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Back pain after surgery is a common problem and can occur after any surgery. Back pain immediately after spine surgery is to be expected, and your surgeon should give you pain medicine to control it. When your back pain does not improve after surgery you may have a more complicated problem.
"back pain because you are immobilized"
After abdominal surgery, such as a tummy tuck surgery, or surgery on your colon or gall bladder, or after a hysterectomy you can have back pain because you are immobilized.
If you have a little arthritis in your back, or even if you don't, lying flat on your back for several days in a row will make most people's back hurt.
If you have back pain after knee or hip surgery, it can also be from lying in bed. In addition, when you do get up you cannot walk correctly and you are using a walker, these can affect your back as well.
"you need to begin moving"
When you are having back pain after surgery other than back surgery the simplest answer is to just get over your surgery and get back to your normal activities. I know that is easier said than done, but it is none the less true. Your doctor or surgeon should give you adequate pain medication, and they will encourage you to walk when they think it is safe. As soon as your surgeon allows it you need to get up and begin moving. It will be good for your back, good for your lungs, it will help prevent blood clots, and it will make you feel better.
"Before deciding that a surgery has been a failure"
When you have back pain after surgery, such as a herniated disc surgery or spinal stenosis surgery, the instructions are the same. When your surgeon tells you it is safe to get up and walk, that is what you need to do.
Chronic back pain that develops after surgery, or failed back syndrome as it is sometimes called can be a complicated problem with multiple causes. Before deciding that a surgery has been a failure there are some questions that should be asked.
Have you given yourself enough time to heal?
Major back surgery is very invasive, and as such, requires an extended period of time just to heal, often several months. Along with this, prior to most major back surgeries such as spinal stenosis surgery, there has been an extended period of incapacity causing marked deconditioning and loss of muscle mass. This too can take several months to regain, and you really can't start working on conditioning until your body has had sufficient time to heal following your surgery.
Have you followed the instructions of your surgeon?
Instructions regarding physical therapy and activity levels must be followed exactly. Doing too much or too little during the postoperative period can contribute to back pain after surgery. If you are told to get up and walk with physical therapy, then it is important that you make every effort to comply. Or if your surgeon tells you not to golf for three months after surgery, then that is it, you just can't golf for three months.
Have you followed up with your surgeon?
Many times surgeons are busy, and it can be difficult to get a follow up appointment, but it is absolutely mandatory.
Usually surgeons will see you daily while you are in the hospital, and then weekly or monthly after your discharge, to monitor your progress. If you are still having back pain after surgery, now is the time to discuss it with your surgeon.
"unrealistic to expect your pain to be completely gone"
In many cases, the goal of spine surgery is to make you more functional, rather than pain free. It may be unrealistic to expect your pain to be completely gone. This should be discussed with your surgeon, prior to your surgery.
For example, when you have back pain and sciatica, spine surgery may relieve the sciatica but it may not relieve the back pain. The back pain you may have to learn to live with.
"Other structures may be the reason for your pain..."
Other structures may be the reason for your pain, or perhaps they were the source of your pain to begin with.
For example, arthritis in your spine, or hips, or sacroiliac joint dysfunction or piriformis syndrome can all cause leg and back pain after surgery, that is easily confused with pain from other sources in your back. But if that area was not addressed by the surgery, you could not expect that pain to be gone.
"there are back surgeries that fail"
Also things like depression, anxiety, and poor sleep habits can contribute to a poor recovery and back pain after surgery. Each of these must be evaluated and considered, independent from the back surgery.
With all of that said, there are back surgeries that fail. The reasons are many and varied.
Perhaps a misdiagnosis led to the wrong surgery being performed, or the surgery may have been performed incorrectly or incompletely.
During the postoperative period, pain may develop due to instability, infection, or scarring.
"resulting in a new problem"
Many times back surgery, especially a fusion, can cause increased stress at adjacent levels resulting in a new problem or transfer lesion. If bone is removed affecting the structural integrity of the spine, abnormal motion and instability may result, causing back pain after surgery.
Infection after surgery can lead to serious complications including sepsis and death. But this is rare because of the modern antibiotics available.
"can also fail because hardware fails"
The more common problem following an infection is excessive scarring. This can tether structures together and prevent normal motion, or cause pain by pressing on nerves.
Back surgeries can also fail because hardware fails; it may break or become dislodged. A fusion may fail because a bone graft slips out of place, or if a graft does not develop a bony union with the vertebrae.
"you may have some degree of residual back pain"
The list of possible problems after a major back surgery is a long one, and depending on exactly what surgery is being performed, you may have some degree of residual back pain.
If it is pain that prevents you from living your life you should have it evaluated. Then getting a second and even a third opinion from qualified spine surgeons is also a reasonable course of action.
"failed back surgeries do occur"
If after two or three complete evaluations it is determined that another surgery is not likely to make you better, you need to consider that this is pain that you may have to learn to live with.
Unfortunately, failed back surgeries do occur, and when they occur, treatments for chronic back pain need to be considered.
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