10 Truths about Spine Surgery Recovery

As if back surgery wasn’t terrifying enough, many people are also scared to ask surgeons the hard-pressing questions about their surgery. A lot of these important, real-life topics and questions touch on sensitive matters, which contributes to the embarrassment surrounding these concerns. These questions often go unasked or are saved for the Physician Assistants, which is where today’s podcast guests come in. In honor of National Physician Assistant Week, three PAs from VSI answer the questions that patients might be too afraid to ask their surgeon.

How bad is back surgery really? How much does it really hurt? After surgery — when can you have sex again, get back to sports, run a marathon, ride a rollercoaster or get pregnant? Thao Allen, Ian Brown, and Sam Mueller have the answers to 10 surgery related questions you probably really want to ask but might be embarrassed to discuss with your doctor.

Question #1: Surgery is scary and I am afraid. Is spine surgery recovery as hard and painful as I fear it is?

Fear is a normal reaction to any surgery and there’s no reason to turn it off. We do see that it’s often reduced when patients get answers and hard data about their injury, see scans and x-rays, and learn details about the procedure they’re facing. We see it reduced when they start to trust us as PAs and their surgeon. We also think it’s important to dig into the specific parts of surgery you fear the most so your medical team can get you the kind of answers that will bring you comfort. We believe in tailoring a plan to patients that addresses not just their physical needs — but their emotional ones too. Once patients know what to expect, they always seem to fear things a little less.

And while any surgery takes a toll on your body, patients often wake up after spinal procedures saying they feel better than they did before them. You can and should expect incision pain and recovery time to build up your strength. But patients often express immediate relief that the procedure is behind them and because the intense back pain that drove them to get the procedure is suddenly gone or lessened.

Question #2: When can I have sexual intercourse after surgery?

This is a very common question and one that you absolutely can and should discuss with your surgeon. The answer varies based on an individual’s health, their pain levels, the type of procedure, and the activity restrictions they have afterwards. Your doctor can detail all of that for you. You might need to get creative or let your partner do a little bit more work for a few weeks but, at the two-week point, you should start having this discussion with your doctors once a physical therapy routine has been determined.

Question #3: Will it hurt to poop after back surgery and for how long?

As PAs, we actually talk about poop a lot at preoperative appointments and you should definitely discuss this topic as a patient with your care team. Medication you take with surgery can be constipating and often you do need to pass a bowel movement at the hospital before you’ll be released.

We believe in being proactive rather than reactive on this issue. That means making sure you have what you need at home in the event you start to feel constipation symptoms. When you’re at the hospital, stool softeners will likely be a part of your post-op medication and you will be closely monitored to see that you’re passing gas, having a bowel movement, and that you have the tools you need once you get home.

You’ll probably get desensitized to this topic pretty quickly as a patient. Expect your care team to ask about it in rounds in the days after surgery and in every post-op phone call and appointment. It’s an important part of the healing process.

Question #4: Is my weight an issue in my surgery or recovery?

If this is on your mind, raise this concern with your doctor. We need to make sure you’re moving right after surgery and, in time, getting back to a physical therapy and exercise regimen. If your weight or a chronic illness is something you think might impact your procedure or how you heal — definitely discuss it with your team to determine course of action. Having a strong core helps promote healing and getting you back in strengthening mode so we may talk about supportive tools or techniques if you aren’t as strong as you’d like.

Question #5: Will I be able to carry and deliver children naturally or do IVF after back surgery?

This is such a personal and important question and, if it’s on your mind, we definitely should discuss it with you. Knowing that having children is a goal for you is something to discuss with your surgeon who can take into account your pathology, condition, and your healing — and share what you need to know to reach your goals.

We’re also often asked if you can have an epidural during childbirth after a spinal fusion or spine surgery. The answer is yes — your doctor can use one but the efficacy of the epidural could be affected depending on what kind of surgery you’ve had or the location of your procedure.

Question #6: Is sitting really the new smoking and how much sitting is bad for your back in a recovery?

There’s no need to be embarrassed about this question because sitting for long periods of time is a requirement for so many jobs and life situations — whether it’s for work or a commute. This is definitely something we want to talk about so we can help you make a plan to modify things at work or in the car. This question also goes to the bigger issue of your lifestyle in general. Is it sedentary or active? Even if your job limits your movement, we can always look at your lifestyle and take the conversation to ways that we can add more movement into your life beyond work hours.

Question #7: After surgery or back injury — how soon can I get back to aggressive sports?

This question should come up very early in your discussions with your care team. In fact, it’s part of our in-take form. We want to know what you were doing before your pain started and what you dream of doing when it’s gone.

If there is a sport or athletic activity that really matters to you, bring that up right from the beginning because that’s what you’re trying to get back to doing. You will likely have a period of time for restrictions, but the whole point of surgery is to get you back to participating in the activities you love. We’ve got physical therapists and sports trainers, return-to-play programs and lots of people on our team that can get you back to whatever it is you want to do and your surgeon can help you set the timeline that is safe and promotes healing.

The specific answer will be tailored to your specific condition and situation. But in general, something we often talk about is the 50–50 rule. Someone who has a goal to run a 10k or get back to golfing 18 holes may start off halfway from where they were before they were injured. See how that feels, give it some time and then slowly progress and build up from there — making those decisions in partnership with your surgeon.

Question #8: Can I lift weights after back surgery?

As we’ve mentioned, there’s always a period of time with activity restrictions after surgery but lifting weights is an important part of strengthening your body after surgery. Your physical therapist will probably be the one to help you get started — likely with lower weights. If you were doing Olympic or serious CrossFit type deadlifts and squats before your procedure, that’s likely going to require a discussion about your individual needs and the risk/benefit ratio with your doctor. In general, weight lifting is a helpful part of a post-op exercise plan.

Question #9: I have a few alcoholic drinks a week — can I do that after surgery? Is that hurting my back? Do I have to cut back?

This is another super common question: “My family’s coming over for dinner and I’m feeling better; can I have a glass of wine or a beer with dinner?” The most important question we’ll ask is — are you off your narcotics? In addition, it’s about how comfortable you feel — what’s your balance and strength like? Alcohol in larger amounts creates inflammation so drinking a lot is likely not advisable. But a glass here or there in moderation is likely fine when you feel ready for it.

Question #10: Can I ride a rollercoaster after surgery?

One of our surgeons, Dr. Colin Haines, says he is asked this question A LOT! And it makes sense. The answer, as is often the case, may come down to your individual factors, if you had a fusion or disc replacement, if it’s your lower back or neck, what’s happening with your body right now, etc. There’s a risk and benefit equation to consider as well.

The bottom line is we don’t ever want to restrict anyone from living their life or doing what makes them happy. But we do try to educate about what could happen and proper steps to minimize any strain you may have afterwards.

Your health and well-being are our top priorities, and open communication is key to achieving the best outcomes. If something is on your mind—whether it’s a concern, a curiosity, or simply a need for clarification—don’t hesitate to voice it. Every question is important because the answers matter to you, and that makes them matter to us as well. Remember, a strong partnership between you and your healthcare providers begins with open dialogue. We’re here to support you every step of the way, so let’s work together to ensure you feel informed, empowered, and confident in your care journey.

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