Expert evaluation and advanced solutions when pain persists after spine surgery
Persistent or recurring pain after back surgery can be frustrating and life-altering. Often referred to as Failed Back Surgery Syndrome (FBSS), this condition describes ongoing back or leg pain that continues despite one or more spine procedures.
At Virginia Spine Specialists, we focus on identifying the true cause of persistent symptoms and developing a personalized plan—using conservative measures, advanced diagnostics, and minimally invasive treatments when appropriate.
Understanding Failed Back Surgery
What Is Failed Back Surgery Syndrome (FBSS)?
Failed back surgery syndrome is not a single diagnosis, but a term describing continued pain after spine surgery. Symptoms may persist immediately after surgery or develop months or years later.
Low back pain is one of the most common ailments affecting the general population. Among individuals with labor intensive work, the prevalence of low back pain is alarmingly high. Even though conservative management is very effective in treating such pain, some cases of low back pain are resistant to all forms of such treatments. When the pain gets excruciating and unbearable for a considerable period, surgery may be one of the treatment options offered to patients.
For the right indications and in selected cases, surgery may offer hope for patients suffering from debilitating back pain. In some cases, however, surgery fails to achieve its intended effect and leaves the patient without significant relief and in some cases even worse off than before. As the number of spinal surgeries being done in the US increases, the number of these failed procedures is also on the rise. This condition has been called Failed Back Surgery Syndrome (FBSS).
Patients suffering from FBSS face significant challenges. They may not get diagnosed with this problem right away and there may be more procedures performed on them that may worsen the situation. It is not uncommon for these patients to have undergone several back operations without significant benefit. It is frequently associated with dependence on long term pain medicine, significant disruption of day to day work and leisure activity and breakdown of social life.
Until very recently, this problem was not fully recognized, much less addressed in a timely manner. Most spine specialists were unaware of existence of this condition and therefore were unable to offer meaningful solution to this problem. Recent advancements in our understanding of spine has helped the spine community tremendously in recognizing and treating this problem at an early stage.
Symptoms After Back Surgery
Patients with FBSS may experience:
- Persistent lower back pain
- Recurring or worsening leg pain (sciatica)
- Numbness or tingling in the legs
- Limited mobility or difficulty standing or walking
- Pain that interferes with sleep or daily activities
Because symptoms can stem from multiple sources, a careful and methodical evaluation is critical.
Common Causes
Common contributing factors for FBSS include:
- Residual or recurrent nerve compression
- Scar tissue formation around spinal nerves
- Incomplete decompression or fusion failure
- Adjacent segment degeneration
- Spinal instability or alignment issues
- Nerve injury or chronic inflammation
Treatment Options
Treatment for FBSS begins with a consultation with a spine specialist who has a special interest and expertise in this problem. Frequently a new set of imaging studies may be ordered to assess the status of spine and the implanted surgical hardware. After a careful history, physical exam and review of up to date imaging studies, the specialist will formulate a plan that would typically involve multiple disciplines. This may include a combination of physical therapy, epidural injections or corrective surgery to address any obvious problems with earlier procedures. A technique that is increasingly being used to treat FBSS is spinal cord stimulation. This can sometimes provide almost immediate pain relief to patients suffering from FBSS.
Failed back surgery syndrome is a complex problem with no easy answers. Patients who suspect that they may be suffering from it need to contact an appropriate Spine Specialist who understands the complexity of modern spinal treatments.
Comprehensive Evaluation First
Before recommending treatment, we focus on understanding why pain persists. Evaluation may include:
- Detailed review of prior surgical history
- Advanced imaging studies
- Diagnostic injections to pinpoint pain sources
This approach helps avoid unnecessary repeat surgery.
Non-Surgical & Advanced Pain Management
Many patients improve with targeted non-surgical or interventional care, including:
- Physical therapy focused on function and stability
- Image-guided injections to reduce inflammation or identify pain generators
- Medication optimization
- Neurostimulation for chronic nerve-related pain when surgery is unlikely to help
Neurostimulation can be especially effective for patients with persistent leg or nerve pain after surgery.
Revision or Salvage Spine Surgery
In select cases, additional surgery may be beneficial when a clear, correctable structural problem is identified.
Modern salvage or revision procedures may involve:
- Minimally invasive decompression
- Revision fusion or stabilization
- Correction of alignment or hardware issues
Surgery is considered only when benefits clearly outweigh risks and when it is expected to improve function and quality of life.
When to Seek Urgent Evaluation for FBSS
Consider specialist evaluation if:
- Pain persists or worsens after back surgery
- Symptoms return months or years after an initially successful procedure
- Conservative treatments have failed
- You’ve been told “nothing more can be done”
Many patients benefit from a fresh, expert review of their condition and options.
Specialized Care for Failed Back Surgery with Dr. Mudit Sharma
As a board-certified neurosurgeon, Dr. Sharma specializes in complex spine conditions and revision spine care. Patients benefit from thoughtful evaluation, conservative decision-making, and access to advanced minimally invasive and pain management solutions.
Call (571) 921-4877 for an appointment.
Serving the residents of Prince William, Spotsylvania, and Loudoun counties in Northern Virginia
Learn more about Neurostimulation.
Read Dr. Sharma’s latest article on Salvaging Failed Back Surgery.
Frequently Asked Questions
Not necessarily. Persistent pain can result from scar tissue, nerve sensitivity, progression of spine disease, or new issues at adjacent levels.
Yes. Many patients improve with targeted pain management, physical therapy, injections, or neurostimulation.
Revision surgery can be more complex than initial surgery, which is why careful evaluation and patient selection are essential.
Even after multiple surgeries, patients may benefit from advanced pain management or minimally invasive options. An expert review can help clarify next steps.
Phone: (571) 921-4877
Toll Free: (855) 774-6334
Fax: (571) 208-0585
Toll Free: (855) 774-6334
Fax: (571) 208-0585
Conditions We Treat
Chronic Back Pain
Neck Pain
Arm Pain and/or Numbness
Leg Pain and/or Numbness
Herniated Disc – Lumbar and Cervical
Sacroiliac Joint (SI) Pain
Slipped Disc
Spinal Stenosis
Spinal Fractures
Whiplash Syndrome
Failed Back Surgery
Office Hours & Locations
Monday – Thursday: 8am – 4pm Friday: 8am – 2pm Loudoun County 24430 Stone Springs Blvd, Suite 250 Dulles, VA 20166 Spotsylvania County 4604 Spotsylvania Parkway, Suite 300 Fredericksburg, VA 22408 Prince William County 9625 Surveyor Ct. Suite 320 Manassas, VA 20110