At a glance
What it is
Persistent or new pain after spinal surgery — not a true syndrome but a general term for unsuccessful surgical outcomes. Affects an estimated 20–40% of spinal surgery patients.
Why it happens
Spine surgery can only decompress a pinched nerve or stabilise a painful joint. It cannot eliminate pain directly. Scar tissue, unresolved nerve irritation, or misidentified pathology are common reasons for ongoing pain.
Approach
Injections and nerve blocks first. Spinal cord stimulation for disabling pain resistant to initial measures. Physiotherapy to restore strength and function.
What failed back surgery syndrome is
Failed back surgery syndrome (FBSS) describes new or persistent pain after spinal surgery for back or leg pain. Pain may remain reduced but still present, or worsen within months of surgery — commonly from scar tissue forming around spinal nerve roots, alongside persistent tissue pain and muscle spasm.
The term does not imply that anything went wrong during surgery. Even with the best surgeon and appropriate indications, spinal surgery predicts a successful outcome in no more than 95% of cases.
**What spine surgery can achieve:** 1. Decompressing a pinched nerve root 2. Stabilising a painful joint
Surgery cannot eliminate pain directly — it changes anatomy. For this reason, the anatomical lesion responsible for the pain must be accurately identified before surgery, not after. Repeated surgery carries a higher likelihood of FBSS.
**Treatment pathway:** Initial treatment typically includes targeted injections, nerve blocks, or radiofrequency ablation to temporarily interrupt pain signals. A graduated exercise programme to restore muscle strength is also a core component.
For pain that is disabling and does not respond to initial measures, **spinal cord stimulation** is an option. One or more leads with small electrical contacts are placed near the affected nerves (along the spine); if a trial period reduces pain, a small battery is implanted to provide continuous stimulation. Large, carefully conducted trials have shown spinal cord stimulation to achieve superior outcomes at lower cost than repeat back surgery for FBSS.
Treatment options at Alimran Medical Center
Injection therapies
- Trigger point injections
- Epidural steroid injections
- Ozone injection
- Prolotherapy
Neuromodulation
Advanced therapies
Physiotherapy & rehabilitation
- Electrical stimulation
- Short and long wave therapy
- Laser therapy
- Ultrasound therapy
- Magnetic therapy
- Therapeutic exercises
- SpineMED® system
- Sigma
Book a consultation
The secretary schedules first appointments during clinic hours; please have prior imaging, operative notes and a current medication list available at the time of the call.
This page provides general information about failed back surgery syndrome (fbss) and is not a substitute for individual medical assessment. If your symptoms are severe or worsening, contact a clinician promptly.