Why do you still have back pain years after surgery?
In most cases the surgery removed the tissue that was pressing on a nerve, but nothing changed the mechanics that pushed that tissue out in the first place. The load on the disc, the segment that was not moving well, the compression through the level: all of it is still there the day after surgery. That is why pain can come back months or years later even when the operation itself went exactly as planned.
Listen, I have this conversation in our Walnut Creek office almost every week. Someone had a procedure in 2016 or 2018 or 2021. They felt better for a while. Then it crept back. And by the time they sit down across from me they have spent years cycling through topical creams, stretching routines, a foam roller, an inversion table, maybe a second round of injections. They are not lazy and they are not imagining it. They just never had the mechanical problem addressed.
What actually brings the pain back after a successful surgery?
Three things account for most of it. Scar tissue forming around the nerve at the surgical site. Extra load transferring to the levels above and below the one that was operated on, which is why the level next door so often becomes the new problem. And a disc that is still degenerated, still compressed, and still under the exact same pressure that herniated it originally.
Think of it like a tire that keeps blowing out because the alignment is off. You can replace the tire. The tire is not the problem. Until something changes the load going through that corner of the car, you are buying tires forever. Surgery is a very good tire change. It is not an alignment.
Here is a patient of ours describing exactly this pattern:
Six years of low back pain. Surgery in 2018. Topical creams and stretches to take the edge off. Then within the first week of decompression therapy he noticed on the drive home that the tightness and soreness in his low back were not there. That is not a cure and I would never call it one. But it is the first honest signal in six years that the tissue can still respond.
Why don’t creams and stretching fix post-surgical back pain?
Because they work on the wrong tissue. Topical creams change how the skin and superficial nerves report sensation for an hour or two. Stretching lengthens muscle that is usually tight as a protective response, not as the cause. Neither one changes the pressure inside a disc, and the disc is where the problem lives.
This is the part that frustrates people the most. They are doing everything they were told. The daily stretches, the heat, the cream before bed, the careful lifting. And the pain is unchanged, which they start to interpret as a personal failure. It is not. Those tools were never capable of decompressing a disc. You would not expect a foam roller to fix a cavity.
Can you do spinal decompression after back surgery?
Often yes, but it depends entirely on what was done. A microdiscectomy or laminectomy from years ago is frequently a good candidate. Fusion with hardware, recent surgery, or certain instrumented constructs may not be, and there are cases where I tell people it is not appropriate for them. We do not know until we see the operative report and current imaging.
That is why we ask post-surgical patients to bring three things: the operative report, the most recent MRI, and an honest timeline of when the pain came back. Those three items tell us whether the level in question can safely be decompressed, whether the real problem has migrated to a neighboring segment, and whether you are a candidate at all. If you want the mechanics of the therapy itself, here is how non-surgical spinal decompression works.
How soon do people notice a difference with spinal decompression?
It varies widely, but early signals often show up in the first one to two weeks. Usually it is not dramatic. It is the absence of something: no tightness on the drive home, no ache when you stand up from the couch, sleeping through the night without repositioning. The bigger structural change takes longer, because discs are slow tissue with almost no blood supply of their own.
I am careful about this with post-surgical patients specifically. Six years of pain does not unwind in a week. What that first week tells us is whether the tissue is still responsive, and that is genuinely useful information to have early instead of eight weeks in.
Is there proof a disc can actually change without surgery?
Yes, and we have published two peer-reviewed papers in the Journal of Contemporary Chiropractic documenting it on MRI. The first followed four patients with lumbar disc herniations through eight weeks of non-surgical spinal decompression plus chiropractic care. Post-treatment MRIs showed disc reductions of 9, 27, 30, and 78 percent, confirmed by independent radiologists, with all four patients 100 percent pain-free and no surgery.
The second paper took on a harder case: a 50-year-old man with a C5-6 disc extrusion, upward migration of disc material, segmental instability, and cervical myelopathy with cord compression. That is the presentation that normally goes straight to an operating room. After a three-month program his follow-up MRI showed a 52 percent reduction in the extrusion with no remaining cord compression, and he was still improving a year later. Both papers are on our published research page.
I point people to those papers instead of testimonials because a follow-up MRI read by an independent radiologist is not an opinion. It is a measurement. We have performed 50,000+ decompression treatments in one of the largest single-location spinal decompression centers in the United States, and the imaging is the part I would want to see if I were the patient.
What should you do if you have already had one back surgery?
Before you agree to a second one, find out whether the mechanical cause was ever addressed. Get your current MRI. Get your operative report. Then have someone look at both and tell you specifically which structure is generating your pain now, because it is frequently not the same level that was operated on.
A second surgery is a much bigger decision than the first, and outcomes for revision procedures are generally less predictable. That does not mean never. It means the reversible options deserve a serious look first. That is the entire premise behind the way we approach surgical candidates, and it applies just as much to people who already had one procedure as to people facing their first.
Frequently asked questions
Is it normal for back pain to return years after surgery?
It is common enough to have its own name in the literature, sometimes called failed back surgery syndrome or post-laminectomy syndrome. Common does not mean acceptable, and it does not mean nothing can be done. It usually means the mechanical driver was never changed.
Can spinal decompression be done after a spinal fusion?
Generally not at the fused level, and in many cases not at all, depending on the hardware and construct. Sometimes the levels above or below a fusion can be addressed. This is a case-by-case determination that requires the operative report and current imaging, not a yes or no you can get over the phone.
How long after back surgery can you start decompression therapy?
There is no universal number, and recent surgery is a reason to wait. We look at the type of procedure, how much time has passed, what the surgeon documented, and what current imaging shows before making that call.
Will my old surgery show up on a new MRI?
Yes. Post-surgical changes, scar tissue, and any hardware are visible, which is one reason we want current imaging rather than a scan from before your procedure. The old films tell us where you were. They do not tell us where you are.
I don’t live near Walnut Creek. Can I still be treated at your clinic?
Yes. Patients travel to our Walnut Creek center from across the Bay Area, out of state, and internationally, and out-of-town cases are scheduled in condensed blocks so the trip is worth making. Send your MRI and operative report ahead of time and we will tell you honestly whether you are a candidate before you book travel.
Bring us your MRI and your operative report
If you had surgery and the pain came back, we will look at your imaging with you and tell you what we see, including if we think decompression is not right for your case.
Contact our Walnut Creek office to get started.
Dr. JD Dudum, D.C.
Dudum Chiropractic, Walnut Creek