Intimacy after Microdiscectomy
Back pain and radiculopathy may limit a patient’s physical intimacy, so much so they may cease their sexual activity. Microdiscectomy is a gold standard surgery to alleviate symptoms of lumbar radiculopathy due to herniated intervertebral disc. However, a symptom most commonly not discussed after the surgery is the resumption of sexual intimacy.
Healthy sex life is an essential predictor of a patient’s wellbeing. Back pain with radiculopathy due to herniated intervertebral disc commonly hampers a patient’s sex life. Pain during sexual activity as well as the anticipation of pain, both play in dissatisfaction during sex. Some patients may cease all sexual activity secondary to discomfort which may only add to the emotional aspect of radicular back pain.
Axial section of MRI of the lumbar spine showing a herniated disc.
Microdiscectomy surgery is a minimally invasive surgery performed with an operating microscope or an endoscope. The minimum invasive nature of the surgery leads to less cutting of the muscles and tissues while accessing the disc. The smaller incision also leads to less formation of fibrotic tissue after the surgery. The patients undergoing microdiscectomy are able to return to work and their day-to-day activities sooner than an open approach surgery.
Sexual activity is a moderately intense physical activity and most patients will need to wait at least 6 weeks before resumption, however, the time period is unique to each patient and may be shorter or longer. During the initial microdiscectomy recovery, the patients are often advised to avoid bending at the waist, lifting more than 5 pounds, and twisting action. Early resumption of sexual activity may lead to pain at the incision site, muscle spasms, and rarely re-herniation.
The approximate time to safely resume sexual activity depends upon the patient’s underlying condition and the type of surgery. The physician usually evaluates the patient’s condition post-surgery and advises the resumption of sex accordingly. The majority of the patients after microdiscectomy surgery find it comfortable and safe to resume sex after 6 weeks.
At 6 weeks, the initial inflammation from the microdiscectomy surgery resolves with the healing of the disc and the tissues cut/separated during surgery. The patient also meanwhile learns about correct posture and adapts to post-surgery precautions to become confident of sexual intimacy. Physical therapy during this period also helps the patient to increase flexibility and strengthen the muscles of the back.
The patients are often advised to resume sexual activity in a position they are most comfortable with. The patients are advised to engage gradually in sexual intimacy and to be honest with their partners regarding their discomfort. Often lying flat and using a rolled-up towel beneath the lower back is helpful.
Similarly, some patients may find it more comfortable when engaging in sexual activity on a firm surface. Some patients may find it comfortable to perform sexual acts in a side position or while sitting on a chair.
Patients with bulging disks often experience pain with bending position as compared to patients with spinal stenosis who experience pain with bending backward. After microdiscectomy, patients may use ice packs, massage, and pain medication to ease pain before sexual activity.
However, a number of patients may experience difficulty sustaining sexual activity which may be psychological due to anticipation of complications after surgery. It is therefore important to discuss sexual activity both with the physician and the physical therapist.
Patients are often able to discover a position in which they are more comfortable during sexual intimacy. Pain and discomfort are a body’s way to warn about possible injury and therefore any position causing pain should be avoided.
Safe resumption of sexual activity is imperative for the well-being of the patient after surgery but the time frame and the positions may vary among different patients. Discuss with your physician and physical therapist the time frame and the level of activity during intimacy.
Do you have more questions?
How long should I wait after microdiscectomy before resuming sexual activity?
Most patients are advised to wait at least 6 weeks before resuming sexual activity, but this period can vary depending on individual healing rates and overall recovery progress. It is essential to follow your physician’s recommendations and ensure that you feel comfortable and pain-free before engaging in sexual activity.
What positions are safest for resuming sexual activity after microdiscectomy?
Safe positions vary among patients, but many find comfort in positions that minimize strain on the back. Lying flat on the back with a rolled-up towel beneath the lower back can provide support. Engaging in sexual activity on a firm surface or in a side-lying position can also be beneficial. It is important to experiment with different positions to find what works best for you and avoid any that cause discomfort or pain.
What precautions should I take during sexual activity post-microdiscectomy?
During the initial recovery phase, avoid positions that involve bending at the waist, lifting your partner, or twisting actions. Gradually ease into sexual activity and communicate openly with your partner about any discomfort. Using ice packs, massage, or pain medication before sexual activity can help alleviate pain. Always listen to your body and stop any activity that causes pain.
What should I do if I experience pain during sexual activity after surgery?
If you experience pain during sexual activity, stop immediately and reassess your position and movements. Apply ice packs or take pain medication as recommended by your physician. If the pain persists, consult your physician or physical therapist to address the issue and receive guidance on managing discomfort and preventing further injury.
Can resuming sexual activity too early cause complications after microdiscectomy?
Yes, resuming sexual activity too early can lead to complications such as pain at the incision site, muscle spasms, and in rare cases, re-herniation of the disc. It is crucial to follow your physician’s advice on when it is safe to resume sexual activity and to gradually ease into it to avoid any setbacks in your recovery.
