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.

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.