What to Expect in the First Week After Minimally Invasive Spine Surgery

Minimally invasive spine surgery uses small incisions, tubular retractors, and imaging guidance to treat spinal problems with less muscle disruption than traditional open surgery. For many patients, this approach means shorter hospital stays, less blood loss, and faster early recovery.

Still, the first week after surgery can feel uncertain. Patients often ask: How much pain is normal; how far should I walk; when can I shower; what symptoms should worry me

This guide walks through what most people can expect during the first week after minimally invasive spine surgery, including pain control, mobility, wound care, and warning signs.

You should contact your surgeon if you develop fever, new or worsening leg or arm weakness, loss of bladder or bowel control, or drainage from the incision.

Before You Leave the Hospital

Hospital to Home: What Usually Happens on Day 0 to Day 1

Right after surgery, you wake in the recovery area while nurses monitor your breathing, heart rate, and pain.

Typical steps with minimally invasive spine surgery include:

• Transition from intravenous to oral pain medications once you are awake.
• Standing and taking a few steps with help from staff or a physical therapist, often the same day or the next day. Early walking reduces the risk of blood clots and lung complications.
• Basic teaching about spine precautions, such as limiting bending, lifting, and twisting, and how to get in and out of bed safely.
• Instructions about caring for your incision and when to schedule your first follow-up visit.

Some patients go home the day of surgery, especially after single-level minimally invasive lumbar procedures. Others stay one night for monitoring and pain control. Your surgeon and anesthesia team decide this based on your procedure and health status.

Pain and Medication in the First Week

Pain Control: What Is Normal and How to Manage It

After minimally invasive spine surgery, pain usually comes from:

• The incision and surrounding soft tissues.
• The muscles that were gently separated to reach the spine.
• Residual nerve irritation if you had leg or arm pain before surgery.

During the first week, it is common to feel:

• Soreness and stiffness around the surgical area.
• Twinges of nerve-type pain as the nerve recovers from compression.
• Fatigue from the stress of surgery and anesthesia.

Most patients go home with a pain plan that may include:

• Short courses of stronger medications for moderate to severe pain.
• Anti-inflammatory drugs or acetaminophen, if appropriate for your health and other medicines.
• Muscle relaxants, in some cases, to help with spasms.

General tips:

• Take medications as directed; early on, a regular schedule can keep pain under better control than waiting until pain is severe.
• Avoid alcohol and driving while using any sedating pain medicine.
• Call your surgeon if pain suddenly becomes much worse, feels very different, or does not respond to the prescribed regimen.

Mobility and Walking

How Much Should You Walk in the First Week

Strict bed rest is rarely recommended after modern spine surgery. Most guidelines encourage early, gentle walking to support circulation and reduce stiffness.

In the first week, many patients:

• Walk short distances inside the home several times a day, such as to the bathroom or kitchen and back.
• Increase distance slowly as pain allows, rather than taking one long walk.
• Avoid sitting or lying in one position for long stretches; short position changes every hour or two often help.

If you have stairs at home and feel steady, you can often use them with handrails and another person nearby, unless your surgeon has told you not to. Always follow the specific limits your surgeon gives, especially if you have a fusion or are using a brace.

Bending, Lifting, Twisting, and Other Restrictions

Movements to Avoid During the First Week

Many spine surgeons use simple rules for the early recovery period:

• No heavy lifting: often nothing heavier than a few kilograms, such as a gallon of milk, although your exact limit should come from your surgeon.
• Avoid bending forward at the waist; instead, bend at the hips and knees when needed and only if you have been cleared to do so.
• Avoid twisting motions of the spine, such as quickly turning to look behind you.

These “no BLT” restrictions, bending, lifting, and twisting, are particularly important after fusion procedures. Less extensive minimally invasive decompressions sometimes have slightly more flexible limits, but you should still protect the area until your surgeon relaxes these rules at a follow-up visit.

Incision Care and Showering

Wound Care and Hygiene in Week One

Your incision is usually small, and it may be closed with sutures under the skin, surgical glue, or small surface strips. Before you leave the hospital, you should receive written instructions on:

• Whether to keep a dressing over the incision and how often to change it.
• When it is safe to shower, many surgeons allow showering after 24 to 72 hours if the wound is covered or protected from direct spray.
• How to dry the area gently by patting with a clean towel instead of rubbing.

General precautions in the first week:

• Do not soak the incision in a bath, pool, or hot tub.
• Do not apply creams, ointments, or powders on the incision unless your surgeon has instructed you to.
• Check the area daily, or have a family member help, to look for signs of infection.

Call your surgeon if you notice:

• Increasing redness, warmth, or swelling around the incision.
• Drainage that is cloudy, yellow, or foul-smelling.
• Opening of the incision.

Sleep, Positions, and Getting Comfortable

Sleeping Positions and Comfort Tips

Sleep can be difficult in the first week because of pain, stiffness, and changes in your routine. Comfortable positions often include:

• Lying on your back with pillows under your knees to reduce strain on the lower back.
• Lying on your side with a pillow between your knees to keep your hips and spine aligned.
• Using a medium firm mattress or adding a supportive topper if your bed is very soft.

To get in and out of bed:

• Roll onto your side while keeping your shoulders and hips in line.
• Use your arms to push up while allowing your legs to swing to the floor, rather than twisting your spine.
• Reverse this process to lie down.

This “log roll” technique helps protect the surgical area while you change positions.

Eating, Hydration, and Bowel Habits

Nutrition and Bowel Changes After Surgery

It is common to have a reduced appetite in the first few days after surgery. Anesthesia, pain medicines, and lower activity can also slow the bowels.

