Post-Operative Recovery Milestones

Immediately After Surgery:

• Wake up in recovery room with monitoring
• Pain managed with IV medications
• Will have catheter temporarily (usually removed within 24 hours)
• Encouraged to sit up and walk the same day or next morning with assistance

Day 1-2 in Hospital:

• Progressive walking with physical therapy
• Transition from IV to oral pain medications
• Learn proper body mechanics (log-rolling, getting in/out of bed)
• Practice stairs if you have stairs at home
• Discharge when able to walk safely, pain controlled with oral meds, eating and drinking normally

Activity:

• Short walks (5-10 minutes) every 2-3 hours
• Rest frequently—your body is healing
• NO bending, lifting, or twisting (BLT restrictions)
• May shower after 48-72 hours (follow specific wound care instructions)
• Sleep in any comfortable position—many prefer recliner initially

Pain & Medications:

• Pain medication as prescribed—stay ahead of pain
• Ice on incision site (20 minutes every 2-3 hours)
• Some muscle spasm is normal; muscle relaxants may help
• Incision discomfort, soreness expected—sharp, severe pain is not

What's Normal vs. Concerning:

• Normal: Soreness, fatigue, mild swelling, minor incision drainage
• Call doctor: Fever over 101°F, increasing wound drainage, worsening leg weakness, loss of bowel/bladder control

Follow-Up Appointment (Week 2):

• Wound check, staples or sutures removed
• X-rays to check hardware position (if fusion)
• Clear to shower normally
• Discussion of progress and next steps

Activity Progression:

• Gradually increase walking distance (work up to 30-60 minutes daily)
• May start gentle stretching if cleared by surgeon
• Continue avoiding BLT (bending, lifting, twisting)
• Can ride in car for short trips
• Most desk workers can return to work around weeks 2-4

Typical Experience:

• Energy improves week by week
• Narcotic pain medication typically weaned off by week 3-4
• Muscle soreness and stiffness gradually improve
• "Good days and bad days" are normal during healing

6-Week Appointment:

• X-rays to assess healing
• Restrictions typically lifted (can resume gentle bending)
• Cleared to start physical therapy
• Driving typically approved if off narcotics and can turn/look comfortably

Physical Therapy:

• 2-3 times per week for 4-8 weeks
• Focus on core strengthening, flexibility, proper body mechanics
• Home exercise program critical for continued progress

Return to Activities:

• Light housework and normal daily activities
• Return to work (physical labor may require 12+ weeks)
• Light exercise (swimming, stationary bike)
• Can lift 10-20 lbs depending on procedure

3-Month Appointment:

• X-rays showing fusion progress (if fusion was performed)
• Assessment of final restrictions
• Most patients at 80-90% of final recovery

Activity:

• Return to most normal activities including sports (low-impact)
• Lifting capacity typically 40-50 lbs (varies by procedure)
• High-impact activities discussed case-by-case

6-Month Mark:

• Maximum improvement typically achieved
• Fusion usually solid (X-rays confirm)
• Annual follow-ups to monitor long-term