Failed Back Syndrome

Failed back syndrome describes the patient who has undergone spinal surgery one or more times, but yet still has persistent pain significantly interfering with their normal daily activities. This pain can come from joints, muscles, and/or nerve damage. Pain can also occur from the hardware, which is the rigid metal that was placed in the spine during surgery to provide the injured spinal area with stability. This hard metal then interacts with the much softer bone and muscle in the area, causing pain. Patients who have had prior back surgery and who have hardware and instrumentation will frequently tell us that there pain is worse when it is cold and when it rains (in fact most painful conditions increase with these factors).


Treatment options for failed back syndrome are directed at the specific cause of the persistent injury. Treatments may be conservative in the form of Physical Therapy, medications, and/or injections. Alternatively this pain may require more sophisticated interventions such as implantable therapies including spinal cord stimulation or spinal drug delivery systems. Treatment of failed back syndrome should progress from less invasive interventions to more invasive treatments. In some patients the use of chronic medications may be appropriate as an adjunct to other treatment directed at the specific cause of symptoms.