasks that require bending, lifting, or twisting. Reduced mobility can lead to dependency on others for assistance with activities of daily living and decrease independence, leading to social isolation, inability to work, or otherwise actively participate in one’s own life.
• Impact on Work and Productivity. Persistent spine and back pain can impair work performance and productivity, leading to missed workdays, decreased job satisfaction, and financial strain. Some individuals may need to modify their job duties, take extended leaves of absence, or even retire early due to their back pain.
• Emotional Distress. Dealing with persistent pain can take a toll on one’s mental health, leading to feelings of frustration, anxiety, depression, and irritability. Coping with the emotional distress of chronic back pain may require support from mental health professionals and strategies for stress management.
• Sleep Disturbances. Back or spine pain can disrupt sleep patterns, causing difficulty falling asleep, staying asleep, or achieving restful sleep. Poor sleep quality can exacerbate pain perception, worsen mood disturbances, and contribute to fatigue and daytime drowsiness.
• Social Isolation. Persistent back or spinal pain may limit social activities and participation in hobbies or recreational pursuits, leading to feelings of isolation and loneliness. Social support from family, friends, and support groups can help mitigate feelings of isolation and provide emotional encouragement.
• Impact on Relationships. Post-surgical spine and back pain can strain relationships with family members, friends, and romantic partners due to changes in mood, behaviour, and participation in activities. Effective communication, empathy, and support from loved ones are essential for maintaining healthy relationships.
• Financial Difficulties. Managing persistent back pain often involves medical expenses, including doctor visits, diagnostic tests, medications, physical therapy, and sometimes surgery or other interventions. Additionally, indirect costs such as lost wages, transportation expenses, and home modifications to accommodate a chronic pain condition may be incurred.
• Fear of Re-injury. Fear of exacerbating existing pain or sustaining new injuries to one’s back or spine may cause you to avoid physical activities or movements, resulting in deconditioning, loss of muscle strength, weight gain and further functional impairment.
• Depression and Frustration. The persistent nature of back pain can lead to feelings of frustration, hopelessness, and despair, especially if your surgery or other treatments are ineffective or symptoms worsen over time. It is essential for post-surgical pain sufferers to maintain hope and continue working with healthcare providers to explore new treatment options and improve their quality of life.

Overcoming the challenges associated with post-surgical spine or back pain requires a comprehensive approach that addresses both the physical and emotional aspects of the condition, along with support from healthcare providers, loved ones, and community resources.

How Do I Find a Post-Surgical Spine and Back Pain Specialist Near Me?

To find a pain specialist near you to treat your post-surgical pain, you can start by discussing your back pain concerns with your surgeon. They can evaluate your symptoms, provide initial treatment, and refer you to a pain management doctor following your spinal surgery.

You can also seek recommendations from friends, family members, or colleagues who have experience with persistent pain treatment. They may be able to recommend a reputable specialist based on their own positive experiences.

The facility where you had your spinal surgery or other nearby hospitals or medical centres may have spine, orthopaedic, neurosurgical or chronic pain departments. Moreover, they may have dedicated spine centres or clinics staffed by spine or back pain specialists. These facilities often have multidisciplinary teams of experts and access to cutting-edge treatments and research.

During your search for a pain doctor near you, be sure to take into account less obvious factors such as the specialist’s location, office hours, and availability when choosing a back pain specialist. Look for a pain doctor who assesses your symptoms, medical history, treatment preferences and has the correct qualifications and local experience in looking after your post-surgical pain.

Ultimately, trust your instincts and choose a pain specialist who listens to your concerns, communicates effectively, and offers confidence in their ability to provide high-quality care.

If you are in the Melbourne area, contact the Persistent Pain Solutions clinic to connect with Dr Mittal who can help diagnose and treat your condition effectively.

Persistent Pain Solutions for Post-Surgical Spinal Surgery Pain in Melbourne

Dr. Meena Mittal and her collaborative team of healthcare professionals are deeply committed to providing compassionate care to every person who arrives at the Persistent Pain Solutions clinic seeking solutions for their post-spinal surgery pain.

We understand the physical and emotional toll that both spinal surgery and associated long term back and spinal pain can take on patients and their loved ones. That’s why we focus on offering empathy, understanding, and support in every interaction. 

From the moment you enter our doors, you will be met with a warm and welcoming environment where your pain and concerns are understood and your priorities are valued. 

Dr. Mittal takes the time to listen, engage, and evaluate your condition. Together, a personalised treatment plan tailored to your unique challenges is developed and instituted.

Compassion is fundamental to health and healing, and Dr Mittal is dedicated to guiding you on your journey to relief from post-spinal surgery pain and improvement in your overall quality of life.