When it comes to lower back surgery, some post-surgical pain is often unavoidable. But what many patients do not know is that, if this pain is mismanaged, it can have an adverse effect on their recovery.

See Getting Adequate Pain Control After Back Surgery

Not responding to conservative treatment is not necessarily a reason to have lower back surgery.
Back Surgery and Neck Surgery Overview

With this in mind, here are three tips to help you create an effective pain management plan in tandem with your surgeon:

See Preparation Before Back Surgery


1. If possible, select a hospital with a surgical pain control service

Many surgeons operate out of multiple hospitals. If this is the case with your surgeon, and you have a choice of hospitals, I suggest that you request that your surgery take place in a facility that offers a post-operative pain management service.

See Specific Questions to Ask Your Spine Surgeon

If you are able to have your surgery at a hospital that offers a pain management service, it is a good idea to make an appointment with the pain management service office as soon as possible (before your surgery). To avoid any confusion, and receive the best post-operative care possible, you will want to work with one specific person within the pain management office/service.

See Specialty Care Physicians and Pain Management

Your pain management physician from the hospital service can help you, in collaboration with your surgeon, develop an effective plan for your post-surgery care and pain management. To aid in this process, you will want to share at least the following information:

  • Any allergies or concerns you may have in regards to pain medications
  • Pain control strategies and techniques that have (and have not) worked for you in the past
  • Medications you are currently taking (this will help you avoid potential complications)

See How to Select a Spine Surgeon

2. Discuss your medication and non-medication options

When it comes to lower back surgery, your post-operative pain control plan will almost always include pain medications. There are numerous pain medication options, and each has its own unique benefits and drawbacks. Typical options include nonsteroidal anti-inflammatory drugs, non-opioid analgesics, opioids, and local anesthetics. Your medical pain management professional can explain the various options to you, and together you can decide on both the best type of medication and the best method of delivery.

See Opioid Pain Medications

In addition to your various options for medication, don’t forget to discuss your non-medication options. This is an important part of your pain management, as patients who receive training prior to their surgery regarding physical coping techniques typically have less pain, need fewer pain medications, and can leave the hospital sooner.

See Pain Management After Outpatient Spine Surgery

These physical coping techniques include:

  • How to cough without hurting yourself
  • Deep breathing and relaxation exercises
  • Ambulation (walking) and other body mechanic techniques

You may also benefit from non-medication pain-control options like heat and/or cold therapy, massage, stretching, and various relaxation techniques.

See Rehabilitation and Exercise Following Spine Surgery

Developing a complete preparation program prior to your surgery can help throughout the entire back surgery process. See How to Prepare Psychologically for Back Surgery

3. Anticipate your pain

The most important aspect of post-operative lower back surgery pain control is to anticipate your pain and stay ahead of it (versus reacting to the pain once it is very severe). You want to address your pain right away, or even before it starts, to avoid rapid escalation—as once your pain gets out of hand, it is difficult to re-claim control. Often, the more your pain is allowed to get out of control, the higher the need for pain medication overall.

See What to Expect from Spine Surgery for Low Back Pain

So then, prior to your surgery you want to make a plan to ensure quick and regular access to your pain medication. It is usually best to take your pain medication on a regular basis (for instance every 4 hours or “time-contingent”) to keep the pain under control, rather than letting the pain get out of control and reacting to it.

Additionally, you will want to write down, and have quick access to, your various non-medication options. When your pain strikes, the last thing you want to do is go searching for medication or a cold gel pack.

See Ice Packs for Back Pain Relief

Additionally, prior to your surgery it is a good idea to make a list of activities that will likely aggravate your pain. Do your best to avoid these activities immediately following your surgery by asking friends or family members for help. For instance, together you might prepare meals ahead of time and freeze them, get all your laundry done, be sure your house is in order, etc.

See Practical Advice for Recovering from Back Surgery

When you do engage in any activities post-surgery, you want to make sure to pace yourself. This is because pushing through the pain is typically not the right approach immediately after surgery. Your surgeon may have you push through the pain more and more as you heal, but immediately after surgery you should be guided by your pain and limit activities accordingly.

See Lumbar Spine Surgery

It is important to remember that your post-lower back surgery pain control plan should be a team effort. Your voice and opinion matters, so make sure to be open and honest with your surgeon and pain control specialist. This in turn will help reduce your post-operative pain and lead to a quicker recovery.

Learn more:

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