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Failed Back Surgery

Villanueva Institute of Pain and Spine

Failed Back Surgery Treatment in Burbank, CA

Failed back surgery syndrome, sometimes called post-laminectomy syndrome or persistent spinal pain after surgery, describes pain that continues or returns after spine surgery. The surgery may have addressed one problem, but you may still be living with back pain, neck pain, leg pain, arm pain, numbness, tingling, weakness, or a pain pattern that has changed since the operation.

This can be frustrating in a way that is hard to explain. You went through surgery expecting relief, recovery, or at least a clearer path forward. Instead, you may still be planning your day around pain, avoiding certain movements, sleeping poorly, limiting work, or wondering whether something was missed.

I am Dr. John Villanueva, double board-certified in PM&R and interventional pain management at Villanueva Institute of Pain and Spine (VIPS). My approach to failed back surgery starts with the details; I review what surgery was performed, what improved, what did not, what symptoms changed, what your imaging shows now, and what you want to be able to do again.

Some patients need advanced pain care after spine surgery. Some need a careful rehabilitation plan. Some need updated imaging, nerve testing, injections, radiofrequency ablation, spinal cord stimulation, or a surgical opinion. The right next step depends on the source of pain now, not only the surgery you had before.

If you are looking for failed back surgery treatment in Burbank, CA, call VIPS at (818) 669-8895 or request an appointment online. We are located in Burbank and proudly serve patients visiting from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

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What Is Failed Back Surgery Syndrome?

Failed back surgery syndrome is a term used when pain continues, returns, or becomes different after spine surgery. It can happen after procedures such as laminectomy, discectomy, spinal fusion, decompression, or other neck or back surgeries.

Despite being labeled “failed,” a back surgery may have been technically appropriate and still left the patient with pain. Spine pain often has multiple sources, and surgery usually addresses a specific structural problem. If another pain generator remains active, symptoms can continue.

For some patients, the dominant issue is nerve pain. For others, it may be facet joint pain, sacroiliac joint pain, recurrent disc herniation, scar tissue, spinal stenosis, adjacent segment degeneration, muscle deconditioning, hardware-related irritation, or a new pain pattern that developed during recovery.

The work begins by asking a practical question: what is causing the pain now?

Common Symptoms After Failed Back Surgery

Symptoms can vary depending on the surgery performed, the area treated, and the pain source.

Patients often describe:

  • Persistent low back pain
  • Persistent neck pain
  • Pain traveling into the leg, foot, arm, or hand
  • Sciatica after back surgery
  • Burning, shooting, electric, or tingling pain
  • Numbness or weakness
  • Pain that worsens with standing or walking
  • Pain that worsens with sitting or driving
  • Stiffness, muscle tightness, or spasms
  • Pain near or above a prior fusion
  • Buttock, hip, or sacroiliac joint pain
  • Difficulty sleeping because of pain
  • Limited confidence bending, lifting, exercising, walking, or returning to work


Some patients say their pain never improved after surgery. Others had good relief for months or years before symptoms slowly returned. Both patterns deserve careful evaluation.

Why Pain Can Continue After Back Surgery

Pain after spine surgery can have several explanations. Sometimes the original nerve was compressed for a long time before surgery and remains sensitive afterward. Other times, the spine develops new stress above or below a fusion or scar tissue forms around a nerve root. Sometimes the painful structure was never the disc or stenosis alone. Pain after surgery can also involve more than one of these factors at the same time. A patient may have leg pain from nerve irritation and low back pain from facet joints or the SI joint. Another may have a successful decompression but still struggle with chronic nerve sensitivity and reduced activity tolerance.

Common contributors include:

  • Ongoing nerve inflammation or nerve sensitivity
  • Recurrent disc herniation
  • Residual or recurrent spinal stenosis
  • Epidural scar tissue or adhesions
  • Facet joint arthritis or facet-related pain
  • Sacroiliac joint pain after lumbar fusion
  • Adjacent segment degeneration
  • Hardware irritation or fusion-related problems
  • Persistent radiculopathy or sciatica
  • Muscle weakness, guarding, or deconditioning after surgery
  • Vertebrogenic low back pain
  • A new pain source that developed after the original operation

How Failed Back Surgery Is Diagnosed

Diagnosing failed back surgery syndrome begins with listening to the timeline. I want to know what symptoms you had before surgery, what the surgery was meant to correct, how you felt immediately afterward, when the current pain began, and whether the pain now feels the same or different.

