My husband had an operation to remove the disc at L45. He was doing so well afterwards. The pain was much less and he could do things he hasn't done for years. Now all of a sudden, his symptoms are back worse than before. How can that be possible if the disc is gone?

Recurrence of back pain after a discectomy (disc removal) is not uncommon. And it can even happen after a long period of pain-free living. There are several possible reasons for this.

The first possible cause is that a disc at a different level can start to protrude causing pain. Or sometimes scar tissue from the previous surgery builds up in the space around the spinal cord or spinal nerve bringing on painful symptoms. Scar tissue has also been shown to develop as a result of an ongoing inflammatory process. This may have happened before the disc was removed.

Another possible cause of painful recurrence is if all of the disc material wasn't removed. Sometimes the surgeon is unable to see the complete disc space. Or sometimes the detached pieces of disc material move to the front of the disc space and are hidden or unreachable without causing damage to the nerve tissue.

This would be a good time for a follow-up visit with the surgeon. Early treatment may give your husband the best results and possibly avoid a second surgery.

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