Congratulations on successfully completing your spine surgery! We are excited for you to learn how to live to your fullest again with your new breakthrough.

Now that you have had spine surgery, there are certain precautions you will need to follow during your daily activities (e.g., bathing, dressing, household chores, etc.) to prevent re-injuring your back. The following section provides information regarding precautions, techniques and recommended adaptive equipment. This information will complement the discussion, demonstration and practice in each of these areas you will work on during your occupational therapy sessions.

The goal is for you to return to your normal lifestyle as safely and independently as possible.

As ordered by your doctor, you will participate in physical and occupational therapy while in the hospital.

Four Basic Precautions

It is critical to your recovery that you follow these precautions for the next eight weeks but we recommend that you consider these precautions a lifestyle change to avoid further injury. You will need to keep in mind each of these precautions as you carry out all of your daily activities.

  1. NO BENDING AT THE WAIST: Bend with your knees, not your back
  2. NO LIFTING MORE THAN 10 POUNDS: Nothing heavier than a gallon of milk
  3. NO TWISTING: Keep your shoulders and hips aligned
  4. NO STRAINING: Don’t hold your breath during activity

Bed Mobility


You will use a log roll to get in and out of bed.

To get out of bed

  1. Bend your knees so your feet are flat on the bed.
  2. Roll onto your side moving your body as one unit. Do not twist.
  3. As you lower your legs off the edge of the bed, push up to a sitting position with your arms.

To get into bed

  1. Sit close to the head of the bed. Scoot back on the bed before attempting to lie down.
  2. Drop down on your elbow and lift your legs into bed as you lower your upper body onto the bed.

Sitting and Standing


If possible, sit in a firm, sturdy chair with armrests.

To sit

  1. Back up to the surface until you feel it with the backs of your knees.
  2. Reach for the surface with your hands.
  3. Keep your back straight as you lower yourself to the surface. 

To stand

  1. Scoot to the edge of the surface you are sitting on.
  2. Pull your feet underneath you.
  3. Push from the surface you are sitting on.
  4. Keep your back straight as you stand. 

You may require the use of a walker for a short time. Your therapist will determine this with you. Crutches and canes are not recommended by your surgeon.

Toilet Transfers

You may require the use of a raised toilet seat for a short time if getting on and off of the toilet is difficult for you. Your occupational therapist will discuss this with you.

To get on the toilet

  1. Back up to the toilet until you feel it with the back of your legs.
  2. Reach back for the edge of the toilet seat or safety rails and slowly lower yourself.
  3. Keep your back straight as you lower on to the toilet. 

To get off the toilet

  1. Pull your feet underneath you.
  2. Push up from the seat of safety rails with your arms.
  3. Keep your back straight as you stand.

Shower Transfer

A bath or shower bench may be helpful for showering if standing for an extended period of time is difficult. A long-handled sponge and/or a handheld shower will be beneficial to reach your lower legs and feet.

  1. Step into the shower stall. Don’t twist.
  2. Reach back for the bath bench with both hands and slowly lower yourself to the seat.
  3. Keep back straight as you lower to the seat.
  4. To get out of the shower, reverse the process.

Tub Transfer


A bath or shower bench may be helpful for showering if standing for an extended period of time is difficult. A long-handled sponge and/or a handheld shower will be beneficial to reach your lower legs and feet.

  1. Stand facing the wall next to the tub.
  2. While holding onto a grab bar, step into the tub with the closest leg. Make sure to leave enough room for your other foot to step in.
  3. Bring your other leg into the tub.
  4. Keep your back straight as you step into the tub.
  5. Reach back for the bath bench with both hands and slowly lower yourself to the seat.
  6. To get out of the tub, reverse the process.

Reaching Items in Low Areas

If something falls on the floor, ideally someone else will be avail­able to pick this up for you. If not, there are three safe ways to pick it up yourself:

  1. Use a reacher to retrieve the item.
  2. You can drop down on one knee, then both knees, then sit back on your heels, keeping your back straight, then grab the item. Reverse the process to stand back up.
  3. Squat down to the floor with your knees apart, then grab the item, keeping your back straight.