The exam matters too. I assess strength, sensation, reflexes, range of motion, gait, tenderness, signs of nerve tension, posture, and how your pain behaves with movement. A spine that hurts with standing and extension may point in a different direction than pain that follows a clear nerve path down the leg.

Testing may include updated X-rays, MRI, CT scan, or EMG/NCS testing depending on your symptoms. EMG and nerve conduction studies can be helpful when numbness, tingling, weakness, or nerve injury needs to be clarified.

Whenever possible, I prefer to review the actual imaging and operative reports. A written MRI report can be useful, but the images themselves often show details that affect the treatment plan.

Failed Back Surgery and Your Broader Treatment Plan

Post-surgical spine pain often needs more than one step. Depending on your condition, your care may include physical therapy, rehabilitation planning, medication review, injections, nerve blocks, RFA, SCS evaluation, EMG/NCS testing, updated imaging, regenerative medicine, Intracept®, mild® procedure, or coordination with a spine surgeon.

A patient with recurrent nerve compression may need a different plan than a patient with chronic nerve sensitivity. A patient with SI joint pain after fusion may need a different plan than a patient with vertebrogenic low back pain. The diagnosis should drive the treatment.

At VIPS, I take time to review your symptoms, exam findings, imaging, operative history, prior treatment response, and daily limitations before recommending a direction. Failed back surgery treatment should help you spend less time trying to protect your spine and more time rebuilding comfort, confidence, and function.

When to Seek Immediate Care After Spine Surgery

Some symptoms after spine surgery need urgent medical attention. Seek emergency care or contact your surgeon promptly if you develop new loss of bowel or bladder control, numbness in the groin or saddle area, rapidly worsening weakness, fever, chills, wound drainage, severe new pain after a fall, or symptoms that feel suddenly and significantly different.

For ongoing pain that is stable but limiting your life, a pain management evaluation can help clarify the next step. The purpose is to identify the source of pain, review prior care, and decide which options are appropriate at this time.

Treatment Options for Failed Back Surgery Syndrome

Treatment depends on the pain source. A patient with persistent nerve pain after surgery may need a different plan than a patient with facet joint pain, SI joint pain, recurrent stenosis, or vertebrogenic low back pain.

At VIPS, failed back surgery treatment may include one or more of the following options.

Physical Therapy and Rehabilitation

After spine surgery, the body often learns to guard. Muscles tighten, movement becomes cautious, and daily activity may shrink around the painful area. Rehabilitation can help rebuild strength, mobility, walking tolerance, posture, and confidence.

As a PM&R physician, I pay close attention to how pain is affecting function. The plan may include physical therapy, home exercise, pacing strategies, gait work, core strengthening, or activity modification.

Epidural steroid injections may be discussed when pain appears to come from an irritated or inflamed spinal nerve. This can happen with radiculopathy, sciatica, foraminal stenosis, recurrent disc herniation, or nerve irritation after surgery.

The injection delivers anti-inflammatory medication near the affected nerve area. Your response can help determine whether nerve inflammation is a meaningful part of the pain pattern.

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A selective nerve root block targets a specific spinal nerve. This can be useful when symptoms and imaging suggest one nerve root may be responsible for pain traveling into the arm or leg.

This type of block can provide diagnostic information and potential relief. If the usual pain improves, that response may help confirm the nerve pathway involved.

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Spine surgery can change mechanics in the back or neck. Facet joints may become a pain source, especially when pain feels deep, aching, stiff, and worse with standing, twisting, or bending backward.

Facet joint injections or medial branch blocks can help evaluate whether these small spinal joints are contributing to pain. If diagnostic blocks provide strong temporary relief, radiofrequency ablation may be discussed.

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Radiofrequency ablation, often called RFA, uses controlled heat to quiet specific nerves that carry pain signals from arthritic or irritated joints. For patients with facet-related pain after spine surgery, RFA may provide longer-lasting relief than a temporary block when the diagnostic process supports it.

RFA can also be used for certain sacroiliac joint or knee pain patterns when appropriate.

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The sacroiliac joint sits where the spine meets the pelvis. After lumbar fusion, some patients develop pain in the low back, buttock, hip, groin, or upper thigh from the SI joint.

A sacroiliac joint injection can help reduce inflammation and clarify whether the SI joint is part of the pain pattern. SI-related pain often worsens with standing, walking, stairs, rolling in bed, or getting in and out of a car.

