I had spinal surgery before but I’m not getting better. What should I do?

There are many reasons why your symptoms may not seem to be getting better after spinal surgery. Your spine is a highly complex structure and surgery for the spine may also be highly detailed and complex.

Reasons why you may not be getting better after spinal surgery

  • Recovery time

Spinal surgery always causes trauma to the structures around the spine. The trauma is much less if the surgery was able to be performed using Minimally Invasive Surgical Techniques, nevertheless it still does exist. It takes some time for this trauma to heal.

  • Long-term damage to neural structures

In cases where the spinal condition has been causing pressure on neural structures, such as the spinal cord or spinal nerves, the damage is not always able to be completely reversed. In other cases it can take a long time for recovery to occur (as long as 6 to 12 months).

  • Long-standing pain

For people who have had very longstanding pain, there are times when the pain does not improve even when the physical cause of the pain is removed. The pain has become a chronic pain problem and will need to be managed by different techniques.

  • Unsuccessful surgery

In rare cases, the surgery will have been unsuccessful in achieving the surgical aims. It may be necessary to repeat the surgery.

  • Need for revision surgery

There are many reasons why spinal surgery may need to be revised. These include for conditions including recurrent disc herniations, adjacent segment disease (which is where the areas of spine above or below the surgical level become affected) or the development of pseudoarthrosis. Your surgeon will be able to tell you whether you have been affected by one of these conditions.

What can I do if I’m not getting better after spinal surgery?

  • Speak to your surgeon

The first thing you should do if you are concerned about your progress is to talk to the surgeon who performed your surgery. Your surgeon may be able to put your mind at ease or provide you with advice or further direction. They may prescribe medication or send you for further scans to check on your progress.

  • Physical therapy

Your doctor may refer you for physical therapy. This may help to improve and hasten your recovery. Physical therapy can help with pain management and help to improve your mobility. The therapist may use manual therapy techniques or other modalities and will prescribe exercises to help to strengthen and stabilize your back and your core muscles.

  • Chronic pain management

For some people, chronic pain management techniques may be appropriate. These techniques will help you manage and understand your pain. These techniques may assist you to return to a full and active life if your pain cannot be completely resolved.

  • Seek a second opinion

If you remain concerned, it may be appropriate to seek a second opinion from another surgeon. Each surgeon will have a slightly different opinion on management and surgical techniques also can vary greatly between surgeons. A second opinion may help to put your mind at rest as to whether any further options may be appropriate for you.

Article Written by
Dr. Kaushik Das is a spinal surgeon in New York.