To support healing and prevent constipation:

• Drink plenty of fluids unless you have a condition that limits fluid intake.
• Eat small, balanced meals with protein, fruits, vegetables, and whole grains.
• Use stool softeners or gentle laxatives as recommended by your surgeon, especially if you are taking narcotic pain medicines.

Call your surgeon if you:

• Have not had a bowel movement for several days despite following the bowel regimen.
• Develop significant abdominal pain, bloating, or vomiting.

Driving, Work, and Household Tasks

What You Can and Cannot Do in the First Week

In the first week, most people are still adjusting to their new limits.

Driving

• You should not drive while taking sedating pain medications.
• Even off these medicines, most surgeons ask patients to wait until they can sit comfortably, move safely, and react quickly. For many, this is after the first week, but you should follow your surgeon’s advice.

Work

• Many patients stay off work for at least the first week, even if they have a desk job.
• Physically demanding jobs that involve lifting or prolonged standing require a longer time away and a gradual return plan.

Household tasks

• Light activities at counter height, such as making a simple meal or washing a few dishes, may be safe if they do not require bending or lifting.
• Avoid vacuuming, laundry baskets, heavy groceries, yard work, or any task that strains your back or neck.

Having a family member or friend at home during the first few days can make this transition much safer and less stressful.

Day by Day: Sample First Week Timeline

First Week After Minimally Invasive Spine Surgery: Example

Every recovery is unique, but many patients notice a pattern similar to the one below.

Day	What Many Patients Experience	Focus for the Day
Day 0	In hospital, drowsy, pain managed with IV and oral medicines, first assisted walk	Safety, pain control, beginning to stand and walk with help
Day 1	More alert, walking short distances with support, often discharged home if cleared	Practice safe walking and transfers, review home instructions
Days 2–3	Soreness and fatigue at home, need help with some tasks, short frequent walks	Manage pain on schedule, protect incision, avoid overdoing it
Days 4–5	Slight increase in energy, walking a bit farther, sitting a bit longer, still tired	Gradual activity, simple home tasks without bending or lifting
Days 6–7	Settling into a routine, pain improving for many, but still need rest breaks	Continue gentle walking, prepare questions for follow up visit

Guideline note: This table is a general guide only. Your first week after minimally invasive spine surgery may be different based on your specific procedure, your overall health, and the plan your surgeon gives you.

Red Flags in the First Week: When to Call Your Surgeon or Seek Help

Warning Signs You Should Not Ignore

Contact your surgeon right away or seek emergency care if you notice:

• Fever or chills, especially with increasing back or neck pain.
• Redness, warmth, or drainage from the incision.
• New or worsening numbness, tingling, or weakness in your legs or arms.
• New numbness in the groin or saddle area.
• Loss of bladder or bowel control, or sudden trouble starting urination.
• Sudden shortness of breath, chest pain, or calf pain and swelling.

It is better to ask early than to wait and worry. Your care team expects questions during this period.

Emotional Recovery: Feeling Anxious Is Normal

The First Week Emotionally

The first week after surgery can be a roller coaster. It is common to feel:

• Anxious about every new sensation.
• Frustrated by limits on usual activities.
• Worried that pain will not improve.

Helpful strategies include:

• Keeping a short daily log of pain levels and walking distance so you can see small improvements.
• Talking openly with your surgeon or primary care doctor if your mood or anxiety feels overwhelming.
• Staying connected with family or friends, even briefly each day.

Emotional recovery often improves once you attend your first follow-up visit and hear from your surgeon that healing is on track.

Final Thoughts

The first week after minimally invasive spine surgery is a time of adjustment. You may feel sore, tired, and limited, yet you are also taking the first steps toward long-term relief and better function.

Focus on a few key goals:

• Manage pain safely with the plan your surgeon provides.
• Walk short distances frequently, without overdoing it.
• Protect your incision and avoid bending, lifting, and twisting.
• Watch for warning signs and ask questions early.

With realistic expectations and close communication with your spine surgeon, most patients move through this first week and into the next phases of recovery with growing confidence.

If you are preparing for minimally invasive spine surgery and feel unsure about what the first week will be like, consider scheduling a detailed preoperative visit with your spine surgeon. Ask for a written “first week plan” that covers medications, activity limits, wound care, and warning signs.

Having clear instructions and a support system in place before surgery can make your first week at home safer, smoother, and less stressful.

Dr. Sanjay Ghosh is a board-certified neurosurgeon at SENTA Clinic in San Diego, fellowship trained in complex spine and cranial base surgery. This content is educational and not a substitute for personalized medical advice.

Reference Links

1. Minimally invasive spine surgery overview, benefits, hospital stay
   Cleveland Clinic – Minimally Invasive Spine Surgery
   https://my.clevelandclinic.org/health/treatments/17286-minimally-invasive-spine-surgery
2. Postoperative instructions, early walking, restrictions after spine surgery
   Hospital for Special Surgery – Recovering from Spine Surgery
   https://www.hss.edu/conditions_recovering-from-spine-surgery.asp
3. Activity, pain control, and incision care after lumbar spine surgery
   UCSF Health – After Lumbar Spine Surgery
   https://www.ucsfhealth.org/education/after-lumbar-spine-surgery
4. Spinal fusion and general spine surgery recovery, movement precautions, sleep positions
   Johns Hopkins Medicine – Spinal Fusion
   https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/spinal-fusion
5. Early mobilization, bowel management, and red flag symptoms after spine surgery
   North American Spine Society – Patient Information: Spine Surgery and Postoperative Care
   https://www.spine.org/KnowYourBack/Treatment/SpineSurgery