💥 Beyond the Blade: Can Chiropractic Care Help After Back Surgery?

For many grappling with low back pain, chiropractic care is a valued, non-surgical path. But what about those whose journey included the operating room? You might be surprised to learn that even after surgery, pain and disability can persist. The burning question remains: Can a Doctor of Chiropractic (DC) still help the post-surgery low back pain patient?

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⚕️ Understanding Persistent Spinal Pain Syndrome-2 (PSPS-2)

When pain lingers after back surgery, it’s now officially known as Persistent Spinal Pain Syndrome-2 (PSPS-2). You may have heard older, more familiar terms like:

• Failed Back Surgery Syndrome (FBSS)
• Postlaminectomy syndrome
• Adjacent-segment degeneration

This challenging condition is more common than you might think. A 2017 review estimated that, depending on the criteria used, 4% to a staggering 50% of patients might experience PSPS-2 following low back surgery.

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🔩 Navigating Hardware and Fusions

The typical low back has five moving segments (L1-L5). However, some people have a spinal variation that can increase movement and decrease stability, often leading to a spinal fusion procedure.

When a patient with a fusion seeks chiropractic care, a DC must be incredibly careful. They need to consider:

• Adjacent Levels: How the fusion affects the motion segments above and below the fused area.
• Surgical Hardware: The type of biomaterials used—things like plates, rods, and screws—which can sometimes loosen or break.

In these delicate cases, the DC often opts for non-thrust treatment methods to ensure safety. These might include gentle spinal mobilization or myofascial release, which targets the muscles and connective tissue.

The Chiropractic Toolkit: Thrust vs. Non-Thrust

Chiropractors are often known for the spinal manipulation (the “adjustment”)—a single, High-Velocity, Low-Amplitude (HVLA) impulse aimed at restoring joint movement. However, the choice of treatment is never one-size-fits-all. It depends on several critical factors:

• Patient and provider preference.
• The presence of underlying conditions like osteoporosis or hypermobility.
• Crucial safety concerns, especially around or near surgical hardware.
• Patient comfort throughout the pre-treatment setup.

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🔎 The Evidence for Non-Thrust Approaches

What does the research say about helping this specific patient group?

A 2020 systematic review analyzed data from 51 studies and found something important: there is moderate evidence supporting the use of non-thrust therapies—like neuromobilization and myofascial release—for patients with PSPS-2 after a lumbar fusion.

For other types of back surgery, the jury is still out, and more research is needed to determine if thrust or non-thrust methods are superior.

The takeaway? Until definitive research exists, the most effective approach is highly individualized. It depends on the patient’s unique clinical presentation, their personal treatment preferences, and the chiropractor’s experience and specialized training.

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Would you like to explore the difference between spinal mobilization and myofascial release, or perhaps look for chiropractors who specialize in post-surgical care? Book a consultation with the Doctors at Corner on Wellness Chiropractic Center to see if they can help with your post surgical pain.