Discectomy, a surgical procedure to remove a herniated disc fragment pressing on a nerve root or the spinal cord, is often seen as a solution for those suffering from severe back pain. However, as with any medical procedure, it does not always yield the desired results. If you have undergone a discectomy and are still experiencing pain or other symptoms, you are not alone. In this article, you will learn what steps you can take when a discectomy does not work as expected.
Understand Failed Back Surgery Syndrome (FBSS)
When a discectomy or other spine surgery does not alleviate pain as anticipated, it is often referred to as Failed Back Surgery Syndrome (FBSS). This term does not necessarily mean the surgery itself failed but rather that the outcome did not meet the patient’s or doctor’s expectations. FBSS can occur for various reasons, including:
- Incomplete removal of herniated disc material
- Formation of scar tissue
- Recurrent disc herniation
- Persistent nerve root compression
- Incorrect diagnosis before surgery
Understanding that you may be dealing with FBSS is the first step in addressing your ongoing pain and finding alternative solutions.
Consult with Your Surgeon
If you are experiencing persistent pain after a discectomy, the first step is to consult with your surgeon. The surgeon can:
- Evaluate your current condition
- Review postoperative imaging studies
- Determine if there are any immediate complications
- Discuss potential causes of ongoing pain
- Recommend next steps based on your specific situation
Be prepared to describe your symptoms in detail, including any changes since the surgery and how the pain affects your daily life.
Seek a Second Opinion
If you are not satisfied with the explanations or recommendations from your original surgeon, do not hesitate to seek a second opinion. Another spine specialist may:
- Offer a fresh perspective on your condition
- Suggest alternative diagnostic tests
- Propose different treatment options
- Recommend a multidisciplinary approach to your care
Remember, it is your right as a patient to explore all available options and feel confident in your treatment plan.
Consider Revision Surgery
In some cases, a second surgery may potentially be discussed and recommended. This could involve:
- Removing residual disc material – If the initial discectomy did not remove all problematic disc fragments
- Addressing a recurrent herniation – If disc material reherniates after the initial surgery
- Decompressing nerve roots – If ongoing nerve compression is causing pain
- Spinal fusion surgery– To stabilize the spine if instability is contributing to pain
While the prospect of another surgery can be daunting, for some patients, it is the best path to relief. Discuss the potential benefits and risks thoroughly with your surgeon.
Explore Nonsurgical Pain Management Options
Before considering revision surgery, many doctors recommend exploring nonsurgical pain management techniques. These may include the following.
Physical therapy
A structured physical therapy program can:
- Strengthen core and back muscles
- Increase flexibility and range of motion
- Teach proper body mechanics
- Reduce pain through targeted exercises
Medication management
Various medications can help you manage pain and inflammation:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Muscle relaxants
- Gabapentin or pregabalin for nerve pain
- Carefully prescribed opioids for short-term severe pain
Always use medications under the guidance of a healthcare professional.
Interventional pain management
Minimally invasive procedures that can provide relief include:
- Epidural steroid injections
- Facet joint injections
- Radiofrequency ablation
- Spinal cord stimulation
These treatments can offer temporary or long-term pain relief without the need for major surgery.
Consider Alternative Therapies
Some patients find relief through alternative or complementary therapies, such as:
- Acupuncture – This traditional Chinese medicine technique may alleviate back pain for some individuals.
- Chiropractic care – Spinal manipulation might provide relief, but consult your surgeon first to ensure it is safe post-discectomy.
- Massage therapy – This can relax muscles and reduce tension contributing to pain.
- Mindfulness and meditation – These practices can help you manage the psychological aspects of chronic pain.
- Yoga or tai chi – Gentle, guided movement can increase flexibility and strength while promoting relaxation.
While the efficacy of these treatments can vary, they may be worth exploring as part of a comprehensive pain management strategy.
Make Lifestyle Modifications
Sometimes, simple changes in your daily life can have a significant impact on post-discectomy pain.
Weight management
Maintaining a healthy weight reduces stress on the spine. If you are overweight, losing even a small amount can make a difference in your pain levels.
Ergonomic adjustments
Evaluate your work and home environments:
- Use an ergonomic chair and desk setup
- Adjust your sleeping position and mattress
- Use proper lifting techniques
Quitting smoking
Smoking can impair healing and contribute to ongoing pain. If you smoke, quitting can improve your overall health and potentially reduce back pain.
Reducing stress
Chronic pain and stress often go hand in hand. Try effective stress-management techniques, such as:
- Regular exercise
- Hobbies and social activities
- Professional counseling
These can help you break the cycle of pain and stress.
Investigate Emerging Treatments
Medical science is continually evolving, and new treatments for persistent back pain are emerging:
- Stem cell therapy – While still experimental for spine-related conditions, some studies show promise in regenerating disc tissue.
- Platelet-rich plasma (PRP) injections – Uses components of your own blood to potentially promote healing.
- Advanced imaging-guided procedures – New techniques allow for more precise diagnosis and treatment of pain sources.
Stay informed about these developing treatments, but approach them cautiously and always under the guidance of a qualified specialist.
Dealing with ongoing pain after a discectomy can be frustrating and disheartening. However, it is important to remember there are numerous options available. From revision surgery to pain management techniques, lifestyle changes, and emerging treatments, you have many paths to explore.
The key is to work closely with your healthcare team, stay informed about your options, and be an active participant in your recovery. Do not lose hope—with persistence and the right approach, many people find effective ways to manage their pain and improve their quality of life even when their initial discectomies do not provide the expected relief.
Even though discectomy surgery is a common and generally quite successful procedure, a hole is frequently left in the outer wall of the disc. In fact, patients with these large holes in their discs are more than twice as likely to reinjure themselves by experiencing what is known as a reherniation. These reherniations often require additional surgery or even fusions. Fortunately, there is a new treatment specifically designed to close the large holes that are often left in spinal discs after discectomy surgery. Barricaid is a bone-anchored device proven to reduce reherniations, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital.
If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us today.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.
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