What to expect
Discomfort around the incision is normal in the first days. Soreness, tingling, or numbness away from the surgical site is also common — that comes from inflammation settling down around nerves that were compressed before surgery. It can feel more intense in the first days than it did before the operation, and it eases over several weeks as healing progresses.
Incision care
Incisions are closed with dissolvable suture under the skin, covered with surgical skin glue or adhesive strips. There are almost never stitches or staples to remove. The strips may discolor or flake off, and can stain the dressing. That is expected and needs nothing from you.
Dressings stay on for a set number of days that depends on your procedure. During that time you can shower with the dressing in place. Keep the wound out of standing water until Dr. Hirsch sees you back in the office: no baths, hot tubs, pools, or ocean. If a dressing gets wet and falls off early, pat the area dry and replace it.
Call the office if you notice drainage or redness at the incision. That is the one finding that warrants a call rather than waiting for your follow-up.
Medication
You will go home with a short course of pain medication and, for most procedures, a stool softener. Take pain medication when you need it rather than on a fixed schedule. If your pain is tolerable, you do not need to take it. Taper down as pain improves rather than stopping abruptly.
If you already see a pain management physician who prescribes for you, make a follow-up appointment with them within the first two weeks. They resume prescribing at that point.
Resume your regular medications for everything unrelated to your spine — blood pressure, diabetes, cholesterol — as soon as you get home.
Activity
Moving early matters. It lowers the risk of pneumonia and blood clots, keeps muscles from stiffening, helps the incision heal into a well-organized scar, and improves how you feel day to day. It does not mean returning to your usual routine.
Week 1. Sleep more than usual and rest through the day. A disrupted sleep pattern is common and settles on its own. Limit bending and twisting to what dressing and using the bathroom require. Avoid sitting longer than an hour at a stretch — get up, walk, or change position. Start a daily walking program, one or two blocks at first, a little further each day. Eat a balanced diet.
Week 2. Return to a normal sleep schedule while still resting during the day. Keep walking, increasing distance and frequency. Observe the lifting limit for your procedure. Sexual activity can resume when you are comfortable. Begin weaning the pain medication. Your follow-up visit is around two weeks after surgery.
Week 3. Light work around the house. Cardio machines are reasonable — treadmill, elliptical, stationary bike. Anything you have not done since before surgery gets reintroduced gradually: low intensity, short duration, and build from there based on how your body responds.
Driving
Not while you are taking prescription pain medication or a muscle relaxant. Once you are off them and feel comfortable operating a vehicle, take a practice run down the block and back before driving any distance, with someone in the car with you.
Return to work
Office-based work with no manual component: most patients are ready about 10 days after surgery. If your job involves lifting or manual labor, that timeline gets set individually at your first post-operative visit. Some patients are ready sooner than others depending on the job, the response to surgery, and what lighter duties are available.
These guidelines are a general framework. There may be bumps in the road. Dr. Hirsch's office handles them with you as they come up, and the patients who do best are the ones who stay proactive about their post-operative care.
Questions after surgery: (949) 781-4704. After hours, leave a message — Dr. Hirsch checks messages from post-operative patients frequently.