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Post-Surgical Pain Treatment in Reisterstown, MD

Post-Surgical Pain Treatment in Reisterstown, MD

Interventional options when recovery stalls after spine, joint or sports surgery

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Common In:10 to 50 percent of patients depending on surgery type, with thoracotomy and hernia repair highest
When to Consider Care:Pain persisting beyond 3 months after surgery despite normal post-op healing milestones
First-Line Workup:Co-management with your surgeon, exam, and electrodiagnostic or imaging review when nerve involvement is suspected
Available At:11459 Cronridge Drive, Suite 250, Owings Mills, MD 21117
Understanding Post-Surgical Pain
Overview

Understanding Post-Surgical Pain

When pain outlasts the expected healing window

Post-surgical pain, sometimes called chronic post-surgical pain syndrome (CPSP), is pain that persists for more than 3 months after a procedure, beyond the timeframe expected for normal tissue healing. Depending on the type of surgery, CPSP has been reported in roughly 10 to 50 percent of patients, with thoracotomy, hernia repair, mastectomy and major joint procedures carrying the highest rates.

At the Pain Treatment Center of Maryland, Dr. Tatyana Reznikov, a board-certified physical medicine and rehabilitation physician with dual fellowship training in interventional spine, sports medicine and musculoskeletal care, evaluates persistent post-op pain through a clear, evidence-based lens. We do not perform revision surgery. Our role is targeted, image-guided diagnostics and interventional treatment, always co-managed with your operating surgeon so your overall recovery plan stays coordinated.

Why Pain Can Persist After a Successful Surgery
Why It Happens

Why Pain Can Persist After a Successful Surgery

Common drivers of chronic post-surgical pain

Pain that lingers past 3 months after surgery rarely has a single cause. In most cases it reflects an overlap of nerve injury, scar tissue, central nervous system changes and deconditioning. A small percentage of cases will involve residual mechanical issues, such as a missed disc fragment after spine surgery, hardware-related irritation, or biomechanical changes from a joint procedure.

It is important to separate dangerous post-op pain from chronic post-surgical pain. Signs of infection (spreading redness, warmth, fever, drainage from the incision) or new neurologic deficits (sudden weakness, bowel or bladder changes, saddle anesthesia) are surgical emergencies and need immediate evaluation by your surgeon or the nearest emergency department. Our team is not a substitute for that follow-up. When your surgeon has cleared infection and structural emergencies, interventional pain care can help quiet residual nerve, scar and myofascial pain that physical therapy alone has not resolved.

Common Post-Surgical Pain Patterns We Evaluate
Common Patterns

Common Post-Surgical Pain Patterns We Evaluate

Including failed back surgery syndrome

Failed back surgery syndrome (FBSS), sometimes called post-laminectomy syndrome, is one of the most recognized post-surgical pain patterns. It refers to persistent back or leg pain after spine surgery, often a mix of residual radicular (nerve root) pain, epidural scarring and adjacent-segment stress. For these patients, image-guided epidural steroid injections, medial branch blocks and selective nerve root blocks can target the specific pain generator.

Other patterns we see include intercostal neuralgia after thoracotomy or rib fracture repair, ilioinguinal and genitofemoral neuralgia after hernia or pelvic surgery, suprascapular nerve pain after shoulder procedures, and persistent myofascial pain around joint replacement scars. Each pattern has its own targeted approach. We tailor diagnostic injections and image-guided therapies to the involved nerves, joints and soft tissue, and we communicate findings back to your surgeon so the whole team stays aligned.

What Causes Chronic Post-Surgical Pain to Develop
Root Causes

What Causes Chronic Post-Surgical Pain to Develop

The mechanisms behind persistent post-op pain

01

Nerve Injury During Surgery

Cutting, stretching or entrapping small sensory nerves (such as intercostal, ilioinguinal or suprascapular branches) can leave behind burning, electric or shooting pain in the surgical region.

02

Central Sensitization

Repeated pain signaling around the time of surgery can amplify the spinal cord and brain pain response, so even normal sensations are felt as painful long after tissue has healed.

03

Scar Tissue and Myofascial Pain

Adhesions, scar tethering and protective muscle guarding around the incision create trigger points and restricted movement that keep pain active months after the procedure.

04

Residual Mechanical Issues

In a smaller subset of patients, hardware irritation, recurrent disc pathology, joint instability or biomechanical overload can continue to drive pain and may need surgical reassessment.

05

Epidural Fibrosis After Spine Surgery

Scarring around nerve roots in the epidural space is a recognized contributor to failed back surgery syndrome, producing radicular leg pain that mimics the original disc problem.

06

Deconditioning and Fear of Movement

Prolonged guarding, reduced activity and fear of reinjury weaken supporting muscles and stiffen joints, which amplifies pain and slows full functional recovery.

