Failed back surgery syndrome is a complex and challenging problem that affects many people who have undergone surgery for their back pain. It is a term used to describe the ongoing symptoms that some people experience following back surgery. These symptoms can include chronic back pain, leg pain, or numbness, as well as dissatisfaction with the results of the surgery. Failed back surgery syndrome is not a specific medical condition; rather, it is a collection of symptoms that can occur after surgery.
In this article, we will take a closer look at some of the research on failed back surgery syndrome, including a study published in the Journal of Pain Research in 2017. We'll explore what the study found, as well as some of the conservative care options that patients can consider before opting for surgery.
Understanding Failed Back Surgery Syndrome
Failed back surgery syndrome is a complex problem that can be challenging to treat. It can occur after one or more back surgeries, and it is characterized by ongoing symptoms like chronic back pain, leg pain, or numbness. Patients who experience failed back surgery syndrome may also feel dissatisfied with the results of their surgery, as it may not have provided the relief they were hoping to experience.
Because failed back surgery syndrome is not a specific medical condition, but a collection of symptoms that can occur after surgery, a careful diagnosis is required before treating it. Treatment plans for this condition should be individualized.
The Study
The 2017 study, titled "Prevalence, Characteristics and Burden of Failed Back Surgery Syndrome, the Influence of Various Residual Symptoms on Patient Satisfaction and Quality of Life as Assessed by a Nationwide Internet Survey in Japan," surveyed over 1 million people and received valid responses from 1,800 individuals who had undergone low-back surgery in the past 5 years.
The study aimed to (1) estimate the prevalence of failed back surgery syndrome based on both residual symptoms and patient perspectives, (2) determine the characteristics of residual symptoms, and (3) evaluate the negative impact of such residual symptoms on patient satisfaction with the surgery, health-related quality of life, and mental health.
Results
The study found that the majority of patients did not experience complete relief from their symptoms following surgery: Low-back pain and leg numbness disappeared completely in only 25% and 34% of patients respectively. Additionally, 12.3% of the patients continued to experience severe back pain, and 43% had moderate pain. Only 7.9% of patients reported no pain in the low back. Between 9 and 36% of surgical patients experienced no change or worsened symptoms. This means that the majority of patients in this study did experience some improvement, but there was also a high probability of coming out of surgery with persistent moderate to severe low-back pain.
Conservative Care vs. Surgery
While surgery can be an effective treatment option for some patients, it is not a guaranteed solution for mobility and pain relief. Surgery carries risks that can have lifetime effects, and it might not provide much, or any, relief. As a result, many healthcare providers recommend conservative care options like physical therapy, chiropractic, massage, acupuncture, and laser therapy before considering surgery.
Conservative care can take longer than surgery, but it can be a better option for patients who are looking for a less invasive treatment option. Conservative care can be effective in treating back pain, and it can have fewer side effects than surgery. Also, conservative care can help patients avoid the risks associated with surgery, like infection, blood loss, and nerve damage.
Before opting for surgery, it is important to have a conversation with your healthcare provider about conservative care options. Effective patient-provider communication is vital for patient satisfaction and health outcomes because it will help patients prepare for surgery by establishing realistic expectations.
Conclusion
Failed back surgery syndrome is a complex and challenging problem that affects many people who have undergone back surgery. The 2017 study we have reviewed highlights the negative impact of residual symptoms on patient satisfaction and quality of life. Before opting for surgery, patients and their physicians ought to consider conservative care options and have realistic expectations—especially regarding anticipated timeframes for improvements through conservative care. With the right treatment plan, patients with failed back surgery syndrome can find relief from their symptoms and improve their quality of life. Even better, pursuing conservative treatments, such as laser therapy for back pain, early on may allow you to forego surgery altogether.
Please note that—although it is typically not advisable to rush into surgery—surgery may be the best option for patients with severe conditions. For emergency situations, surgery may be the only option available, and good surgeons play a pivotal role in improving many patients’ lives every day! However, if surgery is an elective procedure while conservative care options like physical therapy, chiropractic, massage, acupuncture, or laser therapy have not been tried, it is nearly always worthwhile to consider those options before rushing into surgery. Surgery is irreversible and carries risks. When deciding which treatment path to take, patients should always consult their healthcare providers with intentional communication about their treatment-outcome goals. To find a healthcare provider who will have these conversations with you, view our list of LTI Members.
