Meet the story of a man who had already been through 3 back operations but was still in pain every day, and had almost lost hope, until he met a new approach to treatment that changed his life for good.
A true story from someone who had almost given up hope
Pain that never ended
Going back 5 years, a company employee who often had to lift heavy loads began to have back pain. It started slight, but grew steadily worse until he could not bear it. The doctor diagnosed a herniated disc pressing on a nerve and recommended surgery.
The first time he had the operation, he thought he would be back to normal. But not long after recovering, the pain came back. A second operation gave the same result. And when he had a third, this employee began to feel he was caught in a cycle with no way out.
The "unfixable" case everyone had given up on
After the third operation, several doctors told him "this is all that can be done." Some advised him to take painkillers for the rest of his life. Some said he would have to accept the pain and adapt.
He was given the label "unfixable case" by the medical team, meaning a patient with chronic back pain after surgery (failed back surgery syndrome, FBSS), which is very difficult to treat.
His symptoms really were severe:
- Back pain all the time, especially in the morning on waking
- Pain down the leg, numbness in the toes
- Unable to stand or walk for more than 15-20 minutes
- Unable to lie on his back, only on his side
- Unable to do his regular work, with a badly reduced quality of life
The "unfixable" case meets a team that would not give up
An assessment unlike any other
It began by listening to his story in detail, understanding every aspect of the pain, examining him comprehensively, and — importantly — looking for the true cause of the pain that remained.
What the medical team found:
- A core muscle problem: after 3 operations, the muscles supporting the spine were very weak and could not do their supporting job, leaving the spine without stability
- Abnormal pain perception: chronic pain over a long period had led the brain and nervous system to "remember" the pain, so that even a small stimulus produced a great deal of pain
- Unsuitable habits of daily life: the postures for sitting, standing, and walking that had developed from trying to avoid the pain were making the condition worse still
An intensive, whole-person treatment plan
The medical team at PYONG Rehabilitation Clinic designed a special programme, with treatment 4 days a week continuously, each day cared for by a multidisciplinary team consisting of:
- A rehabilitation medicine physician, overseeing the whole picture and adjusting the treatment plan
- A physiotherapist, designing an individual training programme
- The use of every medical technology available
The secret weapons: 4 technologies that changed a life
1. PMS (Peripheral Magnetic Stimulation): waking the power of the muscle
The first technology used was PMS, stimulation with electromagnetic waves, which works by creating a high-strength magnetic field sent into the deep muscle layer.
Why PMS matters:
His core muscles were very weak. After several operations and not daring to move for fear of pain, the muscle had wasted and could not work as it should.
PMS helps to:
- Stimulate the muscle to contract effectively without the person having to exert themselves, so that weakened muscle gradually grows stronger
- Improve the working of the nerves, helping the signalling between brain and muscle
- Reduce pain at depth, so that a training programme can begin without pain getting in the way
2. High Power Laser: treating deep at the root of the problem
The second technology is High Power Laser Therapy, which uses high-intensity laser light energy penetrating as deep as 5-6 centimetres into the tissue.
How it works:
- Stimulating ATP production (the energy of the cell), so that cells have the power to repair themselves
- Reducing inflammation, inhibiting inflammatory mediators and promoting anti-inflammatory ones
- Increasing blood flow, bringing oxygen and nutrients to feed the tissue that needs to recover
- Reducing pain, interrupting the transmission of pain signals
For this employee, there was chronic inflammation in the area of the surgery. This technology helped reduce the inflammation and speed the process of restoring the damaged tissue.
3. Focused Shockwave: destroying pain that has settled deep
Focused Shockwave Therapy with 3D Dynamic Focusing is a technology that delivers high-energy shockwaves precisely into the problem tissue.
The advantages of this technology:
- The focus can be adjusted dynamically according to the depth of the tissue
- It reaches the deep muscle layer as far as 9 centimetres
- It is highly precise and does not affect surrounding tissue
For patients with chronic back pain:
- It helps break down the hardened fibrous tissue (scar tissue) that results from repeated surgery
- It stimulates the body's recovery process at cell level
- It reduces the trigger points arising from chronically tight muscle
4. TMS (Transcranial Magnetic Stimulation): retraining the brain to stop "remembering" pain
TMS is a different technology and a very important one for patients with chronic pain. When a person is in chronic pain over a long period, a change occurs in the brain called "central sensitisation," in which the brain "remembers" that pain.
