Failed Back Syndrome

Failed back syndrome (FBS) is a general term that refers to chronic severe pain experienced after unsuccessful surgery for back pain. Surgery for back pain is conducted when there is an identifiable source of pain-usually to decompress a pinched nerve root or to stabilize a painful joint.

Multiple factors can contribute to the onset or development of FBS. Contributing factors include but are not limited to residual or recurrent disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue (fibrosis), depression and spinal muscular deconditioning. An individual may be predisposed to the development of FBS due to systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease. Smoking is also a risk for poor recovery.

The treatments of FBS include physical therapy, minor nerve blocks, transcutaneous electrical nerve stimulation (TENS), behavioral medicine, non-steroidal anti-inflammatory (NSAID) medications, membrane stabilizers, antidepressants, spinal cord stimulation, and intracathecal morphine pump. Use of epidural steroid injections may be minimally helpful in some cases.