An estimated 15% to 61% of patients suffer from persistent or recurrent spine pain after surgery and up to two thirds of chronic spine pain patients seen at pain centers suffer from failed back surgery. With these numbers it is easy to understand why we say spine surgery should be the last thing you do after all other options have failed. Of course, we have the question of what you should do if you suffer from spine pain after surgery even if the surgery was initially successful. There is this 2002 paper that suggests after failed low back surgery or continued pain after low back surgery the patient should undergo conservative management unless the patient has progressive neurological symptoms. The standard of care for continued pain after surgery is the same standard before surgery, start with the most conservative treatments and progress to the most invasive if conservative measures fail to show improvement. As I mentioned, the one exceptions is if the patient is experiences progressively worsening neurological symptoms such as muscle weakness, loss of sensation, and in extreme cases loss of bodily functions. Where, then, should you start? We say the best place to start is with a chiropractor.
Chiropractic care can be very effective in managing chronic spine pain, even after surgery. If you read some of my previous posts I have several references where I post papers that show how chiropractic care is more effective than standard medical care, about as effective as medical specialty care, and costs less than both. We have several patients who come in with continued pain after surgery who have done well with the care they revived in our office. If you are looking for more concrete proof than take a look at this paper published in September 2013. This paper is a study of several cases so it does not carry as much weight as a randomized clinical trial, but these case reviews do carry some weight in the world of clinical evidence. The paper highlights three cases in which the patients experienced pain after surgery. In all three cases the patients pain levels improved with traditional chiropractic care and none of the three experienced any negative effects. The patient in the second case had a multilevel fusion and chiropractic adjustments helped this patient and he didn’t experience any negative effects. There are some who would advise against treating a patient whose neck is almost entirely fused but a well trained chiropractor with a number of adjusting methods can safely and effectively help even this patient. I am currently treating a patient whose neck is fused from C4-C6, I can adjust the segments above and below the fusion safely and the patient has been doing great.
We firmly believe that surgery has its place and time in the care of spine pain but that place and time should be only after more conservative treatments fail or if a specific set of symptoms are present. We work well with medical doctors in the area and we have refereed patients to surgeons for a consult, once already this year. We also refer patients out to pain specialists when necessary because we value their care when necessary and at times it is necessary. If you are looking for answers to your persistent spine pain we might have them, give us a call today.