Persistent or recurrent pain after spinal surgery may arise from a variety of causes. Frequent causes include returning disc herniation and nerve root compression. Other causes include: scar tissue build-up (fibrosis), joint hypermobility, spinal instability, and facet joint problems. Sometimes returning pain after back surgery arises from systemic reasons such as diabetes, autoimmune disorders and peripheral vascular disease. Post-surgical back pain may also be caused by smoking and the release of inflammatory mediators. Post surgical back pain can be aggravated by depression, anxiety, sleep problems,
