When returning home from lumbar microdiscectomy surgery, patients are usually prescribed medication to help manage the pain. Several home remedies may also be used to reduce pain and improve healing.

Initial Pain Management

During the initial 2 weeks after a microdiscectomy surgery, the pain is most intense. Stronger painkillers, such as opioids, are typically used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). Most patients are gradually weaned off opioids over a period of 1 to 2 weeks. NSAIDs, acetaminophen, or other medications may be used to continue managing pain after opioids are discontinued.

Using heat and ice therapy

In addition to medication, ice packs and/or heat wraps may be used. Special caution must be exercised for patients who have decreased skin sensation at the surgical site and/or pre-existing conditions, such as diabetes.

  • Heat therapy may help relax tissues, reduce spasm in tight muscles, and improve blood flow—aiding in tissue healing. Using a heat pack or hot water bottle before an activity can help loosen the tissues and improve the range of motion in the joints.
  • Ice therapy applied to the lower back can help decrease inflammation and pain. A plastic bag filled with ice or a commercial ice pack is especially useful after activity to decrease any activity-related discomfort or soreness.

Limit ice or heat therapy applications to 15 or 20 minutes at a time, with at least 2 hours of rest in between, to optimize tissue response between applications. A thin towel or t-shirt may be used as a barrier between the heat/ice source and the skin to avoid direct skin injury.

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Long-Term Pain Management

2 weeks post-surgery, most patients are completely off opioids but may continue taking other pain medications, such as:

  • Acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Muscle relaxants

While taking medications, it is important to follow directions on the label (or instructions provided by a doctor) to reduce the risk of adverse reactions or an overdose. For example, acetaminophen is in many common drugs, including cold medicines, which could lead to an overdose if labels are not read.

See Medications for Back Pain and Neck Pain

While pain medications may not be needed by 4 to 6 weeks after lumbar microdiscectomy surgery, some patients may need to continue with pain medications for much longer.

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By 6 weeks post-surgery, most patients discontinue pain medication, however, it is still possible to have painful flare-ups or stiffness that requires medication.

Before using any new medications or going back to old medications, it is important to check with the doctor or pharmacist to reduce the risk of adverse drug interactions or serious side effects.

Dr. Benjamin Bjerke is an orthopedic surgeon. He specializes in minimally invasive and motion-preserving spine surgery.

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