Back surgery is usually performed with a clear goal: to relieve pain, restore function, and help patients get their life back. Many spinal surgeries do just that. But sometimes, even after a technically successful operation, the pain remains, or new symptoms arise. When this happens, you may feel defeated and discouraged—especially after hearing the term “failed back surgery syndrome (FBSS)”.
Despite how it sounds, FBSS doesn’t necessarily mean the surgery “failed” or that your surgeon made a mistake. The term simply describes an unfortunate situation where you continue to have back or leg pain after one or more spinal procedures. It’s really a collection of possible causes, not a single disease or diagnosis.[1]
In recent years, some specialists have started using the term persistent spinal pain syndrome (PSPS) to better describe ongoing spinal pain after surgery or other treatments. Many patients and providers are still more familiar with the term FBSS.[2]
Understandably, still having persistent pain after back surgery can feel frustrating and disheartening, but there is hope.
Understanding what FBSS really means can help you move past that frustration and focus on the next step: finding treatments that help ease your pain.
Does FBSS Mean Your Surgeon Did Something Wrong?
This is one of the most common questions patients ask. The answer is usually no.
A back surgery can be technically successful, meaning the surgeon corrected the structural issue they were targeting, yet you may still have pain afterward. Pain isn’t always straightforward. The spine, nerves, muscles, and joints all work together, and surgery only addresses one piece of that puzzle. How the body heals and how nerves recover after surgery can vary from person to person.[3]
Put simply, there can sometimes be a mismatch between surgical success and pain relief. That mismatch is what leads to the diagnosis of FBSS.
You may feel crushed. You went through surgery expecting relief, and now the pain is still there. But FBSS simply signals that the problem requires a different treatment approach, not that hope is lost.
What Types of Back Surgery Can Lead to Failed Back Surgery Syndrome?
Failed back surgery syndrome most often occurs after lumbar spine surgery, which is surgery performed on the lower back to relieve nerve compression or stabilize the spine.
It’s important to know that FBSS isn’t tied to a single operation. It can occur after several different types of procedures. Studies estimate that 10% to 40% of patients may continue to experience pain after lumbar spine surgery, which is why FBSS is recognized as a clinical condition rather than a rare complication.[3]
Some of the spinal procedures most commonly associated with FBSS include:
Discectomy or Microdiscectomy
These surgeries remove part of a herniated disc that is pressing on a spinal nerve. They are frequently performed to relieve sciatica. In some cases, the disc can herniate again, or nearby discs may develop problems later.[4]
Laminectomy (Spinal Decompression Surgery)
A laminectomy removes part of the vertebral bone to create more space for nerves affected by spinal stenosis. While many patients improve, pain can persist if other spinal structures continue to degenerate.[1] Many doctors historically referred to persistent pain after decompression surgery as post-laminectomy syndrome, which is now generally considered part of the broader category of failed back surgery syndrome.[5]
Spinal Fusion Surgery
Fusion stabilizes the spine by permanently joining two vertebrae together. Over time, the levels above or below the fusion may experience increased stress, which can sometimes lead to new sources of pain.[6]
Repeat Spine Surgeries
Each additional surgery slightly increases the risk of ongoing pain because scar tissue, nerve sensitivity, and structural changes can accumulate.[7]For this reason, doctors today focus heavily on careful diagnosis and targeted treatment when pain continues after surgery rather than automatically recommending another operation.
Why Pain Can Persist After Spinal Surgery
There are several reasons someone may continue to experience pain after spine surgery. In many cases, the pain comes from a different issue than the one originally treated, or from changes that occur during healing.
Some of the most common causes include:
Scar Tissue Around Spinal Nerves
After surgery, scar tissue naturally forms as part of the healing process. In some cases, this tissue can irritate nearby nerve roots, causing ongoing pain.[8]
Residual or Recurrent Disc Problems
A disc herniation can recur at the same level or migrate to a nearby level in the spine.[4]
Spinal Instability or Degeneration
Over time, the segments above or below a surgical site may experience additional stress and degeneration.[6]
Nerve Damage or Nerve Sensitivity
Nerves that were compressed for a long time before surgery may take time to recover—or may remain sensitive even after the pressure is removed.[9]
Muscle and Joint Pain Around the Spine
Pain may originate from nearby structures, such as facet joints, muscles, or the sacroiliac joint, rather than from the original surgical area.[10] Because several factors can contribute to FBSS, a careful evaluation is essential to determine the true source of pain.
H3 How Your Pain Specialist Approaches Failed Back Surgery Syndrome
When someone is diagnosed with FBSS, the focus shifts from “fixing the spine with another surgery” to identifying and managing the pain more precisely.
Interventional pain management specialists use a combination of diagnostic tools and treatments to pinpoint the source of the pain and develop a treatment plan.
