Chiropractic Works with Dr. Birk

Failed Back Surgery and Low Back Pain

Posted: October 1, 2012
By: Dr Ruminder Birk

Back surgery is quite common in North America; at times these are laminectomies and diskectomies, and other times the joints can no longer move because the spine has fused together.  Conservative medical approaches include rest, medication, exercise, and physical therapy. In the event these fail, epidural injections are often used. At this point in the patient's course of care, if there is little relief, chiropractic care is usually not considered and patients are directed toward surgery.

Most surgeons wouldn't consider an operation to be effective for back pain. In reality, the surgery is more indicated when the nerve root is compressed producing neurological signs such as muscle wasting, foot drop, or numbness.  If back pain is the primary issue, not leg pain or numbness, surgery should be avoided.

Most patient with leg pain will have severe low back pain. Patients with continued pain or numbness are called surginal failues- failed back surgery syndrome. Patients are left with few medical options afterward and re-operation is problematic.  The patient may be prescribed an opiate patch, or perhaps an implanted spinal cord stimulator, or both.  These devices send electrical impulses through tiny wires that carry the signal to different areas of the spinal cord.

These approaches may work sometimes, but too often they don't. If you had a joint/disc injury before surgery, it is likely still there. Post surgical cases should be evaluated by a chiropractor to see if there is an underlying joint problem that can be adjusted.

There may be some natural alternatives to electrical implants and long term opiate medications for pain control. Certain physiotherapy, ice, exercise, and massage can be incorporated into a comprehensive drugless management program. Even counseling and behavior therapy can help to lessen the need for medications. Usually patients can be safely adjusted after the initial surgery has healed (about six weeks). It is important to consider all options before repeat operations. Active rehabilitation combined with specific chiropractic care can be the solution for many patients