Immediately After Surgery
In order to be cleared to leave the hospital, one must pass a few simple tests. First, a person must be able to handle the post-operative pain on oral medications. Although not severe, there is typically some pain at the incision and some muscle ache, which will linger for a few days.

Even occasionally, as the nerve regenerates, there may be some twinges of pain that run down the leg along the course of the nerve. As long as these twinges do not become frequent events, they are not surprising and will get better on their own. Like incisional pain, the muscular ache will persist for a few days. In fact, it is not infrequent for the back to be sorer a day later. Once again, as long as it is tolerable, it will get better. Apart from pain, the nurses need to be sure that you can take care of your other basic functions at home. This implies that you will be able to urinate (bladder difficulty can occur after general anesthesia), walk, and tolerate food in your stomach.

What To Expect At Home
The first few days you may be more tired than usual because of the anesthesia. Your back will be tender and you may have residual leg pain, tingling, or numbness. Most people will be taking medications for pain and muscle spasm. These medications are taken for approximately two to three weeks and off and on during physical therapy.

Activities and Follow-Up
We encourage you to walk as much as possible. There are many reasons walking is important. First, it will begin your therapy to strengthen your legs. Walking will also help to prevent blood clots, lung congestion, and increase your general feeling of well-being.

You may take a shower four days after surgery. If you have a clear dressing or gauze over your incision, this may be removed three to four days after surgery. Make sure the dressing is removed before you shower. The Steri Strips® stay in place for one to two weeks. Eventually, they begin to peel off on their own.

Lifting is restricted to five to ten pounds for at least two weeks. Using good body mechanics is very important in maintaining a healthy back. You will begin formal physical therapy two weeks after surgery. The course of physical therapy is usually three times per week for six weeks. During your physical therapy, they will increase your weights gradually and begin stretching exercises. You can expect some increased discomfort once you increase your activity. This should go away quickly. If it does not you should let your physical therapist know so modifications in your plan can be made. They will develop with you a home exercise program. Physical therapy is a crucial part of a successful outcome after your herniated disc surgery. Building strong support muscles will help ensure a healthy back for your future.

Most patients will see a health care practitioner at one week for a wound check and six weeks for a final follow up. The final visit is important to assess how you are doing and answer any questions about future activity.

Conclusions
Back pain and radiculopathy are, unfortunately, common problems that will afflict most of us at one time or another throughout our lives. Thankfully, most of these problems will go away within a few weeks. When the pain persists, surgery may be an option. All surgeries directed at a disc rupture require exposing the nerve and removing the extruded disc material. The differences lie in the manner of the exposure and the post-operative pain that the patient experiences. Unfortunately, no surgery is pain-free. All surgeries require a period of recovery, which may be lessened by using less invasive approaches.

This article is an excerpt from Dr. Stewart G. Eidelson's book, Advanced Technologies to Treat Neck and Back Pain, A Patient's Guide (March 2005).