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Spinal cord stimulation, or SCS, is an advanced option for certain patients with chronic nerve-related pain after spine surgery. It uses mild electrical stimulation near the spinal cord to change how pain signals are processed.

SCS is usually considered after a careful candidacy evaluation. If appropriate, patients begin with a temporary trial. If the trial gives meaningful relief and improves function, a permanent implant may be discussed.

I use a device-agnostic approach with SCS. The system should be chosen based on your anatomy, pain pattern, lifestyle, preferences, and clinical needs.

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Some patients have chronic low back pain that comes from changes in the vertebral endplates. This is called vertebrogenic pain. When imaging and symptoms support that diagnosis, Intracept® may be discussed.

This treatment targets the basivertebral nerve inside the vertebral body. It is a specific treatment for a specific pain pattern, so imaging review is essential.

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The MILD® procedure may be an option for certain patients with lumbar spinal stenosis when thickened ligament tissue contributes to nerve compression. Patients often describe leg pain, heaviness, numbness, or difficulty standing and walking for longer periods.

For patients with prior surgery, the decision depends on anatomy, imaging, symptoms, and whether the target area is appropriate.

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Medication may help calm nerve pain, reduce inflammation, improve sleep, or make rehabilitation more tolerable. The right medication plan depends on your diagnosis, medical history, kidney function, stomach history, other prescriptions, and prior response.

Medication is most useful when it supports a larger plan. I want to know whether it helps you walk farther, sleep better, participate in therapy, return to work, or move with less fear.

Some patients with pain after spine surgery need another surgical opinion. That may be the right step when imaging shows severe compression, instability, hardware issues, failed fusion, recurrent disc herniation, infection, or another condition that may be surgically correctable.

I will be direct if I think surgery should be considered. Pain management is most helpful when it matches the diagnosis honestly.

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Good Candidates for Failed Back Surgery Treatment

You may benefit from an evaluation if pain has continued or returned after spine surgery and is limiting your daily life.

Patients often come in with:

  • Back pain or neck pain after spine surgery
  • Pain traveling into the leg, foot, arm, or hand
  • Numbness, tingling, burning, or weakness
  • Persistent sciatica after back surgery
  • Pain after laminectomy, discectomy, decompression, or spinal fusion
  • Pain near a prior fusion or above or below the surgical area
  • Buttock, hip, or sacroiliac joint pain after lumbar surgery
  • Difficulty walking, sitting, sleeping, driving, working, or exercising
  • Pain that has not improved enough with medication, therapy, injections, or rest
  • Interest in understanding options before considering another surgery


You do not need to know which treatment you need before coming in. Most patients need help sorting out what is causing the pain and which option fits the current pattern.

How I Evaluate You Before Recommending Treatment

Failed back surgery treatment starts with a careful review of your story. I want to understand what led to surgery, what changed afterward, and what your pain is doing now.

During your consultation, I may review:

  • The type of spine surgery you had and when it was performed
  • What symptoms improved after surgery and what remained
  • Where your pain starts and where it travels
  • Whether pain feels burning, shooting, electric, aching, deep, sharp, or pressure-like
  • Whether you have numbness, tingling, weakness, spasms, or balance issues
  • Operative reports, imaging reports, and prior procedure notes
  • X-rays, MRI, CT imaging, or updated imaging when needed
  • Whether EMG/NCS testing may clarify nerve involvement
  • Prior medications, physical therapy, injections, nerve blocks, or procedures
  • How pain affects walking, sitting, sleep, work, driving, exercise, family life, and independence
  • What you would consider meaningful improvement


I also want to know what you have already been told. Patients with pain after spine surgery often carry a long, frustrating history. A careful review helps us avoid repeating the same unsuccessful plan and begin looking at the current pain source with fresh eyes.

Why Choose VIPS for Failed Back Surgery Treatment?

Pain after spine surgery requires patience, detail, and a willingness to look at the entire picture. At VIPS, I take the time to understand what happened before surgery, what happened after surgery, and what your body is telling us now.

When you choose VIPS, you can expect:

I am double board-certified in PM&R and interventional pain management. My PM&R training helps me evaluate movement, function, rehabilitation, nerve symptoms, and disability. My interventional training allows me to perform targeted pain procedures when they fit the diagnosis. I am proud to bring the additional expertise of a Certified Life Care Planner to my work. Along with my double-board certifications, this specialized training enables me to assess the long-term medical, rehabilitation, and future care needs of individuals with complex injuries and disabilities.

