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Back pain after back surgery
Why pain can linger or return after spine surgery, how physicians look for the source, and how rehab helps
Back pain after back surgery is common, and it does not always mean the surgery failed. Pain can linger while tissues heal, come back at a nearby spinal level, or come from muscles, joints, scar tissue or small nerves outside the area that was operated on. A physician examines you, reviews your surgical records and orders imaging only when it will change the plan. Sometimes a diagnostic nerve block is used: if numbing one nerve relieves the pain, that helps confirm where it is coming from. Physical therapy to rebuild strength and movement is part of most plans.
Many people expect back surgery to end their pain for good, so pain that hangs on or returns months later can be discouraging. At Precision Care Medical & Sports Performance, our pain physicians, Ashley Marcus, MD in Brooklyn, Jake Stephen, DO on Staten Island and Yuri Gordin, MD in Manhattan see patients after a laminectomy, discectomy or fusion to work out why the back still hurts. The first video shows a diagnostic nerve block for a patient who had surgery before; the second shows physical therapy after a laminectomy.
Possible causes of back pain after back surgery
- Normal healing: muscles and soft tissue cut or stretched during surgery can stay sore and weak for weeks to months; see recovery after spine surgery
- Muscle weakness and guarding: the back and hip muscles stiffen and weaken after surgery and inactivity
- Nearby joints and levels: the facet joints, the sacroiliac joint or the disc above or below can become painful; see facet joint pain
- Nerve irritation: scar tissue, a new disc problem or narrowing can irritate a nerve root and cause leg symptoms
- Small sensory nerves: in some people, nerves that run along the top of the pelvis can produce pain felt in the low back
These causes can overlap, and symptoms alone do not tell them apart. That is why the next step is an exam rather than a guess.
How a diagnostic nerve block helps find the source
In the first video, the physician explains that nerves running along the iliac crest, the top ridge of the pelvis, can sometimes cause low back pain, especially in people who have had surgery before. Using live X-ray guidance, numbing medicine is placed next to those nerves. If the usual pain eases for the hours the medicine lasts, that points to those nerves as a pain source and helps guide the next treatment. If it does not, your physician looks elsewhere. Blocks like this are done with fluoroscopy-guided injections; see also back pain injections. Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled.
Physical therapy after back surgery
In the second video, a patient who had a laminectomy is having a hard time bending and walking. His therapist starts with the muscles along the spine, then adds pelvic tilts, hip abduction and work on lower back mobility. As the therapist says, the more you move, the better you get at it. Rehab after spine surgery usually builds from gentle motion to core and hip strength to walking endurance and lifting practice; see physical therapy after surgery and core exercises for back pain. Physical therapy is offered at our Brooklyn and Staten Island offices.
When to get checked quickly
Call your surgeon or physician promptly for fever, redness or drainage at the incision, or new or worsening leg weakness or numbness. New loss of bladder or bowel control or numbness in the groin needs emergency care.
More videos: rehab after a laminectomy
More clips from our YouTube channel @precisioncaremedical showing physical therapy for a patient with back pain after a laminectomy.
Related care at Precision Care Medical & Sports Performance
Back pain after surgery: care near you
Searching for a back pain doctor near me after spine surgery? Precision Care Medical & Sports Performance sees patients at three offices. Ashley Marcus, MD practices at our Brooklyn office on Shell Rd, close to Sheepshead Bay, Gravesend and Manhattan Beach. Jake Stephen, DO sees patients at our Staten Island office on Richmond Rd, near Dongan Hills and Grant City. Post-surgical physical therapy is offered at both of these offices.
Yuri Gordin, MD sees patients at the Precision Care Spine & Pain Center in Midtown Manhattan, an easy trip from the Financial District, Murray Hill and Washington Heights. Request an appointment or call the office closest to you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
Is it normal to have back pain after back surgery?
Some pain and stiffness is expected while you heal, often for weeks to a few months. Pain that is getting worse, or returns after improving, should be checked.
Does pain after back surgery mean the surgery failed?
Not necessarily. Pain can come from healing tissue, weak muscles, nearby joints, scar tissue or small nerves outside the operated area. An exam helps find which one.
What is a diagnostic nerve block?
Numbing medicine is placed next to a specific nerve with imaging guidance. If your usual pain eases while the medicine works, that nerve is likely part of the problem, which guides the next step.
When can I start physical therapy after back surgery?
When your surgeon clears you, often within the first weeks. Your therapist starts gently and progresses as you heal.
Will I need more imaging?
Only if the exam suggests it will change the plan. Your physician reviews your surgical records and existing imaging first.
Where can I get help for back pain after surgery near me?
Precision Care Medical & Sports Performance sees patients after back surgery at three offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
- Midtown Manhattan150 E 55th St, Suite 401, New York, NY 10022(212) 840-0135 · Get directions
Post-surgical physical therapy is offered in Brooklyn and Staten Island.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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