Getting ready for back surgery?

Back surgery can be a significant step toward relieving chronic pain and improving your mobility. But just as important as the surgery itself is how you prepare in the weeks and months leading up to it. If you have back surgery on your calendar, here’s everything you need to know (and do) to make sure all goes well. 

Prehab: Your key to a smoother recovery 

You’ve probably heard of physical rehabilitation, or rehab, which is a form of physical therapy that happens after someone has surgery. Pre-surgery rehabilitation, or prehab, is one of the most important steps you can take before elective surgery. 

The physical therapy sessions in prehab will focus on strengthening the muscles that support your spine and posture (including your core, glutes, and back muscles) and teaching you how to move in ways that protect your back. This preparation can make a significant difference in how you recover after surgery. Patients who participate in prehab often experience less post-operative pain and regain function more quickly. 

Pre-surgery lifestyle changes 

In the weeks leading up to your back surgery, use these strategies to improve your overall health and ensure a smoother recovery, including: 

Keep your appointments. Expect to have the following visits leading up to your surgery: 

• A trip to get your lab work done 
• Your primary care physician, who will ensure you’re healthy enough for surgery 
• A specialist if you have any underlying health conditions, like heart or lung problems
• A meeting with the anesthesiologist prior to surgery 

That said, avoid scheduling any dental procedures in the six weeks before your surgery or the three months afterward. Germs in your mouth can enter your bloodstream and potentially infect your joint. 

Quit smoking. If you’re a smoker, it’s critical to quit before surgery. Smoking reduces blood flow, slows down healing, and increases the risk of complications, such as infections, blood clots, heart attack, and stroke. Try to quit at least four weeks before your surgery date to give your body time to recover from the effects of smoking. If quitting feels overwhelming, talk to your doctor about medications, nicotine replacement options, or support programs. 

Manage chronic conditions. If you have underlying health issues, such as diabetes, high blood pressure, or sleep apnea, work with your health care provider to ensure they’re well-controlled before surgery. Uncontrolled conditions can increase the risk of complications during and after surgery. Your doctor may adjust your medications or ask you to monitor certain aspects of your health more closely in the weeks leading up to your procedure. 

Optimize your diet. A healthy diet is always important, and that’s especially true prior to surgery. Nutritious foods support your body’s healing processes. Focus on eating a balanced diet rich in protein, fiber, and vitamins. Protein is essential for muscle repair and wound healing, while fiber helps prevent constipation, which can be a side effect of pain medications. Your doctor may also recommend certain supplements, such as vitamin D or calcium, to support bone health and recovery. 

Managing pre-surgery stress 

It’s natural to feel anxious or nervous before surgery, but mental preparation is just as important as physical readiness. That’s because understanding the surgery process and knowing what to expect afterward can reduce anxiety and improve overall outcomes. 

Take time to address any fears or concerns you have about the procedure. Talk to your surgeon about what to expect during and after surgery, and don’t hesitate to ask questions.  

Practicing stress-reduction techniques, such as deep breathing exercises, meditation, or yoga, can help calm your mind and prepare you mentally for surgery and recovery. And remember: This may be your first time undergoing back surgery, but it’s something your surgeon does frequently. 

Plan ahead for post-op recovery 

The first few days and weeks after surgery can be challenging. Having a clear plan in place will make the process easier. Before your procedure: 

• Round up your support system. Arrange for a friend or family member to help you in the first few days after surgery. You may need assistance with daily tasks such as cooking, cleaning, and bathing. If you live alone, consider hiring a home health aide or asking a neighbor for help during your recovery. 
   
• Prepare your home. Make your home recovery-friendly by setting up a comfortable, accessible space to rest. Consider installing grab bars in the bathroom and rearranging your furniture to create clear walking paths. If your bedroom is upstairs, you might want to set up a temporary sleeping area on the first floor to avoid climbing stairs in the days after surgery. 

If you find it difficult to get comfortable, you may consider renting or buying a supportive chair, such as a recliner. 

Know what to expect on surgery day 

Ahead of your procedure, your health care team will give you guidelines on what to do the day before and the morning of your surgery. They will let you know: 

• When to stop eating and drinking. Your doctor may advise you not to eat or drink after midnight on the night before your procedure or give you other food and drink guidelines. Your doctor will also review the medications you take and let you know whether you should continue taking them in the days leading up to your surgery. Stop alcoholic drinks 48 hours before your procedure, or longer if advised by your doctor. You may also need to follow a special diet in the days before your surgery. Be sure to ask your doctor. And don’t smoke or use tobacco products within 24 hours of your procedure. 
   
• When (and how) to prepare your skin. Take a shower and clean thoroughly with plain soap and water, or with antiseptic soap if recommended by your physician, the night before or the morning of your procedure. Skip products with fragrances during and after your shower, and don’t apply lotions afterward. Scrub your fingernails with a brush and remove nail polish and acrylic nails. But don’t shave the hair on your back. That will happen at the hospital or outpatient center, if needed. 
   
• What to pack. Only bring the essentials. This includes your photo ID and health insurance information. Leave valuables, including jewelry, at home. For an overnight stay, carry only what you’ll need: a case for your glasses or contact lenses and for your dentures, flat walking shoes with nonslip soles, a lightweight robe, sweatpants, shorts, a T-shirt, and clothes to wear when you go home. 
   
• How long you’ll be staying. Depending on the type of back surgery you’re having, you may either be discharged the same day or spend a few nights in the hospital. Your surgeon will explain what to expect based on the specifics of your procedure. Make sure to arrange for a friend or family member to drive you home. 

Know what to expect before you are discharged 

After back surgery, your health care team will monitor your progress to ensure you're stable enough to go home. Here are some key things to anticipate before you leave: 

• Get ready to walk. The nursing staff will have you up and walking shortly after surgery. This helps prevent complications such as blood clots and pneumonia. Walking also promotes circulation, which aids in the healing process. 
   
• You won’t be pain-free, but you’ll feel a lot better. Although you’ll experience some discomfort after surgery, you should also feel significant relief from the pain that led to the procedure. Most patients report that their pain is manageable with medications. Your surgical team will modify your medications until you’re on a regimen that keeps the pain under control. 

Back at home 

When you return home following your surgery, here’s what you can do to optimize your recovery: 

• Wear slip-on shoes with a full back. These will keep you from having to bend over to tie your laces. Be sure they have a bottom surface with traction to avoid slips. 
   
• Get ready for physical therapy. Physical therapy is an essential part of your recovery after back surgery. In the weeks following surgery, your physical therapist will guide you through exercises to improve strength, flexibility, and mobility. Be prepared to commit to your physical therapy routine. It plays a crucial role in your overall recovery and long-term success. 
   
• Continue healthy eating. Good nutrition can help your bones and surgical wounds heal more quickly. Eat a diet rich in protein and fiber, and drink lots of water. If your doctor gives you a post-op diet or suggests supplements or vitamins, follow their orders for the best results. If you’re diabetic, keep your glucose levels tightly controlled to promote healing. 
   
• Stay active. You may feel fatigued when you get home, but your energy levels should improve over the next few weeks. But no matter how tired you may be, don’t stay in bed. Get up every hour or so and take a couple of steps to increase strength and prevent blood clots. And follow your doctor’s orders for exercise or physical therapy.  

You’ve got this 

Preparing for back surgery can feel overwhelming, but by focusing on prehab and thoughtful planning, you can improve your chances of a smooth recovery. Remember, your health care team is there to support you every step of the way, so don’t hesitate to ask questions or seek help as you prepare for your surgery.