Failed Back Surgery

Failed Back Surgery Syndrome

Recurrent herniated disc and scarring after back surgery can produce similar back symptoms of pain and sciatica. Gradually increasing symptoms beginning a year or more after back surgery are considered more likely a result of scar formation. When your pain comes back abruptly at any interval after surgery is more likely due to recurrent herniated disc.

Failed back surgery syndrome is seen in 10-40 percent of patients who undergo back surgery. It is characterized by intractable pain and varying degrees of functional incapacitation occurring after spine surgery.

The clinical features of lumbosacral spinal fibrosis are polymorphic. Lumbar pain and sciatica that become worse, even with minimal physical activities (seen in 60 percent of patients) are the main complaints.

These are most frequent symptoms of failed back surgery syndrome:

  • Nocturnal (night time) cramps and distal (hands and feet) paresthesia (loss of sensation or numbness) are common.
  • Twenty-five percent of patients have low back pain after surgery without radiculopathy (pain along the nerve root – sciatica).
  • Ten percent show cauda equina syndrome (collection of symptomes attributed to compression of lower part of spinal cord) with sphincter dysfunction (problems going to the toilet) and saddle hypesthesia (numbness in the saddle area, lower buttocks and groin).
  • Lasegue’s sign (straight leg raise lying on the back) is positive (pain in the sciatic nerve distribution is reproduced between 30 and 70 degrees of passive flexion of the straight leg) in only 20 percent of the cases, but the absence of knee and ankle reflexes is frequent.

Calodney A: Failed Back Surgery Syndrome

Burton AK: Prediction of the clinical source of low back trouble using multivariable modules. Spine, 16:7-14, 1991.

With thanks to Randy V. Curtis, DC at Chiroweb

P.S. To understand Failed Back Surgery Syndrome better read this article or at least Rapid responses to it.

Food Combining for health

Food combining simplified

I have found that for some of my patients the idea of food combining is difficult to grasp. I made it very simple below:

1. Eat carbs (carbohydrates) and proteins at separate meal times.

2. Salads and CRUNCHY AND COLOURFUL veg can be combined with either proteins or carbs but not at the same time.

3. Eat nothing sweet (including fruits) and drink nothing cold or sweet after meal. Drink hot drinks after meal only.

4. Leave 2-3 or more hours after carb meal and 3-4 or more hours after protein meal before eating anything else unless from the same food group (either protein or carb).

5. Deserts and fruits or sweet drinks both hot or cold can only be eaten before the meal or as a separate meal.

Examples of well combined meals:

  • vegetarian pizza
  • steak with salad and raw or lightly steamed non-starchy veg
  • baked potato with parmesan, rocket salad and pine-nuts
  • salad with seafood
  • chips with salad
  • bacon, sausage and egg with salad and with NO toast or hash browns or chips a little or no beans
  • hash browns (saved from breakfast) with avocado or cheese on toast
Well combined crunchy and colourful veggies with good proteins.

Carbs and proteins are:


  • bread
  • pasta
  • pizza
  • rice
  • potato
  • sugar
  • all overcooked veg


  • meat
  • fish
  • poultry (chicken)
  • egg
  • sausage

Salads (raw)

  • Rocket
  • spinach
  • cress
  • basil
  • lettuce
  • dill
  • parsley
  • coriander
  • and other similar greens and herbs
  • raw peppers
  • raw tomatoes
  • raw courgettes
  • and other colourfull and crunchy veg
  • spring onions

Other poins:

    • some vegetable protein reach foods when raw or slightly cooked classed as “salads” and when fully cooked they classed as carbs (e.g. soy beans).
    • plan your meal in advance and you will be able to eat everything you like.
    • enhance your digestion by probiotic supplements or kefir
    • start your day with a glass of warm water
    • no artificial and processed foods and no sweeteners please
    • don’t forget to brush and floss your teeth after meals
    • please check the full description of food combining here.
Email me if you are in doubt or talk to me in the clinic.
Thank you and good luck!