Homemaking Tips


  1. If using a walker, use a walker apron or plastic bag attached to your walker to transport items within your home.
  2. Carry liquids in containers with lids or covers (e.g., thermos, unopened cans of soda, water bottles).
  3. Slide items along counter tops whenever possible rather than trying to carry them.
  4. Use a reacher to pick up items dropped on the floor or to retrieve items from low areas (e.g., the crisper in the refrigerator, low dresser drawers).
  5. Sit on a high stool whenever possible (e.g., at a kitchen counter for meal preparation, a work table).
  6. Remove all throw rugs in your home to avoid catching your walking aid or foot and possibly tripping or falling.
  7. Use a long-handled brush to clean the toilet and tub.
  8. Use long-handled tools (specifically, ops, brooms, dust pans and feather dusters) for cleaning.
  9. For laundry, use a pushcart or shoulder bag to transport clothing to/from your washer and dryer. You can also have friends or family assist.
  10. When retrieving items from a cabinet, approach the counter with enough room to open the cabinet door without arching your back.

Stairs


There are no stair climbing restrictions. Climb foot over foot, if you are able. Hold onto a rail for stability. If you are continuing to have pain or weakness in one of your legs, lead up the stairs with your stronger leg first and down the stairs with the weaker leg first. Do one step at a time and hold onto a rail.

Vehicle Transfers

Be sure the car is parked several feet away from the curb and on a level surface to ensure that you are on the same level as the car for the transfer.

  1. Before getting in, have the seat positioned as far back as possible from the dashboard and in a semi-upright position for comfort.
  2. Back up to the seat of the car until you feel it with the back of your legs.
  3. Lower yourself to the seat, reaching for the seat with your hands, and keeping your back straight. Hold on to a stable surface.
  4. Scoot back.
  5. Pivot on your bottom while bringing your legs into the car. Be careful not to twist.
  6. Reverse the process to exit the car. 

Your surgeon will clear you when you are safe to begin driving.

Grooming/Hygiene at the Sink


When completing grooming/hygiene tasks at the sink, remember to follow your precautions. Lean into the sink to spit or spit into a cup to avoid bending.

Dressing


In order to avoid bending, you will need to sit and cross one leg over the other to dress your lower body. If crossing your legs is difficult, you may require the use of adaptive equipment. Your occupational therapist will have this equipment available if needed. If your have one leg that is weaker than the other, dress that leg first and undress it last. Sit on the edge of the bed or in a firm armchair for dressing.

Underwear & Pants

  1. Using the reacher, hold the underwear at the waistband. With the reacher, lower the underwear toward your foot and slide the leg hole over your foot, then pull it up to your knee. You can then put down the reacher and holding on to your underwear with both hands, put your other leg in the other opening as you normally would. While sitting, pull your underwear up above your knees as far as you can until you are ready to stand.
  2. Repeat the same process with your pants, to the same point. This way you only have to stand up once to complete the task.
  3. For safety, have your walking aid in front of you and stand up by pushing from the bed/armchair until you are balanced. Pull up your underwear and pants over your hips.
  4. To undress, reverse the process, remembering to remove your clothing from the weakest leg last.

Socks & Stockings

  1. Slide the sock/stocking onto the sock aide until the toe is flush to the bottom of the sock aid. Be sure the top of the sock is not over the top of the sock aid.
  2. Holding onto the straps of the sock aid, toss the sock aid to the floor in front of your foot. Slide your foot into the sock aid and pull on both straps, until the sock comes up your leg. Continue to pull on the straps of the sock aid until it comes completely out of the sock. Unhook the sock aid from your leg. Use the reacher to adjust the sock, if needed.
  3. Put on your other sock onto the unaffected leg by either bringing your foot up to you or using the sock aid.
  4. To take off your sock/stockings, hook the end of the dressing stick, reacher or long handled shoehorn and the top of your sock and slide it down your leg, over the back of your heel and off your foot. Be sure not to twist.
  5. If your sock falls on the floor, pick it up with your reacher or dressing stick.

Shoes

Slip-on shoes are recommended. If you prefer shoes that lace up, your occupational therapist can show you how to use elastic shoelaces.

Slide the toes of one leg into your shoe. Using the long-handled shoe horn, position it in the back of your shoe, and slide your heel down the shoe horn and into the shoe. Be sure not to twist as you do this.



Exercises


While there are no formal exercises, walking will be your best exercise.