Back pain after spine surgery can be frustrating and confusing. Many people expect surgery to fully relieve their discomfort, but sometimes, pain returns or never goes away. This type of pain may result from nerve damage during the procedure, scar tissue formation, or even spinal instability. In some cases, the original cause of pain might still exist, or new problems may arise after healing. It is also possible for muscles around the spine to weaken, which leads to continued discomfort. Pain after back surgery varies for every patient, but it can deeply affect daily life and mental health..

Causes Of Back Pain After Spine Surgery

Sometimes, people continue to feel back pain even after spine surgery. This can happen for many reasons. Knowing these causes can help in understanding the pain and finding the right way to manage it. Let’s look at the most common causes in simple words:

1. Epidural Fibrosis

After back surgery, your body naturally creates scar tissue as part of the healing process. Normally, this scar tissue does not cause pain because it does not have any nerve endings. But sometimes, scar tissue forms close to the nerve roots. This is called epidural fibrosis. When this happens, the scar tissue can press on the nerves and cause pain.

This type of pain often begins 6 to 12 weeks after surgery. Many people feel better right after surgery, but as the scar tissue slowly builds, pain in the back or legs might come back or get worse.

In some cases, the original nerve damage takes longer to heal, which can add to the pain. The pain may feel like a burning or deep, constant ache that doesn’t improve with rest or movement. Doing gentle stretching exercises after surgery can help reduce the chances of nerve scarring and ease the pain.

2. Failure of a Fusion

When doctors do a spinal fusion surgery, they try to help the broken bones in your spine grow back together into one solid bone. This healing process takes about a year to become strong. However, too much movement, improper placement of screws or rods, or overuse of painkillers like NSAIDs can interfere with healing. This can lead to bone cracks and long-lasting pain.

If the part of the spine above or below the fused area gets damaged, it’s called adjacent segment disease. Also, swelling around the nerves in the spine can cause a condition called arachnoiditis, which can lead to more Back Pain After Spine Surgery.

Usually, if you feel better within three months after surgery, you’ll likely stay better. But in 10-20% of people, pain continues until the nerve fully heals. Tingling and numbness often take longer to resolve than pain.

Signs of arachnoiditis include tingling, burning, stinging, or numbness in the legs. In severe cases, the pain can become so bad that walking becomes difficult.

Diagnosing arachnoiditis can be tricky. Doctors often use tests like CT scans, MRIs, and a special test called an EMG (electromyogram). An EMG checks the electrical signals in your nerves and muscles, which can show problems caused by this condition. There is no complete cure for arachnoiditis, but treatment usually includes a mix of physiotherapy, gentle exercise, and pain relief methods to help manage the symptoms.

3. Recurrent Stenosis After Decompression

After a laminectomy (a surgery to treat spinal stenosis), regrowth of bone can sometimes press on the nerves again. This can cause the pain to come back. There can also be problems during the surgery, like missing a small piece of bone, doing surgery at the wrong level, or injuring the nerve by mistake. Sometimes, the surgeon may not remove enough pressure from the nerves during the operation. In such cases, the pain doesn’t go away after surgery, which means the surgery didn’t work as expected.

If less invasive treatments don’t work and the pain continues, patients can think about other advanced surgeries. These include Artificial Disc Replacement (ADR), Total Facet Joint Replacement, or Robot-Assisted Spinal Fusion, if needed. These options help keep the spine moving properly while reducing pain.

4. Post-Fusion ‘Adjacent Segment Disease’

Spinal fusion surgery is performed to stabilise the spine, restore height and alignment, and reduce pain. However, after the surgery, the fused part of the spine can’t move like before. Because of this, the nearby areas of the spine, usually the ones above, have to work harder to make up for the lost movement. Over time, this extra pressure can cause damage or wear and tear in those nearby parts. Sometimes, this new damage may also need another surgery to fix.

Read More: Back Pain After C-Section: Causes and Effective Relief Tips

Effective Treatment Options For Back Pain After Spine Surgery

Continuous back pain can not be bearable for a long time. There are some effective treatments for back pain after surgery. 

1. Epidural Adhesiolysis

Epidural adhesiolysis, also called the Racz procedure, is a simple and less invasive treatment used to relieve long-term back pain, especially for the pain that is often caused by scar tissue around the nerves in the spine and also from the spine surgery. The treatment helps to break or remove this scar tissue, which may be pressing on the nerves and causing pain that spreads from the back down to the legs.

2. Radio Frequency Ablation (RFA)

Another effective treatment of back pain after back surgery is RFA or radio frequency ablation. Radio Frequency Ablation (RFA) is a treatment that helps reduce pain using heat. In this procedure, a doctor puts special needles close to the nerves that are causing the pain. These needles are connected to a machine that sends a small electric current to create heat. The heat stops the nerves from sending pain signals to the brain. This can give long-lasting pain relief.

Best Pain Management For Pain After Back Surgery

Pain Medics Clinic is the best pain management clinic for back pain after surgery. Our Specialist, Dr Rajit Jhingan, is a Certified Interventional Pain Sonologist (CIPS) from the World Institute of Pain (USA) and has 13+ years of experience in the pain management field. If you are suffering from Back pain or any kind of joint pain or pain caused by injury, we are here to help you. Book your appointment today to live a pain-free life.