One of my favourite studies of all time is a paper that looks at spine surgeons who’ve had surgery.  The study examines spine surgeons in North America, including the United States and Canada, a surprising 10% of whom have had an operation on their back.

The most interesting thing about the study is how quickly these spinal surgery experts return to work following the operation.  Many are back within a few weeks, although most return on restricted duties, particularly after a spinal fusion. Spine surgeons tend to have a smooth recovery and are able to return to their usual jobs significantly more quickly than most of the patients they treat.

Why?

Having the operation go well is important, but good post-operative management is just as important for a patient’s rehabilitation.

Experts in the field put together a series of recommendations about restrictions following spinal surgery.  They found:

• That there was no good evidence to apply restrictions on activity after surgery;
• Strong evidence that most post-operative restrictions applied are not necessary;
• Strong evidence that most post-operative restrictions actually delay recovery and return to work;
• That many patients are uncertain about what kinds of activities could or should be undertaken after back surgery; and
• That putting restrictions on activity seems to be mainly influenced by the anxiety and uncertainty of clinicians and patients rather than solid evidence-based advice.

After reviewing 119 research studies, the experts concluded that remaining mobile and returning to full activities as soon as possible after surgery results in better pain relief and earlier return to work. 

They counselled against the concept of “letting pain be your guide,” noting that such an attitude actually slows down recovery.  When too much attention is paid to pain patients become over-cautious and recover more slowly.

This advice matches up with my own observations about recovering from spinal surgery.

A few weeks ago I saw a chap who had spinal surgery eight years ago.  He had done extremely well, and continued to manage a 12-hour day in a job that wasn’t physically taxing, but had him sitting for much of the day.  He managed his situation by a significant focus on self-management, and despite the advice his doctor had given him in the early stages about not returning to work, he’d worked out himself what he needed to do to keep his back strong and to get on with his life.  If he’d taken the advice given his life would’ve taken a different course, and likely a less successful one.

We can learn from the experts do themselves after surgery, to ensure that recovery from spinal surgery occurs as quickly and successfully as possible.