Breaking Down Epidural Fibrosis: Understanding the Challenges and Exploring Shockwave Therapy as a Promising Treatment Option

Back surgery is commonly performed to address a number of issues that cause pain, weakness and discomfort. Certainly in some cases it is appropriate, can provide relief and improve quality of life. However, complications can arise even after seemingly successful procedures, and one such complication is epidural fibrosis. This blog aims to shed light on what epidural fibrosis is, why it poses challenges in terms of treatment, and how shockwave therapy might emerge as a promising solution based on recent studies.

Understanding Epidural Fibrosis

Epidural fibrosis refers to the formation of excessive scar tissue in the epidural space, the area surrounding the spinal cord and nerves. This fibrous tissue can develop after spinal surgery, such as laminectomy or discectomy, where a portion of the vertebral bone or disc is removed to alleviate pressure on the spinal cord or nerves. While surgery is intended to improve the patient’s condition, epidural fibrosis can lead to complications, including nerve compression, pain, and reduced spinal flexibility.

Challenges in Treating Epidural Fibrosis

Several factors contribute to the difficulty in treating epidural fibrosis:

  1. Invasive Nature of Repeat Surgery: Treating epidural fibrosis often involves further surgery, which can be complex and risky. Repeat surgeries may lead to more scar tissue formation, exacerbating the problem.
  2. Limited Efficacy of Traditional Treatments: Conservative treatments like physical therapy, pain medications, and epidural injections may provide temporary relief, but they often fail to address the root cause or provide a long-term solution.
  3. High Recurrence Rates: Even after successful surgical removal of scar tissue, there is a high risk of epidural fibrosis recurring. The body’s natural response to surgery is to produce scar tissue, making it challenging to prevent its formation entirely.

Shockwave Therapy as a Potential Solution

Recent research has explored alternative treatments for epidural fibrosis, and one intriguing option is shockwave therapy. A study conducted on a rat model demonstrated promising results in reducing epidural fibrosis.

Study Overview

The study, published in Joint Diseases and Related Surgery, investigated the effects of shockwave therapy on epidural fibrosis in rats that underwent spinal surgery. Shockwave therapy involves the use of acoustic waves to stimulate healing and reduce scar tissue formation.

Key Findings

The study found that rats treated with shockwave therapy exhibited:

  1. Reduced Scar Tissue Formation: Shockwave therapy significantly decreased the formation of epidural fibrosis compared to the control group.
  2. Improved Functional Outcomes: Rats that received shockwave therapy demonstrated better functional outcomes, including improved mobility and reduced pain, suggesting that shockwave therapy may positively impact the long-term effects of epidural fibrosis.

Mechanism of Action

Shockwave therapy is believed to work by promoting tissue regeneration, improving blood flow, and modulating inflammatory responses. These effects contribute to the prevention of excessive scar tissue formation.

The Takeaway

Epidural fibrosis is a challenging complication of spinal surgery that can significantly impact a patient’s quality of life. While traditional treatments have limitations, emerging research on shockwave therapy provides hope for a more effective and less invasive solution. Although more studies are needed to validate these findings in human subjects, the potential of shockwave therapy to reduce epidural fibrosis offers a glimpse into a promising future for post-surgical care in spinal interventions. As the medical community continues to explore innovative approaches, patients and healthcare providers alike can anticipate advancements that may revolutionize the treatment landscape for epidural fibrosis. Contact us to see one of our physicians in Orlando, Tampa, St. Petersburg, or Sarasota, if this sounds like it applies to you or someone you love.


  1. Haberal, B.; Simsek, E.K.; Akpinar, K.; Turkbey Simsek, D.; Sahinturk, F. Impact of radial extracorporeal shock wave therapy in post-laminectomy epidural fibrosis in a rat model. Jt. Dis. Relat. Surg. 2021, 32, 162–169.
About The Author
Lisa Valastro, DO Medically Reviewed By Ron Torrance II, DO FAOASM

Lisa Valastro, DO Medically Reviewed By Ron Torrance II, DO FAOASM

Lisa Valastro, DO Medically Reviewed By Ron Torrance II, DO FAOASM

Lisa Valastro, DO Medically Reviewed By Ron Torrance II, DO FAOASM

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