Lower Back Pain After Surgery

You are having lower back pain after surgery. What does that mean?

Reasons For Lower Back Pain
After Surgery

Well it could mean a number of things. Such as:

Surgery wasn't needed.

All too often surgery is viewed as a promising procedure. If we just get in there and remove that disc herniation or make more room for the nerve then we will be cured.

Sometimes lower back surgery works... oftentimes it doesn't or it is short lived.

There are millions of people across the globe that have disc herniations and stenosis yet have no pain.

Every so many years there is some new surgical procedure or a surgical “expert” comes to town or there is one in another town. There is a rush for this latest surgery or to see the “expert”.

Then after a few years the number of patients having the new procedure drops off or the doctor is no longer considered the “expert” as the surgeries prove to be no better than the old ones.

And the scenario repeats itself as lower back pain sufferers, desperate for relief, hold out hope that there will be some miracle surgery or powerful drug that will cure them of their lower back pain.

Or, foolishly, back surgery is performed for back pain alone but the real cause of the pain was myofascial pain syndrome or trigger points. Or...

Maybe the referred pain was from a sacroiliac joint. But just because there was a L5-S1 disc herniation it was assumed that the herniation was causing the pain and other symptoms.

Another possibility for lower back pain after surgery is that the sciatica is the result of a piriformis syndrome and not the disc herniation seen on the MRI. A laminectomy is performed, the disc herniation is removed, the back is fused and the pain remains.

Piriformis syndrome can have the exact same characteristics of nerve pressure from a disc. Don't let pain be the determining factor for surgical intervention.

So, was the surgery really necessary? Probably not.

As long as there is no signs and symptoms of permanent damage, or there is a low risk for it, then surgery probably isn't called for. Pain is not an indication for the need of surgery. Once again...

Surgery should not be performed just for the sole purpose of relieving pain.

Surgery may have been "indicated" (whether or not it was needed) and one or more of the following is to blame:

The wrong surgery was performed.

Perhaps a discectomy was performed when in fact there was stenosis that was causing the pressure on the nerve and it was not observed or it was just ignored.

You have adhesion or scar tissue.

Surgery was successful. You have gone without pain for a couple of weeks but now the pain is returning.

Scar tissue following surgery could be to blame for lower back pain after surgery. Scar tissue is often assigned the blame; however, my experience has been that it is a catch-all diagnosis.

When no real cause can be found for the return of the pain or when a failed surgical back diagnosis is rendered too often scar tissue is given the blame and not the fact that the surgery was unsuccessful.

You needed the surgery but it was performed at the wrong level.

Just because there exists a fairly large disc herniation or there is evidence of stenosis does not mean that they are causing your symptoms. It may be that the small herniation at L4-L5 disc is the real culprit. But because the L5-S1 disc was much larger it was assumed to be the disc that was causing all of the symptoms and therefore it was targeted for removal.

You needed the surgery but you have multiple levels of disc pathology and only one level was operated on.

Very often, especially with the advent of MRI technology, it is found that there exists multiple levels of disc pathology. It would be foolish and wrong to just go ahead and perform discectomy at all of those levels.

So based on signs and symptoms, a best assumption is given for which disc is the culprit and that herniation is removed or that segment undergoes laminectomy. When in fact that disc wasn't the cause of the symptoms. It turns out that it was the smaller herniation that was causing all of the problem.

More time is needed for healing.

Perhaps the nerve irritation has been so long-standing that it will require time for healing and regeneration following surgery.

If lower back pain after surgery persist after a logical time has been allowed to pass for healing and regeneration speak to your doctor about the possibility of the wrong surgery or wrong level being operated on. Don't be surprised if he tries to not accept any responsibility for the failure.

Doctors are human and at times they can make an inaccurate diagnosis or perform the wrong treatment. Seek another opinion and take responsibility for your recovery and treatment.

The presence of a new or fresh disc herniation/bulge exists.

If one disc is weak and herniated there is a good chance that other disc are too.

When surgery is performed, when one disc is herniated, or when spinal fusion is performed, whether surgical or due to your body's own doing, there will be added stress to the other discs. It is very possible and highly likely that other "normal" discs will eventually undergo further damage and herniation.

Is Surgery Really Needed?

Prior to undergoing the knife you should be absolutely sure that the surgery is indicated. How do you know if it was indicated. If you had the following then surgery was probably needed;

  1. Long standing, unrelenting, severe pain for more than 6 months despite medical care and chiropractic care. With no evidence of improvement
  2. Loss of muscle strength and/or sensation or muscle paralysis such as foot drop,
  3. Cauda equina syndrome (loss of bladder or bowel control, loss of sensation in perinium)

Most lower back surgeries are not needed and if performed will often lead to future pain, suffering, and disability. Sometimes lower back pain after surgery is worse than it was prior to surgery or the problem is not significantly improved. This is referred to as Failed Surgical Back Syndrome, or FSBS.

Lower Back Surgery Risks

Surgery should always been the last resort and your decision to have surgery needs to be considered very wisely. Surgery is permanent. There is always risks. They include:

  • Failed back surgery syndrome.

  • Infections.
  • Paralysis.
  • Permanent disability.
  • Worse symptoms then prior to surgery.
  • Death.

Be Pro-Active

Sometimes the surgeon will want to perform additional surgery if you still have lower back pain after surgery. Seek at least two other opinions and always exhaust every alternative forms of treatment prior to deciding on surgery.

Be pro-active. Work with your doctors and therapists to outline a program for rehabilitation that addresses ALL of the possible causative or contributing factors for your lower back problem.

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