What is FBSS?
Failed back surgery syndrome (FBSS), also known as failed back surgery syndrome (or FBSS), is the condition characterized by chronic persistent pain following a surgery of the back. This happens when the patient has not had a very successful surgery, or a complication occurs during the surgical process which later results in chronic persistent pain.
As expected, some pain is experienced by the patient after the surgery, but with FBSS, the pain persists. Also, the unsuccessful surgical result is not always because of poor performance on the surgeon’s part – studies show the overall success rate for back surgery is 60-70% and over 20% fail within 2 years.
Failed back surgery syndrome can be a traumatic experience because the patient may have gone through a major surgery, only to end up in more pain and find out it failed. The painful condition before and after the surgery, coupled with the disheartening realization of a failed surgical attempt can lower a patient’s spirit, making recovering even more difficult and slow. However, failed back syndrome can be effectively managed, setting the patient on road to recovery.
Lessening the Pain of FBSS with Topical Medications
The first step in managing FBSS is lessening the pain. If the surgery has failed, and other treatment options are not responding as well, this means the patient’s back problem is a result of some undetermined cause. In such a case, the pain and symptoms take the forefront, causing the underlying condition to remain untreated. So reducing the pain is the first step to give the patient a breather, and boost for a fresh check-up and diagnosis.
Topical prescription pain cream medications can work well for patients recovering from back surgery and those with FBSS. Topical prescription medications come in the form of analgesics and anesthetics and can be used to lessen the sensation of the pain. A combination of analgesics and anesthetics are best, which is known as compounded agents. Analgesics help in reducing the inflammation from the surgery, while anesthetics help in numbing the area and providing temporary relief.
Compounded Topical Medications
Topical compounded medications work when applied directly to the affected area and/or the appropriate nerve dermatone where the pain originates. These creams are customized with combinations of the following medications:
• Anesthetics: Prilocaine and Lidocaine
• Non-steroidal Anti-Inflammatories (NSAIDS): Piroxicam, Ibuprofen, and Ketoprofen
• Vasodiators: Verapamil and Nifedipine
• Muscle Relaxants: Baclofen, Cyclobenzaprine, and Guiafenasin
• Pain Blockers: Ketamine
• Nerve Agents: Gabapentin and Amitriptyline
• Other Ingredients: Capsaicin, Clonidine, and Menthol
Recent Study of Topical Capsaicin
In a recent study regarding the tolerance and efficacy of capsaicin plaster in non-specific low back pain. In a research trial 320 patients, 67 percent rated the use of topical capsaicin rated the medication as either “good” or “excellent.” Of this group, 36 percent said that with the use of topical pain medication they were “symptom free.” Also, side effects and adverse local drug reactions were only found in less than 8 percent of the participants. The researchers concluded that capsaicin was superior to placebo when treating chronic back pain.
The greatest advantage of topical medication is their instant pain relief. Because the medicine is applied directly to the affected site, pain relief response is quicker. Apart from this fact, topical agents also have lesser side effects compared to oral medications. This is why topical medicines are a good treatment option for FBSS.
Topical agents are easily available in pharmacies with a doctor’s prescription and may be purchased as over-the-counter drugs, as well. Long-term use of topical agents is safe, but it is important to not exceed the daily maximum use stated on the label. FBSS can be a chronic and painful condition; however, topical medications can help in managing the pain associated with this. The advantages and ease of use make them an ideal pain-relief solution.
Frerick, H., Keitel, W., Kuhn, U., et al. (2003). Topical treatment of chronic low back pain with a capsicum plaster.