Prior surgery changes the anatomy. I review operative history, imaging, symptoms, exam findings, and prior treatment response before recommending a direction.

Many post-surgical spine injections and nerve procedures are performed with fluoroscopy or ultrasound guidance. The guidance method depends on the target, anatomy, and clinical need.

Care may include rehabilitation, medication management, epidural steroid injections, selective nerve root blocks, facet procedures, medial branch blocks, radiofrequency ablation, SI joint treatment, spinal cord stimulation, Intracept®, mild® procedure, or surgical referral.

I want to know whether pain is limiting walking, standing, sleep, work, driving, exercise, lifting, sitting through a meal, or time with your family. Those details help define success.

I will explain what appears to be driving the pain and why a specific treatment option fits. If another surgeon, neurologist, rheumatologist, or specialist should be involved, we will talk through that directly.

Many patients with post-surgical pain feel discouraged by the time they reach a pain specialist. I want you to feel heard, respected, and more informed after your visit.

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What Happens During Failed Back Surgery Treatment?

Your treatment visit depends on the source of pain and the option chosen.

  • For nerve-related pain, treatment may involve an epidural steroid injection or selective nerve root block.
  • For facet-related pain, it may involve medial branch blocks, facet joint injections, or radiofrequency ablation.
  • For SI joint pain, the treatment may target the sacroiliac joint.
  • For long-standing nerve pain after surgery, spinal cord stimulation may be discussed.


Before any procedure, I explain what we are targeting, how the treatment works, what you may feel afterward, and how we will judge the response. I want the plan to feel clear before we begin.

Some patients need treatment in stages. First, we identify the strongest pain generator. Then we see how you respond. From there, we can decide whether to continue the same direction, add rehabilitation, adjust medication, update imaging, or consider a different option.

What Should You Expect After Treatment?

Your response depends on the treatment performed, the source of pain, and how long the symptoms have been present.

Some injections may provide temporary relief quickly because of local anesthetic. Anti-inflammatory medication may take several days to work. Radiofrequency ablation may take days to weeks before the benefit becomes clear. Spinal cord stimulation begins with a trial, so you can test whether stimulation helps before a permanent device is discussed.

After treatment, I want you to track real-life changes. Can you walk farther? Sit longer? Sleep with fewer interruptions? Stand at the sink without leaning? Drive with less pain? Reduce rescue medication? Participate in therapy with more confidence?

Those details help us understand whether the treatment is helping your life, not only changing a number on a pain scale.

Failed Back Surgery Treatment in Burbank, CA

VIPS is located in Burbank, CA, in the Magnolia Park neighborhood. The office is designed to feel welcoming and personal, with comfortable seating, warm finishes, and original artwork from patients who are working artists.

This is a place where complicated pain stories have time to be heard. I live and work in Burbank, and I care about building a practice where patients feel known, respected, and well informed.

We see patients from Burbank, Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

Burbank Failed Back Surgery FAQs

If pain after spine surgery is limiting how you walk, sit, sleep, work, drive, exercise, or participate in daily life, a careful evaluation can help clarify what is happening now and which treatment options make sense.

To schedule a failed back surgery consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today. The right care may help you spend less time living around pain and more time moving with comfort, confidence, and peace of mind.

Pain after surgery does not automatically mean the surgery was performed incorrectly. Spine surgery may solve one structural problem while another pain generator remains active. The important question is what is causing the pain now and what treatment options fit the current findings.

Testing may include X-rays, MRI, CT scan, EMG/NCS testing, or other studies depending on your symptoms. Operative reports, prior procedure notes, and old imaging can also be very helpful when reviewing post-surgical pain.

Seek urgent medical care if you develop new loss of bowel or bladder control, numbness in the groin or saddle area, fever, chills, wound drainage, rapidly worsening weakness, or sudden severe pain after a fall or injury.

Some patients do need another surgical opinion, especially if imaging shows severe compression, instability, hardware problems, failed fusion, infection, or recurrent disc herniation. Others can move forward with nonsurgical or interventional pain treatment. I will review your findings and explain which direction makes sense.

The cost of failed back surgery treatment in Burbank can vary depending on the evaluation, imaging, medication plan, injections, nerve blocks, radiofrequency ablation, spinal cord stimulation trial, or other treatments recommended. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review.

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