What to Do for Post-Operative Back Pain

The operation is over, but your back pain may still be lingering. What to do for post-operative back pain depends upon the nature of the back surgery and the level of pain you are experiencing. Your spine doctor can discuss your pain with you to determine how you can recover more comfortably.

Post-Operative Back Pain

As with most surgeries, the pain is the most intense in the first few days after the operation, but it should dissipate after that. Pain control for post-operative back pain is essential not only for your comfort but also to start the rehabilitation process.

A patient in pain cannot start the recovery regimen if doing so makes the pain more intense. The time it takes to fully heal depends upon your overall physical condition.

Pain Medication

Pain medication is the initial method of managing back pain immediately post-surgery. For a short while after surgery, patients may receive opioids for pain relief. However, this medication is designed for temporary use and you should stop using it after the prescribed time frame. After that, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen, ibuprofen, or Cox-2 inhibitors can provide relief.

Opiate pain medication provides strong pain relief, but there are possible side effects. These include:

• constipation

• drowsiness

• itching

• nausea

• vomiting

Patients are closely monitored when prescribed opioids and weaned off them as soon as possible. It is important to be honest with your medical team regarding your pain levels after surgery. Adequate pain control is needed to go through the physical therapy and an exercise regimen is necessary for successful healing.

After the initial use of prescription pain medication, the patient may find relief using non-steroidal anti-inflammatory drugs (NSAIDs), which are available over-the-counter. These include drugs such as ibuprofen, under the brand names Advil and Motrin, or naproxen, marketed under the name Aleve. Generic versions of these drugs work well.

Some patients may find pain relief with anti-anxiety or antidepressant drugs. Individuals should discuss this option with their doctor.

In some cases, the doctor may have some classes of NSAIDs administered intravenously. Intravenous or epidural administration of corticosteroids can also reduce inflammation and provide relief. Finally, patients experiencing nerve pain may benefit from the use of antidepressants.

Physical Therapy

Physical therapy is an integral part of pain management and the recovery process. The physical therapist designs a program for each patient, and the exercise therapy will likely focus on muscle facilitation so that the patient can regain strength in their core to provide post-surgical stability.

The therapist may also use treatments such as hot and cold therapy and Transcutaneous Electrical Nerve Stimulation (TENS) units for pain relief. This therapy uses low-voltage electric stimulation, which acts upon the sensory nervous system.

Scar Tissue

Sometimes, post-operative back pain is due to scar tissue at the nerve root. The formal term for such scar tissue is epidural fibrosis. Scar tissue is a normal part of the healing process – it is only when the nerve root binds to fibrous adhesions that pain results.

Such tissue forms within the first three months after the surgery. To avoid the development of scar tissue, the patient is given stretching exercises to perform during the healing process. These exercises help prevent the tissue from binding to the nerve root.

Behavioral Modification

For some patients, behavioral modification, in the form of cognitive therapy, may help alleviate post-operative back pain. This includes the use of relaxation techniques and biofeedback.

It is crucial that patients learn to listen to what their body is telling them. While recuperating, they must pace themselves and not try to “speed up” their recovery and risk harming the back. It is important to avoid movements causing pain, as well as repetitive motions. It is also crucial to always speak to the surgeon or physical therapist if prescribed exercises are causing excessive pain.