How to Deal With Long-Term Pain From a Cervical Fusion

For many people living with severe neck pain and symptoms from a herniated disc, degenerative disc disease, or a pinched nerve, a cervical fusion is the final treatment option. The purpose of the surgery is to relieve pain, yet many people find themselves suffering from persistent or worsening pain in the weeks and months following the procedure.

When a cervical spine surgery fails — meaning it doesn’t deliver the expected outcomes — the continued pain and symptoms are known as cervical post-surgery syndrome or failed neck surgery syndrome.

Several factors could lead to long-term neck pain and symptoms following a cervical fusion. Post-surgical pain might be radicular (radiating from the nerve roots) or musculoskeletal (stemming from the joints or soft tissues) in nature.

• What causes radicular symptoms? The most common reason for experiencing continued nerve pain after a fusion surgery is inadequate decompression of a pinched nerve during the initial procedure. If the spinal cord nerve is still fully or partially compressed, you’ll have lingering pain and symptoms afterward. Another reason may be scar tissue formation during the healing process. In some cases, new scar tissue can trap a nerve root, leading to a resurgence of nerve pain weeks or months after your procedure. And unfortunately, some people present with nerve damage or chronic compression that’s too severe to treat. In these cases, surgery might ease some of the pain and pressure, but not all of it.
• What causes musculoskeletal symptoms? Cervical fusion alters the biomechanics of the structures in the neck. When two vertebrae are fused, the process transfers an increased load to adjacent vertebrae and joints. Increased load bearing can cause muscle tension, tightness and accelerated degeneration of surrounding joints, bones and spinal discs. New degenerative changes could lead to a new onset of pain and inflammation in the neck. Other causes of postoperative musculoskeletal symptoms are recurrent herniated discs or degenerative changes that were already present at multiple levels of the cervical spine. Additionally, in some cases the bones fail to fuse properly after surgery — a condition known as pseudoarthrosis.

An incorrect initial diagnosis can also cause neck surgery to fail. Multiple neck conditions present with the same type of pain and symptoms, making it difficult for doctors to accurately pinpoint the source of pain in the neck. Failing to identify a clear etiology of pain prior to surgery increases the risk of developing cervical post-surgery syndrome.

SYMPTOMS

Some amount of neck discomfort, soreness, tenderness, and swelling is normal after a spinal fusion procedure. Additionally, you may feel some discomfort in your upper back and shoulders as your body adjusts to the altered biomechanics created by the fusion. However, if the procedure is successful, your pain should be controllable with pain medications and diminish as you heal and become stronger during the rehabilitation process.

Failed neck surgery syndrome is diagnosed if you experience the following symptoms in the weeks and months after surgery, despite participation in post-surgical rehabilitation and therapy.

• Neck pain that remains at the same level it was at before surgery
• Neck pain that worsens in the weeks and months after surgery
• Muscle tightness, cramps and spasms
• Pain, weakness, numbness and tingling that radiates from the neck to the shoulder, arm, hand and fingers
• Reduced mobility and difficulty moving the neck through its full range of motion

WHAT TREATMENT OPTIONS ARE AVAILABLE?

In many cases, your doctor will not want to perform a second surgery right after a failure of the first surgery. Research shows that the success rate drops for each subsequent surgery following the initial procedure. Your doctor will begin by recommending a course of conservative treatments. You may have already tried some of these treatments to reduce neck pain and symptoms prior to undergoing surgery.

• Physical therapy. Physical therapy is one of the best treatment methods for reducing pain and aiding recovery following neck surgery. A physical therapist will help you regain muscle and joint strength and restore full range of motion in the cervical spine. Strengthening the spine can reduce pain and inflammation and help improve functionality and mobility.
• Medications. Over-the-counter anti-inflammatories, prescription anti-inflammatories, oral steroids or muscle relaxants may be prescribed to help relieve pain and inflammation.
• Injections and nerve blocks. A cortisone injection can help temporarily reduce pain and inflammation around inflamed and irritated spinal cord nerves or joints. A nerve block can help block pain signals originating from a pinched or inflamed nerve root.
• Chiropractic care. Manual manipulation can help reduce pain and maintain your spine in proper alignment.

Conservative measures may provide some relief, but are not always effective. In some cases, a surgical revision is recommended after non-surgical treatments fail to sufficiently reduce pain and symptoms.

WHAT TREATMENT IS AVAILABLE FOR CHRONIC PAIN FOLLOWING A SPINAL FUSION?

If you’ve already undergone one surgery that failed, you may be very reluctant to undergo a second one with no guarantee of success. But if you’ve been living with chronic neck pain for several months following surgery, what other treatment options are available?

You may be a candidate for scrambler therapy. Scrambler therapy is a non-invasive, non-surgical, and non-drug treatment used to relieve chronic pain for people who don’t respond well to other treatments. Scrambler therapy uses electrostimulation to replace pain information with non-pain information in the brain. Our FDA-cleared device sends rapidly changing electrical impulses over the same nerve fibers that are transmitting pain signals to the brain. Over the course of several therapy sessions, the brain comes to recognize and accept the non-pain information as correct. How? Because the human brain is neuroplastic, meaning it’s capable of creating new pathways and adapting to new circumstances.

Scrambler therapy has successfully been used to help with multiple types of chronic pain, including neuropathy, sciatica, low back pain, fibromyalgia, and failed back and neck surgery pain. The therapy is very safe and has no reported side effects.