As the back continues to heal, patients usually start to feel better and find they can take on more activities.

The worst pain is generally over by 4 weeks after surgery. Pain is likely to continue to decrease gradually, but some patients continue to have pain 3 to 6 months after surgery.

Crucial Time for Fusion

During this time period of about 1 to 3 months after the surgery, the lumbar fusion bone mass is becoming established. While the fusion is growing together and strengthening, these movements should continue to be avoided to prevent stress at the fused segments:

  • Excess lifting (anything over 10 to 15 pounds)
  • Bending forward and backward
  • Twisting the upper body to the sides

See Practical Advice for Recovering from Back Surgery

If a back brace was previously prescribed to help immobilize the back, it may be advised to continue wearing it up to 3 months after surgery.

See When to Consider a Back Brace

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Increasing Activity Levels

As pain gradually alleviates and the energy level rises, it is good to gradually increase activity levels. As long as it has been cleared by the surgeon, the patient can start doing more of the following:

  • Walking longer distances
  • Light chores around the home
  • Driving

By 4 to 6 weeks after lumbar fusion surgery, most patients are cleared to return to school or work that does not involve physical labor.

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Physical Therapy’s Benefits

About 6 weeks to 3 months after surgery, an outpatient physical therapy program may be started. Techniques are tailored to the individual, with more and more activities added as strength builds. Physical therapy helps patients stay aware of how they walk, sit, stand, and lie down to help prevent back pain from recurring. Safe ways to lift, pull, or push objects are also covered.

See Physical Therapy after Spinal Fusion: Weeks 6 to 9

Patients may progress from Techniques for Effective Exercise Walking to more demanding exercises, such as swimming. Special exercises to strengthen the muscles supporting the lower back are emphasized. Physical therapists typically propose adjustments to the work environment to help patients return to the workplace. If a job is strenuous, it may take 6 months for the individual to return to work.

See Physical Therapy after Spinal Fusion: Weeks 9 to 12

Dr. John Sherman is an orthopedic surgeon at Twin City Orthopedics. He specializes in spine surgery and has been practicing for more than 25 years. Dr. Sherman has served as Assistant Professor in the Department of Orthopaedic Surgery at the University of California, Los Angeles and has conducted research on motion preservation technology and minimally invasive spine surgery.

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