Most people return home the same day of lumbar microdiscectomy surgery and typically experience pain, fatigue, and drowsiness. On the first day after surgery, pain levels can vary from mild to severe and may become more when the effect of the strong pain-relieving medications wear off and/or the nerve(s) starts to heal.
Successful pain management involves strictly following the surgeon’s instructions for medications, activity restrictions, and walking as tolerated.
Restricting Activity After Lumbar Microdiscectomy
During the first two weeks after a lumbar microdiscectomy surgery, the following common activities are restricted:
- Bending. While bending the knees and hips are fine, bending the back (such as when bending at the waist) is not advised, as it may irritate sensitive tissues in the lower back and increase pain.
- Lifting. Light objects may be carried but lifting anything weighing more than a gallon of milk—about 8 pounds—is typically not recommended. Some doctors may restrict lifting to a lighter load, such as 5 pounds or less.
- Twisting. Some adjustments in routine activities may be needed to avoid twisting the spine, such as when getting into a car or in and out of bed. It may also be necessary to have someone else help with chores initially, including laundry and yardwork.
- Driving. Pain, drowsiness, and reduced coordination prevent driving during the first week or two after lumbar microdiscectomy. Car rides are also limited to short, necessary trips.
Fatigue and drowsiness are more prevalent the first few days after this surgery, in part because of the medications used during the procedure and for ongoing pain management. Getting plenty of rest and sleep is advised, rather than trying to push through fatigue.
While it is important to get rest, periodic low-impact movements are necessary for healing. Short walks are recommended and can typically begin a few hours after a microdiscectomy. In the beginning, it is advised to only walk on flat surfaces, such as floors and sidewalks, rather than sloped or unsteady ground. A walker or cane may be used if the patient feels unsteady or still dealing with leg pain. Climbing stairs is also typically not advised.
Getting Sleep After Lumbar Microdiscectomy
Adequate and restful sleep is essential for faster healing. If sleep medications or supplements are considered, it is important to check with the doctor or pharmacist to avoid adverse interactions with other medications.
Log-roll method to maintain spinal alignment
To avoid or reduce painful bending and twisting movements, it helps to know the log-rolling technique for getting into and out of bed.
Log-rolling involves keeping the knees together and maintaining a straight back while:
- Sitting down on the bed’s edge
- Lowering the head to the bed while lifting the legs
- Rolling onto the back
It may also help to try different types of body pillows for support while lying down.
Caring for the Lumbar Microdiscectomy Incision
It is important to keep the incision site clean and dry. To reduce the risk for infection, dampening, wetting, or submerging the incision site in water must be avoided at this stage. Most surgeons consider the incision water-resistant, but not waterproof. Showers or sponge baths are generally allowed if the incision site can be kept dry, but not regular baths in a tub.
However, this recommendation may change based on the sutures used to close the incision, so it is important to discuss any questions or concerns about the suture with the surgeon.
Potential signs of localized infection at the incision site include increased redness, pain, or discharge. Other general signs of infection are possible, such as fever or chills.
Recognizing When to Seek Immediate Medical Care
It is normal to feel fluctuations in pain and energy levels after a lumbar microdiscectomy, especially during the first two weeks of recovery. However, some signs and symptoms require immediate medical evaluation, including:
- Pain that worsens despite taking the medication as prescribed
- Numbness and/or weakness in the leg(s) or perineal area (between the thighs)
- Reduced or complete loss of bowel/bladder control
- Increased redness, pain, or discharge at the incision site
- Fever or chills
- Nausea, dizziness, or severe headache
Most people are able to recover well at home after lumbar microdiscectomy, but it is important to monitor symptoms and check with the doctor’s office if any troubling symptoms or signs arise.