Understanding Back Precautions for Spinal Fusion

Your spinal fusion has a limited range of safe motion while it is healing. For about four months following surgery, you must follow special back precautions to protect your new fusion.

These precautions will help to prevent injury to your back until it heals. While you are in the hospital, your healthcare team will constantly remind you of your back precautions. Once you get home, you must remember to follow these precautions until told otherwise. 

Back Precautions Do’s

• Do keep a balanced, aligned position of comfort at all times. When lying on your side, place a pillow between your knees and at your back.
• Do arrange work areas so they are above your hips and below your shoulders to prevent bending, stooping, or reaching.
• Do lie down when you rest. Lying down puts less stress on your back than sitting.
• Do walk as much as a mile each day. You can walk outside, but be careful not to fall.
• Do go up and down steps, unless your surgeon tells you not to. Go slowly, and hold onto the hand rails.
• Do pace your activities so you don’t get too tired.
• Do limit visitors. Too many visitors can be very stressful.
• Do bend your hips and knees when lifting, don’t bend at the waist. Lift with your legs, not with your back.

Back Precaution Don’ts

• Don’t twist your spine when turning; turn your whole body.
• Don’t pull on the side rails of the hospital bed; this will strain your back.
• Don’t reach, stoop, or bend forward at the waist or from side to side.
• Don’t lift anything heavier than 10 pounds; hold objects close to your body.
• Don’t do an excessive physical activity until your surgeon says that it is okay to do so.


Changing body positions while lying down helps blood circulation, prevents pressure sores, relieves muscle tension, and reduces pressure on your surgical site. Right after surgery the nurses will “logroll” you while you remain passive by keeping your body stiff and not “helping” the nurses turn you.

Then you will be shown how to “logroll” to change positions while lying down and to change from lying down to sitting up. Logrolling prevents excessive bending, twisting, and straining of your spine which could disrupt the surgical repair. Avoiding excessive bending, twisting, and straining will protect your fusion while it heals. Bone healing typically takes up to 3-6 months to occur. 

Special Equipment for Spinal Fusion Recovery

Following your back precautions can hinder daily activities such as dressing and bathing. However, there is special equipment to help you. The following items will make it easier and safer for you while you heal.

• A sock donner helps you put on socks without bending over too far.
• A dressing stick helps you pull clothing up over your head.
• A long-handled shoe horn allows you to put on your shoes without bending over too far.
• Elastic shoelaces can turn your lace-up shoes into slip-ons.
• A grabber helps you pick up things which are on the floor without bending over too far. You can also use the grabber to reach items above your head, such as from high cabinets in the kitchen or closet shelves.
• A long handled sponge makes it easier to wash while taking a shower or bath.
• A walker allows you to walk by yourself. The physical therapist can teach you how to walk with a walker if you need one.

Precautions While Sitting

Your back precautions affect where and how you should sit, and how you should get up from a sitting position. A good rule to remember when sitting is “always sit with your hips higher than your knees”. This will reduce the amount of stress on your back as you stand up. So, before surgery, check out your favorite sitting areas at home. Sit on:

• your favorite chair
• the seat of your car
• the side of your bed
• the toilet
• the sofa

Are your hips higher than your knees? If not, add a firm pillow to your seat to raise the level of your hips. You can buy or rent a raised toilet seat that has arms.

When you return home, sit in chairs that have straight backs, firm seats, and sturdy arms. When getting up from a sitting position scoot your hips to the edge of the seat, push up on the chair arms while pushing yourself up with your legs.

Lying down puts the least stress on your back. Standing puts more stress on your back than lying down. Reclining is somewhere between lying down and standing up. Sitting puts the most stress on your back. Therefore, your surgeon will tell you how long and how often you may sit after surgery. Limiting the time you spend sitting can last up to four months. However, you can recline, lie down, stand, and walk for as long and as often as you feel you can.

Your surgeon will tell you when you can drive or ride with others. Also, since sitting puts the most stress on your back, avoid sitting for long car trips. Avoid sitting in sports cars; the seats are usually low and getting in and out can put extra pressure on your back. Also, avoid vans, trucks, or sports utility vehicles that are high off the ground and hard to get into and out of.

Note that the information in this article is purely informative and should not be used in place of recommendations from your surgical team. 

Related Articles

Lumbar Spinal Fusion
Most Common Causes of Lumbar Back Pain
Your Visit With The Surgeon
Getting Yourself Ready For Surgery
Understanding Back Precautions
Making Arrangements For Surgery
Your Hospital Visit
Lumbar Spinal Fusion Surgery
Recovery At Home
When To Call Your Surgeon
Long Term Care For Your Back

More Information:

Lumbar Spine Structure and Function


  1. Michael Elizabeth Ruff says

    4 wks out. My body rejected dissolvable stitches, and the 22 staples my dr. used to close me up. At 2weeks post surgery, somehow one of my screws was a little off, but not enuf to bother the doc. What is bothering us both is that my body, I found out, is highly allergic to the dermabond glue and ALL forms of medical adhesives (including the paper tape). As anyone can well imagine, the incision sight is NOT closed. In fact, is bigger, about 3″ long, about an inch wide and about and inch deep….and is necrotic. I will be having a second surgery in 2 days where the doctor will be cutting out the dead tissue, but also checking the fusion to make sure I am not having a reaction to the metal. Prayers please! Thanks so much!