Treatment may include:
- Diagnostic nerve blocks to identify the specific nerves causing pain
- Epidural steroid injections to calm inflammation around irritated nerves
- Radiofrequency ablation to disrupt pain signals from facet joints
- Targeted spinal procedures designed to treat disc-related pain
For patients with persistent nerve-related pain, therapies like spinal cord stimulation (SCS) may also be considered. SCS uses a small implanted device that modifies pain signals before they reach the brain.[11]
If disc degeneration contributes to ongoing pain, regenerative treatments such as VIA Disc NP may also be part of the conversation in appropriate cases.
Supportive therapies are also essential, including physical therapy to improve stability and mobility, as well as behavioral health support that helps patients cope with chronic pain.[7]
Why Pain Specialists Use a Multidisciplinary Approach to Treat Your FBSS
Treating failed back surgery syndrome usually requires more than one type of therapy. Because pain after spinal surgery can involve nerves, joints, discs, and muscles, pain specialists often use a multidisciplinary approach that combines several treatments.
While the name failed back surgery syndrome can sound discouraging, it doesn’t mean your situation is hopeless. What it really means is that the original surgery addressed one issue in the spine, but another source of pain may still be present. Sometimes nerves remain irritated, nearby joints begin to cause pain, or scar tissue forms during healing. Identifying the true source of that ongoing pain is the first step toward treating it effectively.
The encouraging news is that modern interventional pain management offers many targeted treatments designed specifically for patients with persistent spine-related pain. After your pain specialist evaluates your condition and develops a personalized treatment plan, many patients can reduce pain, move more comfortably, and return to activities they enjoy.
If you’re still experiencing pain after back surgery, it doesn’t mean your treatment journey is over. It may simply mean it’s time for a more specialized approach to pain care.
Disclaimer: This content is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Pain conditions and treatment options vary from person to person, so always talk with a qualified healthcare provider about what’s right for you. If you experience sudden or worsening pain, or symptoms like numbness, weakness, chest pain, shortness of breath, or changes in bladder or bowel control, seek medical care right away.
Resources:
- Orhurhu VJ, Chu R, Gill J. Failed Back Surgery Syndrome. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: Accessed March 12, 2026. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539777/
- Thomson S, Simpson B, Huygen FJ, Stanton-Hicks M, North RB, Barolat G, Scott H, Duarte RV. The Implementation of Persistent Spinal Pain Syndrome (PSPS): Mechanism-Based Recommendations. Pain Pract [Internet]. 2026 Jan;26(1):e70104. doi: 10.1111/papr.70104. PMID: 41222498; PMCID: PMC12611182. Accessed March 12, 2026. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12611182/
- Vleggeert-Lankamp CL, Arts MP, Jacobs WCh, Peul WC. Failed back (surgery) syndrome: time for a paradigm shift. Br J Pain. 2013 Feb;7(1):48-55. doi: 10.1177/2049463713479095. PMID: 26516497; PMCID: PMC4590153. Accessed March 12, 2026. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4590153/
- Sebaaly A, Lahoud MJ, Rizkallah M, Kreichati G, Kharrat K. Etiology, Evaluation, and Treatment of Failed Back Surgery Syndrome. Asian Spine J [Internet]. 2018 Jun;12(3):574-585. doi: 10.4184/asj.2018.12.3.574. Epub 2018 Jun 4. PMID: 29879788; PMCID: PMC6002183. Accessed March 12, 2026. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6002183/
- Fallabel C. What Is Post-Laminectomy Syndrome After Spinal Surgery? Healthline [Internet]. Published January 24, 2024. Accessed March 12, 2026. Available from: https://www.healthline.com/health/post-laminectomy-syndrome
- Thomson S. Failed back surgery syndrome – definition, epidemiology and demographics. Br J Pain [Internet]. 2013 Feb;7(1):56-9. doi: 10.1177/2049463713479096. PMID: 26516498; PMCID: PMC4590156. Accessed March 12, 2026. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4590156/
- Ganty P, Sharma M. Failed back surgery syndrome: a suggested algorithm of care. Br J Pain [Internet]. 2012 Nov;6(4):153-61. doi: 10.1177/2049463712470222. PMID: 26516487; PMCID: PMC4590103. Accessed March 12, 2026. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4590103/
- Parker L. Scar Tissue and Pain After Back Surgery. Spine-health [Internet]. Updated June 07, 2023. Accessed March 12, 2026. Available from: https://www.spine-health.com/treatment/back-surgery/scar-tissue-and-pain-after-back-surgery
- Bordoni B, Marelli F. Failed back surgery syndrome: review and new hypotheses. J Pain Res [Internet]. 2016 Jan 12;9:17-22. doi: 10.2147/JPR.S96754. PMID: 26834497; PMCID: PMC4716715. Accessed March 12, 2026. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4716715/
- Yeo J. Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review. Journal of Yeungnam Medical Science [Internet]. 2024;41(3):166-178. Published online June 10, 2024. Accessed March 12, 2026. Available from: doi:https://doi.org/10.12701/jyms.2024.00339
- Garcia N. Failed Back Surgery Syndrome Definition. International Neuromodulation Society (INS) [Internet]. Published 2018. Accessed March 12, 2026. Available from: https://www.neuromodulation.com/failed-back-surgery-syndrome-definition
