What to expect after spine surgery

Undergoing spine surgery is a significant step toward addressing chronic back pain or spinal conditions. While the procedure itself is crucial, the recovery process that follows is equally important for achieving optimal results. Understanding what to expect after spine surgery can help reduce anxiety and prepare you for a successful healing journey.

Mount Nittany Health’s Dr. Eric Emanski shares his expert opinion on recovery after spine surgery.

Immediate post-surgery recovery: Hospital stay

The first 24-48 hours after back surgery focus on pain management, monitoring vital signs and ensuring proper healing begins. Right after surgery, you’ll wake up in a recovery area and medical staff will watch your brain function and pain levels closely.

Most patients experience some degree of pain, which your care team will manage through prescribed medications. Depending on your surgery type, you may have a drain at the incision site to prevent fluid buildup. Hospital stays depend on the procedure. Minimally invasive surgeries may need only 1-2 days. More complex operations, like spinal fusion, may require 3-5 days in the hospital.

“Depending on the size and type of surgery, many patients may go home using a rolling walker to help with mobilization for the first week or two,” says Dr. Emanski.

The first two weeks at home

“Realizing your home situation before coming to the hospital is very helpful,” says Dr. Emanski. “It’s helpful to tell the physical therapist and case workers in the hospital how many stairs you have to climb in and out of the house and how many stairs you will have to climb if your bedroom is upstairs. If possible, it’s recommended to have a bedroom with easy access to a bathroom on the first floor of the home.”

Having a shower that can accommodate a shower chair is also beneficial; it’s OK to shower after surgery, however, submerging in a bathtub is not recommended. Many patients find it beneficial to have elevated toilet seats as well to make it easier to get on and off the toilet.

Wound care becomes your responsibility, so follow your surgeon’s instructions to keep the incision clean and dry. Watch for signs of infection such as increased redness, warmth, drainage and fever.

Pain management during the period typically involves prescribed medication taken on a schedule. Movement restrictions are critical during early recovery. Avoid bending, lifting (anything over 5 pounds) and twisting motions. Your surgeon will provide specific guidelines for safe positions, movements and restrictions based on your procedure.

Warning signs for immediate medical help:

• A fever over 101°F
• Increased pain that medicine does not relieve
• New or worsening numbness or weakness
• Drainage from your incision
• Trouble breathing

Recovery milestones: Weeks 2-6

Physical progress expectations vary by procedure. Minimally invasive surgeries often allow for faster recovery, while fusion surgeries require more time for bone healing. By weeks 3-4, many patients notice a significant decrease in surgical pain, though some discomfort during activity is normal.

Your activity level will gradually increase, with short walks becoming longer as your stamina improves. Many surgeons recommend starting physical therapy during this period to help restore function and strength safely.

Common challenges during this phase include constipation — often from pain medication — sleep disturbances and mood changes. You can usually start light daily activities again in about 4 to 6 weeks. However, avoid bending, twisting and lifting heavy objects until your surgeon gives you the okay.

Long-term recovery: 6 weeks to 6 months

Physical restrictions will slowly ease between 6 weeks and 3 months. This timeline can change based on your procedure and healing progress. Return-to-work timelines depend on both your occupation and surgery type. Desk jobs typically allow a return around 4-6 weeks, while physically demanding work may require 3-6 months or longer.

You can typically drive 2-4 weeks after surgery when you no longer need narcotic pain medications and can react quickly in emergency situations. A structured strengthening and flexibility program becomes increasingly important during this phase to support long-term spine health.

“I explain to patients that although we may operate on your neck or back, the goal of surgery is to get rid of nerve pain into the extremities. Our goal with surgery is to address the nerve pain; its still quite common to have back pain or neck pain following surgery, as this is usually due to degenerative changes in the spine or muscular pain,” says Dr. Emanski.

“I think it’s important to set proper expectations before surgery, so I explained to patients that taking care of the nerve pain is the most important aspect,” he continued. “We’re not doing surgery for back or neck pain, although that may improve if it is present in the setting of nerve pain radiating to the extremities. We rarely offer surgery to treat isolated pain in the back or neck without radiation to the extremities, with some exceptions.”

Pain reduction expectations should be realistic — improvement is typically gradual rather than immediate. Most patients continue to see functional improvement for up to a year after surgery.

Pain management after spine surgery

Pain management typically transitions from prescription medications to over-the-counter options as recovery progresses. Non-medication pain relief strategies include proper positioning, ice or heat application as your surgeon recommends, gentle movement and relaxation techniques.

“We do not recommend taking medications for pain after surgery without checking with your surgeon,” Dr. Emanski explained. “You’ll usually be given some combination which may include muscle relaxers, pain medication, anti-inflammatories or neuropathic pain medication. However, this will vary depending on the type of surgery. It’s not advised to take any other medications without checking with your physician.”

Contact your doctor if your pain suddenly increases, changes in character or isn’t controlled by your prescribed medications. As your recovery progresses, expect to gradually reduce dependency on pain medications under your doctor’s supervision.

Preventing complications and optimizing recovery

Proper body mechanics, like bending at the knees rather than the waist, protect your spine during recovery and beyond. Nutrition plays a crucial role in healing, too. Focus on protein-rich foods to support tissue repair, plenty of fruits and vegetables, and adequate hydration to promote circulation and healing.

“It’s all quite common to get some numbness, tingling and strange sensations in the extremities while nerves heal,” he says. “This is usually a normal part of the healing process, but it should be discussed with your surgeon. In my surgical consultations, I advised patients that this is all a normal part of the nerve healing. This way, if they do experience it postoperatively, they’re prepared and understand it’s a normal part of surgery and usually not something to be concerned about.”

Signs of potential complications include increasing pain, new neurological symptoms, fever, wound drainage or excessive swelling. Report these to your surgeon promptly. Attend all scheduled follow-up appointments, even if you’re feeling well.

Good spine health depends on a few key factors:

• Keep your core strong
• Use proper body mechanics
• Maintain a healthy weight
• Avoid tobacco — it can impair healing and bone health

Recovery from spine surgery is a journey that requires patience and dedication. Knowing what to expect and following your healthcare team’s advice can improve your healing. This will help you get the best results from your procedure.

If you’re experiencing challenges during your spine surgery recovery or have questions about what to expect, contact our spine specialists at Mount Nittany Health. Our team is dedicated to supporting you through every stage of your healing journey.