The human body was created to heal itself, and supporting the healing process requires eating and/or supplementing with essential nutrients. The right nutrients are especially important after a major health event, such as spine surgery, or any type of damage to the back or neck.

See Food for Thought: Diet and Nutrition for a Healthy Back

Using nutrients to improve recovery and healing is an area of medicine called immunonutrition.

In This Article:

Role of Nutritional Supplements for Back Pain and Surgery

Research suggests use of certain nutritional supplements can help the body heal and recover after spine surgery. 1 As cited in Qureshi R, Rasool M, Puvanesarajah V, Hassanzadeh H. Perioperative Nutritional Optimization in Spine Surgery. Clin Spine Surg. 2018 Apr;31(3):103-107. doi: 10.1097/BSD.0000000000000579. PubMed PMID: 29596212. , 2 Wainwright, T. W., Immins, T., & Middleton, R. G. (2016). Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery. Best Practice & Research Clinical Anaesthesiology, 30(1), 91–102.doi:10.1016/j.bpa.2015.11.001.

See Healthy Habits After Back Surgery

The goal of using immunonutrition after back surgery and other stressful health events is to:

  • Minimize the risk of complications, such as infection
  • Aid in healing
  • Shorten recovery times

See Practical Advice for Recovering from Back Surgery

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People who have significant ongoing back pain, and/or those who have undergone spine surgery, may have unique challenges that may make it difficult to get sufficient nutrients through a healthy diet.

Examples of these nutritional issues include:

  • A suppressed appetite, often a side effect of back pain medications

    See Medications for Back Pain and Neck Pain

  • Significant constipation creating pain and discomfort, a common side effect of medications following spine surgery or for chronic back pain

    See Preventing Constipation After Back Surgery

  • The inability to keep foods down due to nausea
  • Discomfort swallowing solid foods after neck surgery (typically temporary)

    See After ACDF: Trouble with Swallowing

  • The desire to lose weight prior to back surgery in order to decrease joint stress or decrease surgical risks 3 Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Obes Surg. 2008;18:1028–1034. As cited in Qureshi R, Rasool M, Puvanesarajah V, Hassanzadeh H. Perioperative Nutritional Optimization in Spine Surgery. Clin Spine Surg. 2018 Apr;31(3):103-107. doi: 10.1097/BSD.0000000000000579. PubMed PMID: 29596212. ; reducing caloric intake with an unbalanced diet can result in certain nutritional deficits

    See Weight Loss for Back Pain Relief

  • Mobility issues related to back pain that decrease a person’s ability to shop for food and cook nutritious meals
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Due to the many challenges with getting enough of the right nutrients through diet alone, immunonutrition therapy typically uses supplements, such as:

  • Oral supplements, either in pill form or specially manufactured drink formulas
  • Liquid supplements that are administered intravenously

Whether supplements are taken orally or given intravenously does not influence their overall effect. 4 Lewis SR, Schofield-Robinson OJ, Alderson P, Smith AF. Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit. Cochrane Database Syst Rev. 2018 Jun 8;6:CD012276. doi: 10.1002/14651858.CD012276.pub2. Review. PubMed PMID: 29883514; PubMed Central PMCID: PMC6353207.

  • 1 As cited in Qureshi R, Rasool M, Puvanesarajah V, Hassanzadeh H. Perioperative Nutritional Optimization in Spine Surgery. Clin Spine Surg. 2018 Apr;31(3):103-107. doi: 10.1097/BSD.0000000000000579. PubMed PMID: 29596212.
  • 2 Wainwright, T. W., Immins, T., & Middleton, R. G. (2016). Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery. Best Practice & Research Clinical Anaesthesiology, 30(1), 91–102.doi:10.1016/j.bpa.2015.11.001.
  • 3 Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Obes Surg. 2008;18:1028–1034. As cited in Qureshi R, Rasool M, Puvanesarajah V, Hassanzadeh H. Perioperative Nutritional Optimization in Spine Surgery. Clin Spine Surg. 2018 Apr;31(3):103-107. doi: 10.1097/BSD.0000000000000579. PubMed PMID: 29596212.
  • 4 Lewis SR, Schofield-Robinson OJ, Alderson P, Smith AF. Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit. Cochrane Database Syst Rev. 2018 Jun 8;6:CD012276. doi: 10.1002/14651858.CD012276.pub2. Review. PubMed PMID: 29883514; PubMed Central PMCID: PMC6353207.

Dr. Stephen Hochschuler is an orthopedic surgeon and co-founder of the Texas Back Institute. He specializes in the lumbar spine and has been a practicing spine surgeon for more than 40 years.

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