Low Back Surgery: Recovery

Full recovery from low back surgery depends on the procedure performed. For instance, recovery from a discectomy (when a herniated disc is removed from the spinal canal) may take anywhere from one to four weeks. On the other hand, recovery from a spinal fusion (when the soft tissue between two or more spine bones is replaced with bone or metal) may take up to a year.

But regardless of the type of low back surgery you have, there are some bedrocks to ensuring its success, including following up with your healthcare provider as advised, avoiding/restricting certain activities, and caring for your wound site. You will also need to remain fully committed to your post-operative physical therapy/rehabilitation program.

Surgery Follow-Up

After any low back surgery, you can typically expect to see your surgeon at the following points:

• One to two weeks after surgery
• Four to six weeks after surgery

At the one- to two-week post-operative visit, any non-absorbable sutures or staples placed in your lower back will be taken out.

Your surgeon will also see how well you are healing and evaluate you for surgical complications, like wound infection. In addition, they will ask you about common post-operative symptoms like pain, constipation, and mild numbness or weakness in your legs.

During the first or second visit, your surgeon will taper you off opioid pain medication. Moving forward, you will probably be advised to take Tylenol (acetaminophen) and/or a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen, for any pain. You may also be prescribed a muscle relaxant, such as Flexeril (cyclobenzaprine).

Recovery Timeline

Right after surgery, your surgeon will advise you to avoid twisting your spine and bending at your waist. If you do have to pick up something off the floor, you will need to bend at your knees; be extra safe by holding onto the back of a chair or table when doing so.

You will also be instructed to not lift anything greater than 10 pounds or engage in any strenuous activities or sports until four to 12 weeks after your surgery.

Generally speaking, you can expect to resume the following activities as outlined. But since this can vary, always speak with your surgeon about what you should plan for in your case:

• Driving: Patients can usually return to driving around two weeks after surgery or when they are off all opioid pain medications.
• Working: Patients who work desk jobs can usually return within four to six weeks. People with labor-intensive jobs or those that require a lot of movement will require a longer period of time off.
• Sex: Patients can usually resume sex two weeks after surgery.

Never resume any activities without your healthcare provider giving you the green light—even if you feel up for them.

Healing and Rehabilitation

Of course, a big factor in the speed of your recovery is your post-surgery rehabilitation and care. Physical therapy is essential, as it promotes healing and helps restore strength and range of motion in the spine. But self-care and wound-care strategies are important as well.

Wound Care

For the first five to 10 days or so after surgery, your surgeon will probably want you to keep your wound site completely dry. To allow you to shower right after surgery, a water-resistant dressing will likely be placed over your incision(s).

When given the OK by your surgeon, you can gently remove the water-resistant dressing and shower with the wound site uncovered. Use mild soap when washing and be sure to pat the wound site dry with a clean towel.

Do not apply any type of medication, lotion, cream, or ointment to your incision site (e.g., Neosporin or hydrogen peroxide).

Avoid hot tubs or swimming in pools or lakes until given the approval by your surgeon, which is usually for at least six weeks after surgery.

Call your surgeon if you develop any signs of wound infection, such as:

• Fever or chills
• New or worsening redness, swelling, warmth, or pain around the wound
• Abnormal drainage (yellowish-whitish color or bad odor) from the wound

Seek immediate medical attention if you develop any of the following symptoms:

• A headache that worsens when sitting or standing up
• Calf pain or swelling
• Chest pain or trouble breathing
• Dizziness or fainting

Physical Therapy

Research indicates that people who engage in exercise after back surgery have superior outcomes compared to those who do not. Seeking the guidance of a physical therapist can ensure that whatever movement you are doing is safe and appropriate for your point in recovery.

You can expect to start your physical therapy program within twelve weeks after surgery.

The goals of your program will typically include the following:

• Attain and maintain proper posture while sitting and standing
• Optimize lower spine range of motion and flexibility
• Improve the strength of your lower back muscles, as well as those in your abdomen and legs
• Improve your overall functional endurance

Self-Care

You will also need to make sure that you are taking certain steps at home. Some of these may even begin in the hospital before you are discharged, if you stay overnight:

• Icing your lower back around the incision area at regular intervals (e.g., 20 minutes several times a day)
• Eating a regular diet as tolerated (you may have an initial loss of appetite after surgery)
• Taking an iron supplement or other vitamins (per your surgeon) to boost wound healing
• Walking around as soon as possible after surgery (aim for at least three times a day, increasing both the frequency and distance as tolerated)
• Slowly climbing stairs using a handrail as tolerated

Your surgeon will also advise you on using special devices or products to optimize your healing process. These instructions may be modified depending on the type of low back surgery you had and your surgeon's preferences.

• Use pillows in between your knees (if sleeping on your side) or behind your knees (if sleeping on your back) to prevent rolling over onto your stomach
• Use assistive devices at home to prevent falls, promote comfort, and avoid certain back movements (e.g., slip-on shoes, a shower stool and rails, elevated toilet seat, and a reacher/grabber)
• Use a rigid recliner for sitting and avoid prolonged sitting (no more than 45 minutes at a time)
• Wear a back brace (if underwent spinal fusion) to encourage the meshing or "fusion" of the bones
• Use a cane or walker for a short period of time after surgery for your comfort and stability (if advised)

Coping With Recovery

The healing phase of low back surgery is highly variable. For some, it may mean a couple of weeks of minor discomfort mixed in with a combination of rest, walking, and physical therapy. For others, especially those undergoing a lumbar spinal fusion, recovery may be more grueling, painful, and time-intensive. Patience and realistic expectations can help you navigate this period.

What seem like small strategies can help you cope during this time. For example:

• Consider creating a daily schedule not just to make sure you have something queued up to keep you occupied, but to track your progress toward any goals your surgeon has set for you.
• Be sure to incorporate small, daily naps and time for walking within your schedule.
• Eat nutritiously during this time too and avoid smoking (if applicable) to ensure a safe and speedy recovery.
• Ask for help when you need it. This could be anything from your neighbor walking your dog to your friend picking up your prescription at the drugstore.

Keep in mind that you may experience unpleasant emotions during the recovery period. Anxiety or fear of moving is common. Some people even develop symptoms of depression.

If you are struggling to cope well after low back surgery, it's important to reach out to your surgeon or primary care healthcare provider. You may benefit from seeing a therapist or psychologist. They can help you not only feel better, but adopt healthy strategies to manage your pain, activity limitations, and/or overall expectations after surgery.

A Word From Verywell

With any low back surgery, it's important to prepare yourself not only for the surgery itself, but for the healing period afterward. You can do this by thoroughly reviewing the details of the surgery and post-operative plan with your surgeon beforehand. During these early appointments, be sure to also review what you can realistically expect after surgery, as well as your surgeon's success rates.