Every week in our office, patients ask us a lot of the same questions — before surgery, right after surgery, and months into recovery. We thought it would help to gather some of the most common questions from this past week and answer them here, in case you’re wondering the same thing.
How much pain is normal in the first few days after surgery, and when does it start getting better?
It’s very common to have real stiffness and tightness for the first two to three days after spine surgery, even with our awake, minimally invasive approach. Most patients describe this window as the hardest part — and then notice a clear turning point after day three, when things start loosening up. We usually have patients take ibuprofen and Tylenol on a regular schedule at first, then taper down as the pain eases. A short course of a stronger medication is sometimes used right after surgery, but most patients are surprised how little of it they actually need.
When can I shower, and how do I take care of my incision?
With our technique, closures are typically placed underneath the skin, so there’s usually nothing external to remove. Most patients are cleared for a full shower at their first follow-up visit. Once the incision is healed, a simple vitamin E moisturizer applied after showering can help keep the skin from getting dry or itchy as it continues to heal.
How much walking should I be doing after surgery?
Start slow and build up. In the first week or two, walking on flat, familiar surfaces — even just back and forth in the house — is a great start, and some fatigue or mild discomfort along the way is normal. From there, we like to see patients working toward 5,000 steps a day, with a goal of 5,000 to 10,000 steps a day by the four-week follow-up visit.
When can I go back to work?
This really depends on what your job involves. If it’s a desk job, patients often return sooner; if it involves standing for long periods or lifting, we’ll put together written restrictions for your employer so you can ease back in safely. Let us know what your job requires and we can tailor a return-to-work plan and letter around it.
I’m having a sudden flare of severe leg pain, numbness, or weakness. Does that always mean I need surgery right away?
Not necessarily. Even patients with a long history of back issues can have a sudden, intense flare-up of nerve-related pain down the leg. Our first step is usually a combination of medication to calm the nerve down and getting physical therapy started quickly. Many patients improve significantly with this conservative approach and never need surgery at all. If symptoms don’t improve, or if there are certain warning signs, surgery remains an option — but it’s never the automatic first move.
I’m struggling with balance, or with a cane, walker, or brace — is that normal?
Recovering strength and coordination after a nerve compression injury can take real time, and it’s common to feel frustrated moving between assistive devices — from a cane to a walker, for example — as your needs change. What’s most important is safety: if you notice dizziness, unsteadiness, or you’ve had a fall, please tell us right away so we can address it. If a brace isn’t fitting or working well, we can also look into a better, more custom-fitted option.
Months after surgery, I still notice some tingling or swelling. Should I be worried?
Mild residual tingling or swelling can stick around for a while after both neck and back procedures, and it typically continues to fade gradually as you heal and progress through physical therapy. Rather than expecting every symptom to disappear overnight, we like to track functional progress — how your balance and walking are improving over time — as the better measure of recovery.
I started a new exercise routine and noticed something looks a little asymmetric. Should I be concerned?
Painless asymmetry that shows up around the same time as a new fitness routine, or after some recent weight change, is usually just a benign muscular adaptation rather than a structural problem. That said, it’s always worth mentioning to your provider so it can be looked at directly — that’s exactly what visits like this are for.
Can everyday activities cause joint pain that has nothing to do with my spine?
Absolutely. Repetitive strain from everyday tasks — lifting, manual work, even something as simple as forcing a stuck door or handle over and over — can lead to overuse injuries in joints like the wrist, entirely separate from any spine issue. Rest, splinting, and modifying the activity are usually the first steps. As a spine and performance practice, we’d always rather hear about a new ache, even if it seems unrelated to what brought you in originally.
Have a question of your own?
These are just a handful of the questions we hear during a typical week of visits. If something about your own recovery has you wondering, don’t hesitate to bring it up at your next appointment — there’s no such thing as a question that’s too small.
