Your Recovery

Microdiscectomy is surgery to remove part or all of a bulging (herniated) disc in the spine. A bulging disc may press on the spinal cord or spinal nerves and cause leg pain and numbness. Your doctor made a 2.5 to 5 centimetre cut (incision) in the skin over the spine. He or she inserted a special microscope (scope) to see the area and then used surgical tools through the incision to do the surgery.

You can expect your back to feel stiff or sore after surgery. This should improve in the weeks after surgery. You may have relief from your symptoms right away, or you may get better over days or weeks. In the weeks after your surgery, it may be hard to sit or stand in one position for very long and you may need pain medicine. It may take up to 8 weeks to get back to doing your usual activities.

Your doctor may advise you to work with a physiotherapist to strengthen the muscles around your spine and trunk. You will need to learn how to lift, twist, and bend so you do not put too much strain on your back.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• Ask your doctor when you can drive again.
• Avoid riding in a car for more than 30 minutes at a time for 2 to 4 weeks after surgery. If you must ride in a car for a longer distance, stop often to walk and stretch your legs.
• Try to change your position about every 30 minutes while you sit or stand. This will help decrease your back pain while you heal.
• Your time off from work depends on how quickly you feel better and on the type of work you do. If you work in an office, you likely can go back to work sooner than if you have a job where you are very active. Talk with your doctor about your work needs.
• You may have sex as soon as you feel able, but avoid positions that put stress on your back or cause pain.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water, and pat it dry. Don’t use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

Exercise

• Do back exercises as instructed by your doctor.
• Your doctor may recommend that you work with a physiotherapist to improve the strength and flexibility of your back.

Other instructions

• To reduce stiffness and help sore muscles, use a warm water bottle, a heating pad set on low, or a warm cloth on your back. Do not put heat right over the incision. Do not go to sleep with a heating pad on your skin.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You are unable to move a leg at all.
• You passed out (lost consciousness).
• You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor or nurse call line now or seek immediate medical care if:

• You have pain that does not get better after you take pain medicine.
• You have new or worse symptoms in your legs or buttocks. Symptoms may include:
  • Numbness or tingling.
  • Weakness.
  • Pain.
• You lose bladder or bowel control.
• You have loose stitches, or your incision comes open.
• You have signs of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the incision.
  • Pus draining from the incision.
  • Swollen lymph nodes in your neck, armpits or groin.
  • A fever.
• You have blood or fluid draining from the incision.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

• You do not have a bowel movement after taking a laxative.
• You are not getting better as expected.