Low back pain becomes a hard reality for so many of us as we age. Feeling discomfort in your lower back and wondering why it is happening to you? Remain calm, you are not alone in this! Anybody, regardless of risk factors or history of injury, can develop lower back discomfort at any moment, but often it gets better on its own and is not necessarily serious.  However, there are situations where lower back discomfort turns into chronic low back pain.

Our lower back only consists of five vertebrae, which is less than the mid-back and neck, but these vertebrae are capable of tremendous power. Lower back supports the weight of your upper body by connecting your spine to your pelvis! However, constant action means there is a lot of movement and strain in this area, which increases your risk of tears and injury. 

Want to find out more about lower back pain and how to deal with it? Some patients go through surgery for these issues, but even after that, they might still struggle with pain management. Follow us on our journey in the exploration of lower back pain management after surgery! 

What is Low Back Pain?

Low back pain or LBP is a type of severe pain condition that affects the area between the lower border of the ribcage and your pelvis region. Acute, sub-acute, and chronic - these are the three types of lower back pain that cause health issues to millions! LBP impairs mobility and has a negative impact on mental health and quality of life because it may restrict one's ability to go on with their life as they normally otherwise would. 

LBP may or may not be non-specific. Confused? Let us explain! Pain that arises from a specific disease, an anatomical issue with the spine, or when the pain travels to another area of the body is known as specific LBP. On the other hand, when a particular illness or anatomical cause cannot be found to account for the pain, the condition is referred to as non-specific LBP. Treatment is crucial for severe lower backache of all kinds in order to help the patient get back to their normal life! For certain LBP, such as chronic low back pain, specialized care options can be required.  

Be Aware of the Common Symptoms of LBP  

You may think, how can I possibly not know the symptoms of LBP because won’t I clearly feel the pain? Unfortunately, it is not always that easy, and at times, the source of the discomfort might not be apparent to you! Severe lower backache symptoms might develop gradually or unexpectedly, and pain can often be triggered by a particular action, like leaning down to pick something up. Your lower body or the backs of your legs may experience dull, aching pain (sciatica), or you can even hear a "pop" as your back tenses up during movement. Your pain might not be too severe in the early stages, but you will feel many other signs of discomfort. 

• Posture issues - It might be difficult for many persons with back pain to stand up straight, and instead of having your torso in line with your spine, you can stand "crooked" or bowed.  
• Spastic muscles - Following a dull pain sensation, the lower back's muscles may contract erratically or spasm, and later, severe discomfort can result from this! Muscle spasms can also make standing, walking, or moving difficult or impossible for some people.
• Stiffness - You might find it difficult to move, or it might take some time for you to get up from a seated position when you have stiffness. You could feel as though you need to stretch constantly to loosen up! 

Lower Back Pain after Back Surgery

Have you made the decision to get surgery in order to alleviate your back pain? That is certainly an option in severe cases. When it comes to low back pain issues, surgery is often performed to enhance function and mobility, address nerve damage or prospective damage, and address the intensity and duration of the pain. Remember that surgery aims to greatly alleviate symptoms, stop further damage, and restore as much movement as possible, but not all low back damages are repairable. So, even after surgery, your pain may not go away fully, and in those circumstances, you need to learn how to manage the pain long-term! 

Both non-surgical and surgical therapies are available for the management of failed back surgery syndrome (FBSS), and for all patients, before considering invasive therapies, a number of nonsurgical treatments are attempted for a few months. In general, FBSS development and treatment are difficult for medical professionals and patients alike, and that is why a methodical approach to identifying and addressing the underlying source of pain becomes necessary. The pain management options we have mentioned below have the main objectives of minimizing discomfort, enhancing the patient's quality of life, and maximizing function restoration. 

• Guided Physical Therapy 

For FBSS, guided physical therapy is often one of the first pain management methods doctors offer. It is possible to improve lower back range of motion and muscular strength with guided physical therapy! These objectives are accomplished by the patient when they perform a sequence of exercises that their therapist has specifically recommended based on their strengths and limits. 

• Spinal Cord Stimulation (SCS)

Spinal cord stimulation is a pain treatment that involves passing regulated electric pulses close to the spinal cord to block pain-transmitting nerves to manage back pain. A device placed in the patient's lower back generates the electrical pulses! You need to know that a trial phase may be used to evaluate the efficacy of spinal cord stimulation, and only if successful, permanent implantation may be carried out later. 

 

• Medications

Non-steroidal anti-inflammatory medicines (NSAIDs), opioid analgesics, and anticonvulsant medications are the common oral treatments for low back pain after surgery. These drugs work by either obstructing the brain's ability to perceive pain or by decreasing swelling and inflammation in the lower back region, and a doctor's prescription is required for these medications.   

• Injections

Spinal injections help with back pain management after unsuccessful back surgery in some patients!  

Epidural steroids - Steroid drugs are injected into the epidural space of the spine! The dura, a sac around the spinal cord, is surrounded by the epidural space, which is made up of fat, blood vessels, and nerves. The steroid injected into the epidural space relieves pain and offers relief by dispersing the drug into the nerve endings. 

Adhesiolysis - In this procedure, a doctor would inject a solution, such as a steroid, saline, or hyaluronidase, into the epidural scarring region during a minimally invasive injection if the pain is caused because of internal scars. Adhesiolysis therapy may need only one session, or many sessions spread over a few days, and if necessary, the process can be repeated in a few weeks.  

Radiofrequency ablation - Radiofrequency ablation, also known as radiofrequency neurotomy, is a treatment for back pain after surgery that heats a portion of a pain-transmitting nerve using a radiofrequency needle. The capacity of the nerve fibers to transmit pain is lost after the RFA lesion is formed, and pain signals from that region are not sent to the brain anymore. 

Final Remarks

Lower back pain traumatizes millions, and some of them might make the difficult decision to go for a back pain surgery. But that may not be the end of suffering for the most unfortunate souls, since back surgery may sometimes fail, and then they need constant treatment for back pain after surgery! The common back pain management methods after surgery are usually non-invasive, and can really help the patient finally manage their pain condition, but only if they stick to their doctor's instructions.