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Paul Tortland, DORegenerative Orthopedics
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Non-surgical orthopedics · Glastonbury, CT · New England

 Pain After Back Surgery in Glastonbury, CT

Still in pain after a discectomy, laminectomy or fusion? Non-surgical regenerative orthopedics with Dr. Paul Tortland in Glastonbury, CT.

Written and clinically reviewed by

Paul D. Tortland, DO, FAOASM, CAQSM, RMSK

Dr. Paul Tortland, DO is a non-surgical orthopedic & sports medicine physician specializing in regenerative orthopedics and surgical alternative treatment. He is dual board certified in Sports Medicine & Osteopathic Manipulative Medicine (OMM) and Regenerative Medicine, Fellowship-trained in Sports Medicine. He became the first physician in the world to earn board certification in Regenerative Medicine in 2015. Diplomate, American Board of Regenerative Medicine (ABRM), 2015. Registered in Musculoskeletal Ultrasound (RMSK).

Last clinically reviewed

October 2026

Condition

Why do I still have pain after back surgery?

Pain after back surgery is normal while you heal, but pain that never improved, came back, or lasts well past your expected recovery is called persistent spinal pain, or failed back surgery syndrome. Dr. Paul Tortland, DO, looks for the real source, which often sits in the joints and ligaments around the operated level, not in the surgery itself.

Why the workup comes first: The spine is complicated, and scan findings often do not match what hurts. In a review of 3,110 people with no back pain, disc wear showed up in 37 percent of people in their 20s and 96 percent of people in their 80s. So the most important steps come before any treatment: listening closely to your symptoms, a hands-on exam, and, when appropriate, a diagnostic injection to confirm the true pain source.

Source: Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173

Often the pain is in the support structures, not the disc: After spine surgery, the tissues around the operated level are common pain sources too. These include the paraspinal muscles, the lumbar facet ligaments, the SI ligaments, and the interspinous and supraspinous ligaments between the spine bones. Treating and strengthening them is a core part of the plan, and it can mean avoiding another operation.

Wound and muscle pain settles over weeks, nerve pain can take months, and soreness after a fusion can last several months. Published reviews put persistent pain after spine surgery at about 8 to 40 percent of patients. About 60 to 70 percent of Dr. Tortland's patients come for spine pain, and many have had a discectomy, laminectomy or fusion. Patients travel from across New England for a non-surgical second opinion.

Common sources of pain after back surgery:

  • Facet joints and their ligaments at and around the operated level
  • The SI joint, especially after a lumbar fusion
  • Wear in the segments above or below a fusion
  • Scar tissue around a nerve root, or a recurrent disc herniation
  • A fusion that has not fully healed, or weak back muscles

Worsening leg weakness, foot drag, or loss of bladder or bowel control needs urgent care.

Explore related conditions: Browse the Back and spine condition hub for related diagnoses and treatment options.

Anatomical illustration of the spine and rib cage seen from behind, down to the pelvis
Anatomical illustration of the spine and rib cage seen from behind, down to the pelvis

CARE OPTIONS

How is persistent pain after back surgery treated?

Dr. Tortland's treatment options: He starts with your history, exam and ultrasound, then looks at what the surgery did and did not address. Your operative notes and a recent MRI help. In his clinical experience, persistent pain after back surgery often comes from the structures around the operated level, not from the operation itself. Results vary.

  • Test injection first: Dr. Tortland places a diagnostic injection, mostly numbing agent, under ultrasound guidance in the office to find the pain generator before treating it. Epidurals (interlaminar, transforaminal or caudal) may also be used, often to confirm where the pain comes from.
  • PRP or prolotherapy after fusion: the most common treatments after a fusion. They strengthen and stabilize the facet ligaments around the fused level, not only calm inflammation.
  • SI joint injection: when the SI joint is part of your pain, Dr. Tortland injects the joint as well.
  • Bone marrow aspirate with PRP: for more severe cases in patients who have not had a fusion. It is not used after a fusion.

What to expect: Judge one PRP treatment at least 10 to 12 weeks after the injection. If you improve but are not finished, a second PRP may be added.

Second opinion before more surgery: A fresh look before revision surgery is reasonable, especially when the first operation did not relieve the pain you had. Dr. Tortland tells you plainly when a spine surgeon should be involved and refers you.

When other care may be needed: Progressive weakness, foot drag, saddle numbness, or new bladder or bowel changes need emergency assessment. A failed fusion, loose hardware or a recurrent disc compressing a nerve may call for a surgical opinion. Evidence for PRP in the spine is early. One pooled analysis of 16 studies and 85,643 patients (Cureus, 2023) found persistent pain in about 15 percent of patients after lumbar discectomy.

Comparison

Compare your treatment options

Common care options for this condition, who each suits, and what to know
OptionBest forWhat to know
Guided rehab, medication and timePain that is easing, or recovery still within your surgeon's expected timeline.Wound and muscle pain settles over weeks, nerve pain over months, and fusion soreness can last several months. Pain that never improved, or eased and returned, deserves a fresh look.
PRP or prolotherapy, SI joint and epidural injectionsPersistent pain after a discectomy, laminectomy or fusion when the joints and ligaments around the operated level are the source.Dr. Tortland starts with a test injection under ultrasound. Judge PRP at 10 to 12 weeks, and a second PRP may follow. Bone marrow aspirate with PRP is for more severe cases, never after a fusion. Evidence is early and results vary.
Spine surgeon evaluation or revision surgeryWorsening weakness, foot drag, bladder or bowel changes, loose hardware, or a clear structural problem.Saddle numbness and bladder or bowel changes need emergency assessment. Dr. Tortland tells you plainly when a spine surgeon should be involved and refers you.

Common questions

Questions about pain after back surgery

Why do I still have pain after back surgery?

Surgery treats the structure the surgeon targeted, and your pain may come from somewhere else. In Dr. Tortland's clinical experience, it often comes from the facet joints, ligaments or SI joint around the operated level. Scar tissue, a fusion that has not healed, and wear above or below a fusion are other causes.

What treats persistent pain after a spinal fusion?

After a fusion, the most common treatments are PRP or prolotherapy to strengthen and stabilize the facet ligaments around the fused level. If the SI joint is part of the pain, Dr. Tortland injects it as well. Bone marrow aspirate with PRP is not used after fusion. A spine surgeon is involved when a structural problem needs one.

How long does PRP take to work for pain after back surgery?

Judge one PRP treatment at least 10 to 12 weeks after the injection. If you improve but are not finished, Dr. Tortland may add a second PRP. Results vary, and he starts with a test injection to confirm the pain source before treating it.

Should I get a second opinion before another back surgery?

A second opinion before revision surgery is reasonable, especially if the first operation did not relieve the pain you had. Dr. Tortland looks for a non-surgical source, such as the joints and ligaments around the operated level, and refers you to a spine surgeon for worsening weakness or bladder or bowel changes.

Not sure which treatment fits your condition?

Patients travel from across New England to see Dr. Tortland in Glastonbury, CT. He reviews your imaging and history, examines you with ultrasound, and recommends the most appropriate non-surgical path forward, and he tells you plainly when a surgeon is the better choice.

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