27/08/2026
Pain after surgery...Patients often dont get told this important information before surgery (it doesnt just apply to spinal surgery). Physiotherapy can help with many post op issues. We've recently seen several patients post spinal surgery with ongoing pain. A combination of sofrt tissue release, stimpod to get the nerces firing properly, education and exercise can address the issues discussed in this post. Some of these patients suffered for months and in one case years before being referred to physio ๐ and now they are finally getting back to doing the things they love โค๏ธ ๐
Why are you still in pain after spine surgeryโฆ even when everything went perfectly?
This is one of the most honest conversations I have with patients.
The surgery may have successfully decompressed the nerve, corrected the instability, or removed the herniation. The imaging looks clean. The hardware is in perfect position. And yet the pain is still there.
Hereโs why that can happen:
โข Nerves that were compressed for months or years donโt always โswitch offโ the moment pressure is gone. They can stay irritated or hypersensitive for a long time.
โข Scar tissue (epidural fibrosis) forms as part of normal healing and can tether or irritate a nerve root.
โข The original pain generator wasnโt the only one โ facet joints, sacroiliac joints, or adjacent levels can become the new source once the main problem is fixed.
โข Your deep stabilizing muscles (especially the multifidus) can stay inhibited โ essentially โturned downโ by the nervous system โ even after the structural problem is fixed. This is a protective response that often lingers and makes full recovery harder.
โข In some cases the nervous system itself has become sensitized โ a real biological change, not โin your head.โ
Successful surgery does not always equal immediate zero pain. Healing is rarely linear.
What we typically evaluate next:
โข A detailed clinical re-assessment and careful review of your imaging โข Diagnostic injections or blocks to pinpoint the true pain generator โข Specialized physical therapy focused on reactivating the deep stabilizers and restoring motor control
If youโre months out and still struggling, it doesnโt automatically mean the surgery failed. It means you need a careful look at why the pain is persisting.
โ Dr. Steven Cyr | Orthopedic Spine Surgeon | ๐San Antonio & Houston
Important: Contact your surgeon right away if your pain is accompanied by new weakness, fever, or changes in bowel or bladder control.
Have you experienced this after surgery? Drop a comment below ๐