  2. Theodora says

    I’m 6 week’s post up and i bent accidentally and now I’m hurting. Should i be concerned, I’m hoping I didten messed up my fusion L5, S1

  3. Ruth Brooks says

    To clarify prior post:
    My surgery was 7 years ago
    In Feb 2013.

  4. Ruth Brooks says

    I see I am not the only one confused.
    Had 5-level lumbar fusion/laminectomy 2/13
    “Bending” needs further explicit definition. I watched a video and swear I cannot see the difference between the right and wrong ways to bend.
    I keep getting my pelvis tilted then it locks up. My hips get uneven. Then I have difficulty walking. My diaphragm also is tight probably due to a spinal
    injury at c2-c3 I endured at the same time of my fusion. My motto is: “Fusion causes confusion.”
    Have massage therapies 5x/month. Gabapentin and baclofen prescribed. Numb left leg. Altered sensation especially left foot. Lots of stretching. Nothing helps for long. Any ideas?

  5. Jean Causey blumenthal says

    I bent over today to pet my cat…totally forgot about no bending…now I am panicking. I can’t log roll out of my bed I swing my legs over and sit up. Had surgery October 23…9 weeks ago.. completely pain free. Now I worry I may have moved something in my spine…by bending…I see my neurosurgeon in a week..

  6. I am at 1 month to my lumbar spinal surgery.Before i got pain at my lower side of my back. At times the pain could radiate to my buttocks then leg that is before the surgery. Now i still have the pain off n on during which sitting walking n roll on my rigth side only when i get up from bed.
    I also use my leg to pick up things ie socks etc. which has fallen on the floor .At times i bend slightly my knees to reach out something .Now i feel my right side of my buttocks ache abit often .
    After lying down i felt better. But log roll put pressure on my roht side

  7. I am 8 weeks post op for spinal fusion in lower spine area. Had bottom disc repacked with attachments to pelvis. I bent over today from a sitting position, totally not thinking.. I now feel a burning in the lumbar section of my back. Is there a cause for concern.? How do you tell if you have a screw loose or damaged?

  8. I am in my 7th week after surgery. Dr said ok to drive, walk a lot. I find myself. Sweeping floors. Toss and turn in bed. Twist doing things, tired and little pain discomfort at incision site. As if something under Neath me like scar tissue. Am I doing too much after 7th week? What should I do or not do?

  9. What happens if you accidently twist or bend does it hurt your surgery? How do you tell if you have hurt your surgery? I am seven weeks after surgery. Please send this information via email please.

  10. I am now 10 weeks post L4/S1 fusion. My last visit to my physiotherapist she was shocked at how “scew” my body has become. My shoulders and hips are not inline. Getting in and out of bed was mainly done on my dominant side and I personally think it has something to do with that(one side of the bed only)

    I am trying to work the other side of my body by now only using the other side of the bed.

    With the exercise that I must do to align my shoulders and hips again, it hurts like hell.

    Also lying down caused allot of other issues, mainly joint pain in shoulders and hips from lying down on my sides. Lying down flat on my back causes my ribs to dislocate between my shoulders-blades. I am now at the point where the only other option is to sleep on my stomach.

    The question of “was the operation a success?” kills me every minute of every day. Some say it is way too early to decide on that. I believe the surgeon was the best at the time and I still believe that it was the right thing to do after suffering from a fractured vertebrae and a popped/burst disc for 12 years.

  11. my friend has just had spinal fusion done this week ,i dont know the different types of sergury but i presume the maximum allowed weight to lift for the rest of his life would be no more then 20lbs or he risks damage.

  12. Haresh Kagathara says

    Respected Sir. My lumber spinal fusion surgery was done before 07month.presently I can walk for 10 minutes ,standing for 30minutes then for same time I have to take bed rest (30+10) minutes and then I can stand & walk but less than 40 minutes. I can sit only one hour in a day. My recent MRI, x-ray,. Blood and urine test are normal. My doctor not give positive response. Them visited to physiotherapy doctor he ask that first of all your fusion have to heal properly then you can do exercise means you have to functionally OK first like walking, sitting, standing ,as per him do all this activities within pain limit.I also have polio in right leg (right leg is shorter (2 cm) and thin then left leg.presently I walk in balance by special question is how much time to heal fusion and how it is diagnosis? Because I have completed seven month of the surgery. Fusion will heal fast by walking?
    I can send my report by whats up or e mail.
    Please reply me for my better health.

  13. Education of assisting family members at home is a must!

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