Why Patients Choose PTCOFMD for Post-Surgical Pain Care
Why Us

Why Patients Choose PTCOFMD for Post-Surgical Pain Care

Co-managed, image-guided care with your surgeon

  • Dual-Fellowship Interventional Expertise
  • Surgeon Co-Management
  • Honest, Evidence-Based Approach
  • Convenient Owings Mills Location

Interventional Options for Post-Surgical Pain

How treatments we offer compare for chronic post-surgical pain

Treatment Best For Session Time Results Timeline Maintenance
Epidural Steroid Injection Radicular leg or arm pain after spine surgery, including failed back surgery syndrome with epidural scarring 20 to 30 minutes Pain relief within 3 to 7 days, peak at 2 to 4 weeks Repeat as needed, typically up to 3 per year
Nerve Block Region-specific post-op nerve pain such as intercostal, ilioinguinal or suprascapular neuralgia 15 to 30 minutes Diagnostic relief within hours, therapeutic benefit over days to weeks Series of blocks depending on response
Medial Branch Block Persistent post-fusion or post-laminectomy facet joint pain in the neck or lower back 20 to 30 minutes Diagnostic relief within hours, confirms candidates for ablation May be followed by Radiofrequency Ablation
Radiofrequency Ablation Confirmed facet-mediated post-surgical neck or back pain after positive medial branch blocks 30 to 60 minutes Significant relief within 2 to 3 weeks Repeat every 9 to 18 months as needed
Trigger Point Injections Scar-related myofascial pain, taut bands and tender muscle knots around the surgical site 10 to 20 minutes Reduction in muscle tension within days Series of injections paired with rehab
Sports Injury Treatment and Rehabilitation Deconditioning, stiffness and movement loss after orthopedic or spine surgery 30 to 60 minutes Strength and mobility gains over 4 to 12 weeks Ongoing home program plus periodic check-ins
Signs You May Have Chronic Post-Surgical Pain
Is This You?

Signs You May Have Chronic Post-Surgical Pain

Patterns that suggest a pain medicine evaluation could help

  • Pain Beyond 3 Months Post-Op
  • Burning or Electric Nerve Pain
  • Persistent Leg or Arm Pain After Spine Surgery
  • Scar and Trigger Point Tenderness
  • Pain That Limits Rehab Progress
  • Surgeon Has Cleared You for Pain Management
FAQ

Frequently Asked Questions About Post-Surgical Pain Treatment

Honest answers from our pain medicine team

01 How long after surgery should pain be considered chronic?

Most pain medicine guidelines define chronic post-surgical pain as pain that persists for more than 3 months after a procedure and cannot be explained by another diagnosis. If your pain is severe, getting worse, or accompanied by red flag signs like fever or new weakness, you should contact your surgeon or seek emergency care rather than wait.

02 Do you do revision surgery if my first surgery did not work?

No. The Pain Treatment Center of Maryland does not perform revision spine, joint or sports surgery. We focus on image-guided diagnostic and interventional pain procedures and rehabilitation. If your evaluation suggests a structural problem that needs surgical reassessment, we will refer you back to your operating surgeon or to an appropriate specialist.

03 Will you work with my surgeon?

Yes. Co-management is central to how we treat post-surgical pain. With your permission, we share notes, imaging review and procedure details with your operating surgeon so your overall recovery plan stays coordinated. Many of our patients are referred to us directly by their orthopedic, spine or general surgeon.

04 When should I go to the emergency room instead of waiting for a pain appointment?

Go to the emergency department or contact your surgeon urgently if you develop spreading redness, warmth, drainage or fever near your incision, sudden new weakness in an arm or leg, new bowel or bladder changes, severe unrelenting pain after a recent procedure, or any sign of a possible blood clot. These are not chronic pain problems and need immediate evaluation.

05 What is failed back surgery syndrome?

Failed back surgery syndrome (FBSS), also called post-laminectomy syndrome, describes persistent back or leg pain after spine surgery. It is usually a mix of residual nerve root irritation, epidural scarring and adjacent-segment stress rather than a true surgical failure. Many of these patients respond well to targeted epidural steroid injections, medial branch blocks, radiofrequency ablation and structured rehabilitation.

06 Are injections the only option, or do you also recommend therapy?

Injections are most effective when combined with active rehabilitation. We frequently coordinate care with physical therapy, sports medicine rehabilitation and home exercise programs so that pain relief from an injection is matched with strength, mobility and lifestyle changes that protect your result.

Recommended Add-Ons

Complementary Non-Invasive Therapies

Gentle, non-invasive muscle activation can help rebuild strength lost during surgery and immobilization while supporting tissue recovery. These therapies complement post-surgical pain management once cleared by your provider.

Location116 Westminster Pike, Suite 106
Reisterstown, MD, 21136
Emailzalina@ptcofmd.com
Phone(410) 833-1011
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Scientific References

  1. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention (Lancet 2006). PubMed (PMID: 16698416).
  2. Macrae WA. Chronic post-surgical pain: 10 years on (Br J Anaesth 2008). PubMed (PMID: 18055522).
  3. Chan CW, Peng P. Failed back surgery syndrome (Pain Med 2011). PubMed (PMID: 21539702).
  4. Manchikanti L, Knezevic NN, Navani A, et al. Epidural interventions in the management of chronic spinal pain: ASIPP comprehensive evidence-based guidelines (Pain Physician 2021). PubMed (PMID: 33492918).
  5. Wildgaard K, Ravn J, Kehlet H. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention (Eur J Cardiothorac Surg 2009). PubMed (PMID: 19297184).