How can I address the psychological aspects of resuming sexual activity after surgery?
Anticipating pain or complications can create psychological barriers to resuming sexual activity. Open communication with your partner about your concerns and discomfort is vital. Discussing these issues with your physician or a physical therapist can provide reassurance and help you develop a plan to safely and comfortably resume sexual activity. In some cases, counseling or therapy may be beneficial to address any lingering fears or anxiety.
Will physical therapy help in resuming sexual activity after microdiscectomy?
Yes, physical therapy can significantly aid in your recovery and help you safely resume sexual activity. Physical therapists can teach you exercises to increase flexibility, strengthen your back muscles, and improve your posture, all of which are essential for a healthy and active sex life post-surgery. They can also provide personalized advice on safe positions and movements during sexual activity.
What should I communicate to my physician regarding sexual activity post-surgery?
It is important to be open and honest with your physician about your concerns and experiences with sexual activity after surgery. Discuss any pain, discomfort, or psychological barriers you face. Your physician can provide guidance, recommend appropriate positions, and adjust your recovery plan to ensure you can safely resume sexual intimacy.
How can I tell if I’m ready to resume sexual activity after microdiscectomy?
You might be ready to resume sexual activity when you can perform your daily activities without significant pain or discomfort. Ensure you can walk, bend, and twist with minimal discomfort. It’s also important that you have been cleared by your physician during a follow-up visit. Communicating openly with your doctor and following their guidance is essential.
Can I use pain medications before sexual activity to ease discomfort?
Yes, using pain medications as prescribed by your physician can help manage discomfort before sexual activity. Over-the-counter pain relievers, ice packs, or topical analgesics might also provide relief. However, always consult your doctor before using any medications or therapies to ensure they are safe for your specific condition.
Are there specific signs I should watch for that indicate I should stop sexual activity?
Yes, if you experience sharp or intense pain, muscle spasms, numbness, or weakness during sexual activity, you should stop immediately. Persistent pain at the incision site, unusual discomfort, or any new symptoms should also be reported to your physician.
How can I maintain intimacy with my partner during the recovery period?
Maintaining intimacy can involve non-sexual activities that foster closeness, such as cuddling, kissing, and spending quality time together. Open communication about your recovery progress and any limitations is crucial. Exploring other forms of physical and emotional intimacy can strengthen your relationship while you heal.
Can physical exercises help in resuming sexual activity after microdiscectomy?
Yes, specific physical exercises prescribed by a physical therapist can strengthen your core and back muscles, improve flexibility, and enhance overall physical function. These exercises can help prepare your body for the resumption of sexual activity and reduce the risk of injury.
What role does posture play during sexual activity post-surgery?
Good posture is crucial during sexual activity to avoid unnecessary strain on your back. Maintaining a neutral spine position and avoiding extreme bending or twisting can prevent discomfort and potential injury. Your physical therapist can provide guidance on maintaining proper posture during sexual activity.
Is it normal to feel anxious about resuming sexual activity after surgery?
Yes, it is normal to feel anxious about resuming sexual activity after surgery. Concerns about pain, injury, or performance can cause anxiety. Discussing these feelings with your partner, physician, or a mental health professional can help alleviate anxiety and provide strategies for managing it.
What should I do if I experience re-herniation symptoms during sexual activity?
If you experience symptoms of re-herniation, such as severe pain, numbness, or weakness, stop all activities immediately and seek medical attention. Contact your physician to assess the situation and determine the appropriate course of action.
How important is gradual progression in resuming sexual activity post-microdiscectomy?
Gradual progression is essential to avoid overloading your healing spine and to prevent pain or injury. Start with less strenuous activities and slowly increase the intensity as you gain confidence and comfort. Following your physician’s and physical therapist’s advice will ensure a safe and gradual return to sexual activity.
Can certain sexual positions exacerbate my condition post-surgery?
Yes, certain positions that involve bending, twisting, or placing strain on your lower back can exacerbate your condition. It’s important to find positions that provide support and minimize stress on your spine. Consulting with your physician or physical therapist for personalized recommendations is advisable.
How does overall physical fitness impact the resumption of sexual activity after microdiscectomy?
Overall physical fitness plays a significant role in your recovery and the resumption of sexual activity. A strong, flexible body can better support the spine, reduce the risk of injury, and enhance sexual performance. Engaging in regular physical activity, as advised by your physician or physical therapist, can improve your fitness and facilitate a smoother transition back to sexual intimacy.
Dr. Suhirad Khokhar
My name is Dr. Suhirad Khokhar, and am an orthopaedic surgeon. I completed my MBBS (Bachelor of Medicine & Bachelor of Surgery) at Govt. Medical College, Patiala, India.
I specialize in musculoskeletal disorders and their management, and have personally approved of and written this content.
My profile page has all of my educational information, work experience, and all the pages on this site that I've contributed to.
