The assessment and management of the failed back, Part II.

Despite adequate surgery a number of patients have a return of back pain and sciatica following operation, the so-called failed back. The results of a prospective study of 101 patients entering an intensive rehabilitation programme for the failed back is described. The programme consists of a team approach to the patient and his problems, using a variety of techniques to produce pain relief. Non-organic pain represents a significant problem in the failed back; 58% of patients were completely or substantially relieved of their pain. Transcutaneous nerve stimulation was found to be the single most useful treatment with exercise second. Non-organic pain was able to be relieved by this programme.