The result is that even a small stimulus produces a great deal of pain, or sometimes there is pain with no clear cause, because the brain is sending out the pain signal itself.
The core muscle training programme
Besides the medical technology, what allowed this employee to recover in a lasting way was a core muscle training programme designed specifically for him.
Why the core muscles matter
Think of the spine as a tent pole and the core muscles as the ropes holding the pole upright. If the ropes are slack, the pole falls.
After back surgery, his spine no longer had the stability it once had, and the muscles that should have supported it were very weak, so that every movement compressed the nerve and produced pain.
The programme designed specifically:
- Stage 1: activation — waking the sleeping muscle
- Special techniques are used to "wake" the deep core muscles that have not worked for a long time
- It begins with training correct breathing to stimulate the diaphragm and the pelvic floor
- Stage 2: strengthening — building strength
- Training basic postures that emphasise stability before strength
- Using special equipment such as a Swiss ball, TRX, and a Reformer to train safely
- Stage 3: functional training — training for real use
- Training the postures used in daily life, such as getting up, sitting, standing, bending, and lifting
- Making the muscle able to support real-life activity
A result beyond expectation
After an intensive rehabilitation programme of 4 days a week for 3 months, this employee saw a remarkable change:
Month 1:
- Pain down by 40%
- Able to stand and walk for longer, up to 30-40 minutes
- Beginning to lie on his back without much pain
Month 2:
- Pain down by 60%
- Able to do almost all his daily activities
- Able to reduce painkillers considerably
Month 3:
- Pain down by 80%
- Back at work
- Able to do light exercise
The facts about failed back surgery syndrome
Many people may wonder what failed back surgery syndrome (FBSS) is, and why it is so hard to treat.
What is FBSS?
FBSS is a condition in which the patient still has back pain or leg pain after spinal surgery, even though the operation was successful and corrected the structural problem.
FBSS has several causes:
- Fibrous tissue arising from surgery (scar tissue) pressing on the nerve
- Weak core muscles, unable to support the spine
- Chronic inflammation
- The brain and nervous system remembering the pain (central sensitisation)
- Abnormality in the spinal joints near the operated level
Why repeat surgery is not the answer
Many people with FBSS may be advised to have repeat surgery, but the figures show that a second operation has a lower chance of success than the first, and the more often surgery is performed, the smaller the chance of improvement.
The better option is: a whole-person rehabilitation programme focused on:
- Restoring the muscle and the working of the nervous system
- Managing pain with modern medical technology
- Changing habits and lifestyle
Who is this programme suitable for
The intensive rehabilitation programme at PYONG Rehabilitation Clinic is not only for people who have had back surgery, but suits:
- People with chronic pain of more than 3-6 months, who have tried several treatments without improvement
- People who have had surgery but still have pain or have not improved as they expected
- Older adults with problems of movement, balance, and muscle weakness
- Patients with neurological disease, such as stroke or Parkinson's disease
- People who have been told "nothing more can be done"
Begin your own road to recovery
If you or someone you love is facing chronic pain that seems impossible to fix, or has been told it is an "unfixable" case, this employee's story proves that there is always still hope.
PYONG Rehabilitation Clinic
Management of pain and musculoskeletal disorders, by specialist physicians
Location:
999 Room BF-11, Floor L, Gaysorn Village
Ploenchit Road, Lumpini, Pathumwan, Bangkok 10330
(near BTS Chit Lom)
Free valet parking
Opening hours:
- Monday-Friday: 16:30-20:00
- Saturday-Sunday: 10:00-20:00
PYONG Rehabilitation Penthouse Clinic
Care for older adults and neurological rehabilitation, by a team of specialist doctors and allied health professionals
Location:
127 Room K, Floor 11, Gaysorn Tower
Ratchadamri Road, Lumpini, Pathumwan, Bangkok 10330
Opening hours:
- Monday-Friday: 10:00-20:00
- Saturday-Sunday: 10:00-20:00