What to expect from the operation
Leg pain is usually the first thing to improve, sometimes as soon as you wake up. OrthoInfo explains that after a microdiscectomy, pain tends to improve first, then strength, then feeling, and that leg pain usually improves more than back pain. Numbness can take weeks or months to lift. Some back soreness from the operation itself is normal for a few weeks.
The NHS says most people leave hospital two to five days after lumbar decompression, depending on the operation. Many microdiscectomies are done as a day case or with one night in hospital.
The first two weeks
Walking is the main treatment. You will be helped up on the day of surgery or the next day. At home, take short, frequent walks several times a day. MedlinePlus advises short walks for the first two weeks, gradually increasing the distance. OrthoInfo describes rehabilitation that builds toward around 30 minutes of walking a day.
Do not sit for long. Sitting puts more load on the lower back than standing or lying. MedlinePlus advises avoiding sitting for more than 20 to 30 minutes at a time. Get up, walk around, then sit again.
No bending, lifting or twisting. For the first few weeks, you will usually be told not to bend at the waist, lift, or twist. Bend your knees and squat if you must pick something up, or better, use a reacher. MedlinePlus gives about 10 pounds (4.5 kg) as an upper limit for lifting: roughly a full bag of shopping.
Keep the wound dry for as long as you were told. MedlinePlus suggests keeping it dry for the first five to seven days and having someone with you for your first shower.
Pain relief. The NHS says you may need painkillers for several weeks. Take them as prescribed, and remember that strong painkillers cause constipation, which makes straining painful. Our guide to relieving constipation after surgery helps.
Sitting, sleeping and getting out of bed
Sitting. Choose a firm, upright chair with arms, at a height that keeps your hips level with or slightly above your knees. Avoid low sofas. A small lumbar cushion helps you sit upright rather than slumping.
Sleeping. MedlinePlus says to sleep in any position that does not cause back pain. On your back with a pillow under your knees, or on your side with a pillow between your knees, both keep the spine in a neutral line.
Getting out of bed. Use the log roll: bend your knees, roll onto your side as one unit, then push up with your arms as you swing your legs off the bed. It avoids twisting. Our guide to getting in and out of bed after surgery walks through it.
Weeks two to six
Walk a little further each week. You may be referred to physical therapy for exercises to strengthen your back, core and legs. Do the exercises you are given, not ones from the internet, and stop anything that brings back the leg pain you had before surgery.
Keep avoiding heavy lifting, vacuuming, gardening and sports until your surgeon says otherwise. MedlinePlus lists swimming, golf, running, vacuuming and heavy cleaning as things to wait on.
Driving. MedlinePlus says not to drive for the first two weeks, and then only short trips if your surgeon agrees. As a passenger, stop every 30 to 45 minutes on a long journey to get out and stretch. You need to be able to sit comfortably, turn to check your blind spot and brake hard. See our driving after surgery guide.
Work. The NHS says many people return to work around four to six weeks after lumbar decompression, depending on their job. Desk work is often sooner after a simple microdiscectomy, with a phased return and the freedom to stand up regularly. Heavy manual work takes longer.
Six to twelve weeks and beyond
The NHS says it can take up to 12 weeks to get back to all your usual activities. By then most people are walking normally, sitting for longer, and building back into exercise.
A disc can herniate again. OrthoInfo puts the lifetime chance of a disc herniating again at up to 20 to 25 percent, whether it was treated with surgery or not. The habits that protect your back long term are the same ones you practice in recovery: regular walking, a strong core, lifting with your legs, not sitting for hours without a break, and keeping a healthy weight.
Warning signs
Contact your surgeon or hospital, or in the UK NHS 111, if you have:
- A wound that is red, hot, swollen, oozing or opening up, or a fever of 101°F (38.3°C) or higher.
- Leg pain, numbness or weakness that is new or getting worse.
- Back pain that is getting worse and does not ease with rest and pain relief.
- A severe headache that your usual pain relief does not help.
- Pain, swelling or warmth in one calf, which can be a blood clot.
Get emergency help immediately (999 or 911) if you have new difficulty controlling your bladder or bowels, numbness around your bottom or genitals, or weakness in both legs. These can be signs of cauda equina syndrome, which needs urgent treatment. Also call for chest pain or sudden shortness of breath.
The short version
Walk early and often, keep sitting to short spells, and do not bend, lift or twist for the first few weeks. Expect leg pain to improve first and numbness to take longer. Most people are back to work in four to six weeks and to most activities by around three months. Know the emergency signs, and follow your surgical team’s specific instructions, which come before anything general.