Failed back surgery syndrome – often referred to as FBSS – is not a syndrome at all but simply a descriptive term. The term is used to describe patients who have had spine surgery, but are still in pain. Spine surgery can either decompress a pinched nerve root or stabilize a painful joint – that’s it. If a patient’s pain does not originate from a pinched nerve or an unstable joint, he or she will likely continue to experience pain. Frankly speaking, in an FBSS scenario, a back surgery is not necessarily “failed” because it may have achieved the goal of changing the anatomy – decompression or stabilization. Sadly, the patient’s pain may be stemming from something else such as post-surgical scar tissue, an improper rehabilitation approach or various other issues…and so the pain continues.
As Chandler pain doctors, we see countless patients with chronic neck and back pain in Arizona and many of them are post-back-surgery patients. We have many different approaches and methods that can help with FBSS, and one of them is spinal cord stimulation. In Gilbert, Chandler and the rest of Phoenix, chronic back pain. The FDA approved spinal cord stimulation back in 1989 so this is not a new medical therapeutic approach. But in the almost 20 years since it’s approval, spinal cord stimulation devices have improved considerably with smaller and more effective devices being manufactured. Spinal cord stimulation is not for every type of back pain in Chandler, but it can be a great option for those suffering from peripheral neuropathy in Arizona (a continuous burning leg pain), chronic low back or neck pain, complex regional pain syndrome (severe pain and swelling) and select others.
Spinal cord stimulation has been the subject of many studies – many of which offer promising outcomes. One such study was undertaken to find out if spinal cord stimulation (SCS) was effective when used in addition to conventional medical management (CMM). One hundred patients with leg pain of neuropathic radicular origin were randomly selected to receive either SCS plus CMM or CMM alone. After 6 months, 24 SCS patients (48%) and 4 CMM patients (9%) (p<0.001) achieved the primary outcome of 50% or more pain relief in the legs. Compared with the CMM-only group, the SCS plus CMM group experienced improved leg and back pain relief, quality of life, and functional capacity, as well as greater treatment satisfaction (p<or=0.05 for all comparisons). The study concluded that, in selected patients with FBSS, SCS provides better pain relief and improves health-related quality of life and functional capacity compared with CMM alone.
Similarly, a 2017 study investigated the effects of spinal cord stimulation (SCS) devices to treat neuropathic chronic pain secondary to Failed Back Surgery Syndrome. Although this study only had 8 patients, preliminary data suggests SCS has the potential to improve posture and gait when turned on and may also allow for reduction of pain during rehabilitation interventions. A 2016 report reviewed spinal cord stimulation systems for chronic pain and concluded that there is plenty of solid evidence “to support the safety and efficacy of traditional SCS therapies in the treatment of chronic refractory low back with predominant limb pain. More than 50% of all patients with chronic painful conditions experience sustained and significant levels of pain reduction following SCS treatment.” This is very promising news for those with chronic back pain in Chandler.
Spinal cord stimulation in Arizona involves surgically implanting a generator just below the skin of the chest, buttocks or abdomen. This generator is connected to lead wires which are placed near the affected are of the spine. Then, the patient-controlled-generator sends electrical impulses of varying degrees to mitigate the pain response. Before anything can be surgically implanted, however, the patient must first undergo a trial to ensure the treatment will be effective. For the trial period, the leads are inserted into the spine, but the generator is worn on the outside of the body. The patient administers his or her own stimulation and records the data for 5-7 days. If significant pain relief is achieved the patient is considered a good candidate for the subdermal generator.
If you are in chronic neck, back, leg or arm pain, you owe it to yourself to find out if spinal cord stimulation can help. Whether you suffer with neuropathic pain or another pain syndrome, our Chandler pain doctors are here to advise you on whether or not this modality can help mitigate your pain.