Medication for Failed Back Surgery Syndrome

Nonsteroidal anti-inflammatory drugs, or NSAIDs, relieve back pain by reducing inflammation in nerve roots and spinal joints. This creates more space in the spinal canal—the opening through which the spinal cord runs—preventing nerve compression. Types of NSAIDs commonly used include ibuprofen, naproxen, and aspirin.

If over-the-counter NSAIDs don’t relieve your pain, your doctor may prescribe a stronger dose for several weeks or until surgery to treat the condition.

Your doctor may prescribe muscle relaxants to help alleviate pain and reduce muscle spasms, which can occur when muscles are bruised, moved, or cut during back surgery. These medications work by depressing—or lessening the activity of—the central nervous system, relaxing muscles.

If NSAIDs don’t relieve back pain, your doctor may recommend an injection of corticosteroids, which reduce inflammation, and a local anesthetic, which reduces pain, into the spinal canal. In some people, the injection can alleviate pain for weeks, months, or even years. However, there is no reliable method for predicting the effectiveness of this treatment.

You can expect to return home immediately after the injection. You may feel slight tenderness at the injection site for a day or two. Doctors typically recommend limiting spinal injections to no more than two or three per year.

Rarely, NYU Langone doctors may prescribe opiates, which are derived from poppy plants, or opioids, which are synthetic medications, to treat severe pain in people with failed back surgery syndrome. Because these medications have the potential to become addictive, they are prescribed for short periods of time, typically before or after surgery for failed back surgery syndrome.

Neuroleptic medications stabilize overactive cells in the spinal cord called neurons to relieve back pain associated with nerve compression. Some people who take them daily by mouth report relief from pain.

Your doctor determines how long you take these medications based on the severity of your back pain and how effective they are in relieving your symptoms.