Pain Control Treatment Options

Week 1-2

Expect post procedure flare up of mild to moderate back pain and mild extremity symptoms. If more severe back pain and moderate extremity symptoms persist after the first week, consider an oral Prednisone taper (60mg for 3 days; then 40 mg for 2 days, then 20mg for 2 days).

Week 3-4

Mild Pain(1-3 VAS)	Moderate Pain (3-6 VAS)	Severe Pain (7-10 VAS)
NSAID's, if tolerated	NSAID's, if tolerated	NSAID's, if tolerated
Ice 1-3 times/day	Ice 1-3 times/day	Ice 1-3 times/day
Rest	Rest	Bed Rest (for 2-3 days)
Mild Activity Restriction	Corset (Recommended)	Corset (Recommended)
	TENS(Optional)	TENS(Optional)
	Vicodin (Opiate Analgesics)	Prednisone *
	Moderate Activity Restriction Prednisone * (for extremity flare)	Vicodin (Opiate Analgesics)

* if no suspicion of infection

Guidelines for Activity Restrictions

• Rest : 1-3 days post-op, then as needed (preferred positions: reclining, limited vertical sitting)
• Corset: recommended during the first 6 weeks (to limit patient activity)
• Return to Work (recommendations to be on an individualized basis by the physician):
  • sedentary work : 1-5 days post-op
  • heavy work : 3 or more months (dependent on post-operative functional capacity)
• walking
• driving : begin 1-5 days post-op
• sitting : 30-45 minutes for the first 2 weeks, then increase to tolerance
• lifting : 0-10 lbs for 2 weeks, 25-50 lbs for 3 months
• bending : none (proper body mechanics to be taught)
• twisting : none
• light housework : may resume after 1 week