Do you have spondylosis, a bulging disc, stenosis, scoliosis, or chronic back pain? Considering back/spine surgery to treat your condition? Read on to learn how much pain to expect after surgery.
When you’ve got chronic back pain, the thought of going through a procedure that will temporarily cause more pain is scary. Back surgery provide relief of painful symptoms, however fighting through a painful recovery may be unavoidable. So, this begs the questions: what pain can you expect after back surgery? How painful is back surgery? What is the back surgery recovery time?
Who Will Get the Most Pain Relief from Back Surgery?
Before we talk about post back surgery pain, it’s important to discuss with your surgeon the best course of action. After all, not all back pain is created equal and not all pain can be relieved with surgery. The spine is a very complex joint system and unlike replacing an arthritic knee or hip, it can be difficult to address the root cause of back pain with surgery. If your back pain is more general and chronic and not stemming from a visible, mechanical/ structural issue, surgery may be like a “stab in the dark”. For your surgeon, patient selection is of the utmost importance when choosing who spine surgery can help.
Dr. Singh, Scottsdale-based orthopedic surgeon explains, “if someone has shooting leg pain and on an MRI we can see structural findings that can be fixed with surgery (like a stenosis or a bulging disc nerve), then a successful outcome is likely.” In other words, seeing a structural issue that is linked to the type of pain the patient is experiencing allows for a more reliable surgical result.
Back surgery is most successful at relieving pain if:
- You’ve been diagnosed with a structural back pain issue that directly relates to your pain (e.g. stenosis, pinched nerve etc.). This is the most determining factor.
- Your surgeon can visibly see the cause of your back pain on an MRI/ X-ray. Your physical examination and tests should correlate to your pain patterns.
- This is your first back surgery. If you’ve had a previous back/spine surgery that did not alleviate symptoms, secondary surgeries have an even lower chance of addressing pain and mobility issues.
- Alternative treatments (like injections) have helped you. If alternative treatments that target the troubled area of your back/pain successfully reduce pain and numbness or improves mobility, this shows that you’re on the right track. A more permanent solution addressing the underlying issue could offer greater relief.
- You have more than just general pain/ chronic pain. The back and spine are very complex. Although you may have back pain, it could stem from other parts of the body (like a hip or knee). Back pain is also very closed linked to mental health, anxiety, and depression.
What We Know About Post-Op Spine/ Back Pain
There are many different types of back surgery. The most common 4 are: discectomy, laminectomy, spinal fusion and vertebroplasty/ kyphoplasty.
Learn more about the 4 different types of surgery and which back problems and pain they address.
A lot of factors determine your post-op pain and recovery. How painful your back surgery may be is affected by: the type of back surgery you’ve had; the extent of your osteoarthritis/ disease/ bone degradation; your age; pre-surgery fitness and mobility level; your mental state; if you have chronic pain etc. For instance, pain after spinal fusion surgery of multiple vertebrae may be worse than a minimally invasive laminectomy on a younger, fitter patient.
Here’s what we know about back surgery post-op pain:
Did you know: The more you mentally and physically prepare for back surgery, the smoother and less painful your recovery will be?
- Right after surgery, you will feel pain in the surgical area. Your body went through a traumatic experience and there will be overall discomfort.
- After surgery, you will feel pain from your wound, swelling around the nerves, and general swelling around the wound. After surgery, pain is no longer achy and arthritic but stems from wound healing, swelling and inflammation.
- You will experience some pain outside of the hospital.
- For most back surgeries, it will take 1-1.5 months to resume “normal” mobility and function. During this time, pain should be tolerable and controlled.
- By the 1.5 month mark, you should feel noticeable pain relief.
- Those who’ve been on narcotic pain medication for their back pain prior to surgery tend to have a more painful recovery.
- Doing PreHab in the weeks leading up to back surgery is an absolute must! PreHab reduces post-op pain by better preparing your body, strengthening supporting muscles, teaching you how to control pain, losing extra weight and offloading your joints etc.
- After spine surgery, scar tissue along the spinal column will form. This happens between 3 months and 1 year post-op. Pain may be temporary as nerves heal but in some cases when scar tissue binds with nerve roots, it can be more permanent and challenging for patients The process of scarring after a back surgery is called “epidural fibrosis” or “failed back surgery syndrome” (FBSS).
If after several weeks you’re still experiencing moderate-severe pain, consult your physician. If at any point in your recovery pain is intolerable, reach out to your care team right away. The easy-to-remember acronym, “WORST”, (applicable to all joint surgery) teaches you the red flags to watch out for after surgery.
How Much Pain After Back Surgery is Normal?
Most of your healing from back surgery will take place during the first couple of months but bones can take a year or more to fully heal. As you leave the hospital, your body may be achy from surgery. As you’re pain medication dose tapers off (likely around the 1-2 week post-op mark) you may also notice an increase in pain. Pain spikes can also occur as you ramp up movement and physical therapy in the weeks after your procedure date.
However, as a general rule of thumb, the further you are into post-op recovery, the less pain you should be experiencing. Of course there will be ebbs and flows where some days will be more painful than earlier days, but as a whole, week by week, you should be noticing an improvement to your back pain levels.
Tips for Controlling Back Pain After Surgery
Controlling pain is part of your recovery success. If you are fighting through moderate or severe pain, your body cannot heal quickly. Always talk to your physician if your pain exceeds “discomfort” and is not manageable.
- Keep on your physician’s recommended schedule for pain medication. Skipping medication because you are feeling better can backfire. Consult your doctor before changing doses.
- During recovery, switch positions often. If one position is painful for your back, do not add pressure by staying in it.
- Keep up with your icing after surgery! Typically, icing is recommended 4-5 times a day for 15-20 minutes. This helps with swelling, and therefore cuts down pain.
- Be patient and understand the mental side of pain. If you move forward with surgery, know that surgery is traumatic on your body and healing takes time. Cut yourself some slack and give yourself the time you need to heal.
- Fear and anxiety about pain actually contributes to the amount of pain you feel. Employing mindfulness meditation and other stress-reducing breathing techniques are a great way to manage back pain.
- “Motion is lotion”. Before and after surgery, you should keep moving (as much as your physician signs-off on). Craig, physical therapist with the PreHab Guys explains, “Across the board, the most important thing for individuals with lower back pain, acute or chronic, is to sustain movement.” Remember to listen to your body during daily movements and recommended exercises. If it hurts, do not push through it. Check out these 13 best at-home exercises designed for lower back pain.
- Before surgery, work through a complete PreHab program that will get you mentally, physically and environmentally prepared for surgery. The more you do to prepare for surgery, the better your body (and mind) will respond to the procedure.