Make Pain a Thing of the Past – surgery – Physician Partners of America

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Cyndi: Anyone who suffers from chronic back pain knows they’ll try anything to get relief. Well, sometimes that means undergoing surgery. But what if that doesn’t actually work? Failed back surgery syndrome can sometimes be a result, and avoiding surgery is an important measure to stamping out FBSS. Dr. Rudy Gari is here from Florida Pain Relief Group to talk more about this, FBSS, Failed Back Surgery Syndrome.

Dr. Gari: Yes.

Cyndi: Okay. How common is it to see this?

Dr. Gari: It’s very common. So we have great neurosurgeons, they do fantastic work, but unfortunately, you know, it’s not 100%. And so we have some patients that, despite a great surgical procedure, the patient continues to have back pain afterwards. So we actually get a lot of referrals from our surgeons when they’ve done everything possible that they can and they still have that back pain.

Cyndi: Are there certain people, in particular, that are more prone to this?

Dr. Gari: That can really happen to just about anybody. The more surgeries that you have, it makes more sense, the more likely that you are… Because the first surgery has a high success rate, the second one is less, and the third one’s even less. So yes, our surgeons do everything that they can, but unfortunately there are some patients that, despite that, they still continue with pain. And that’s where we come in and we can help out.

Cyndi: I imagine, after going through all that, these patients that are coming to you are at their wit’s end because they’ve tried. They’ve gone through major surgery, and they still have pain. So what can you do for them?

Dr. Gari: Sure. So we can do a lot of things for ’em. The first thing we do is perform a thorough history and physical examination and see what’s going on, make sure there’s nothing else that we can do from a surgical point of view. After that, that’s medications. We can do nerve blocks, physical therapy, spinal cord stimulation, stem cell therapy. There’s a lot of different tools that we can have, and we learn more and more every day. It can be pretty debilitating. I’ve had some patients say, “Doc, I just wanna be able to go to the mall and go shopping. I mean, things that we take for granted, they can’t do that. But we can help them, and sometimes that’s a success, is different treatments to allow you to go shopping, to go do grocery shopping, you know, those kind of things.

Cyndi: Does it require a lot of visits to you to get this relief, or is it something that takes time because everyone wants it fixed, you know, yesterday? But obviously you have to assess what the matter is first and then start with the treatment. But is it ongoing treatment usually, or is it a treatment that’s one time and then you’re good?

Dr. Gari: It’s both. So we have some patients that all that they need is, perhaps, you know, two or three nerve blocks and physical therapy and then they’re good. And then, if they aggravate their back again, they come see us. We have other patients where, you know, they just have a lot of damage. They have a lot of scar tissue and different things where they do require more visits from us.

Cyndi: I hear a lot about people who have pain due to scar tissue. Why does that cause so much pain?

Dr. Gari: So what happens is that a scar can form around the nerve, so that nerve is constantly being squeezed. We actually have a procedure that’s called epidurolysis, and what that does is, is that we can actually go in and try to remove, if not loosen up, that scar tissue. And we do that without surgery. We do it through a needle and then a little bit of a catheter. We can go in there and try to loosen that scar tissue.

Cyndi: And that relieves that nerve.

Dr. Gari: Yes.

Cyndi: Ah, and stops the pinching.

Dr. Gari: It’s that squeezing on the nerves by the scar tissue that is formed around it.

Cyndi: Oh, sounds like some really good advice and good news for a lot of people that are out there right now that are going through this because they may think there’s nowhere else to turn. But there is, definitely.

Dr. Gari: Yes, there is.

Cyndi: Thank you, Dr. Gari. Florida Pain Relief Group even offers a same day appointment, so you can visit their website. It is, or give them a call right now, 844-KICK-PAIN. Dr. Rudy Gari, thanks again.

Dr. Gari: My pleasure.

Cyndi: We’ll be right back.

Get Relief from Pain After Back Surgery

When making the decision to go forward with back surgery, the hope is that by having the procedure done it will reduce or eliminate pain.

The reality is that back surgery can be unsuccessful and ultimately leave you with the same level of pain, or even greater pain, than when you first had the procedure.

The issue has become so common that it has a name: Failed Back Syndrome. Tampa pain specialist Dr. Jorge Leal with Physician Partners of America has this first-hand in his patients over the years.

“Sometimes the pain can occur immediately after the surgery.The pain you feel does not get better,” Dr. Leal said. “Sometimes it’s a period of days or weeks after the initial surgery.  The pain goes away but then it comes back.”

Symptoms of Failed Back Syndrome are varied. However, typically a patient will feel pain in their back and usually down one or both of the lower extremities.

“A patient could feel numbness in their legs, tingling sensations and also muscle atrophy,” Dr. Leal said. “If the nerves have been damaged, there could be a loss of reflexes, depending on the degree of residual damage.”

Physician Partners of America offers patients pain relief without surgery.

Treating failed back syndrome can be done using conventional measures such as physical therapy and anti-inflammatory medication. Another option is nerve blocks if they have not been tried in the past.

“If no further surgical treatment is required or desirable, then we look at implantable devices like spinal cord stimulation or a morphine pump,” Dr. Leal said.

The prognosis for someone with Failed Back Syndrome varies widely based on the kind of surgery that was performed and where the pain is coming from. Sometimes the pain will subside with treatment, but it is not a guarantee.

“What we can do is, through various diagnostic nerve blocks, we can identify the pain generator,” said Dr. Leal.  “From there we can concentrate on it and determine the best course of treatment for such a pain generator.”