What medication is given after spine surgery?

October 14, 2025 •

4 min read

Each year, surgeons in the U.S. perform approximately 1.62 million instrumented spinal procedures [1.10.1]. A crucial component of recovery is understanding what medication is given after spine surgery to manage pain, reduce inflammation, and facilitate a return to daily activities.

Quick Summary

Post-spine surgery recovery utilizes a combination of medications to manage different types of pain. This typically includes opioids for severe pain, NSAIDs, muscle relaxants, and nerve pain agents as part of a multimodal approach.

Key Points

Multimodal Analgesia is Key: Modern pain control uses a combination of different medications to improve effectiveness and reduce opioid use [1.7.1].
Opioids are for Short-Term Use: Powerful opioids are used for severe, acute pain right after surgery and are tapered off as pain subsides [1.3.3, 1.11.3].
NSAIDs and Fusion: Anti-inflammatory drugs like ibuprofen may be used cautiously, as some studies suggest they can affect bone fusion [1.7.1].
Multiple Pain Types are Treated: Medications target not just surgical site pain but also muscle spasms and nerve-related pain [1.9.4, 1.8.1].
Supportive Meds are Crucial: Stool softeners are essential to counteract opioid-induced constipation, a very common side effect [1.11.1].
Acetaminophen is a Baseline: Tylenol is a safe and effective non-opioid pain reliever that doesn't interfere with bone healing [1.3.3].
Patient Safety is a Priority: Side effects like drowsiness and dizziness from muscle relaxants and opioids increase fall risk, requiring caution [1.6.1].

The Modern Approach: Multimodal Analgesia

Effective pain management after spine surgery is critical for patient comfort, early mobilization, and better overall outcomes [1.2.5]. The modern standard of care is multimodal analgesia (MMA), a strategy that involves using a combination of different types of pain medications that act on various pain pathways [1.7.1, 1.7.3]. The goal is to provide superior pain control while reducing the reliance on any single medication, particularly opioids, thereby minimizing their associated side effects [1.3.3]. An MMA plan is tailored to the individual and the specific type of spinal procedure performed [1.2.3]. This approach often begins before the surgery and continues throughout the recovery period [1.7.4].

Key Medication Classes After Spine Surgery

Immediately following surgery, pain is often managed with intravenous (IV) medications in the hospital, with a transition to oral medications as the patient recovers [1.2.2]. The regimen typically includes a combination of the following classes.

Opioids for Severe, Acute Pain

Opioids are powerful analgesics used for managing moderate-to-severe pain in the immediate post-operative period [1.3.3].

In the Hospital: Initially, medications like Morphine or Dilaudid may be administered intravenously, often through a Patient-Controlled Analgesia (PCA) pump that allows the patient to self-administer a controlled dose [1.2.2, 1.2.3].
At Home: Upon discharge, patients are typically prescribed oral opioids such as oxycodone (OxyContin), hydrocodone, or tramadol [1.2.3, 1.2.4].
Important Considerations: Opioids are intended for short-term use. A key goal is to taper off them as the acute pain subsides [1.11.3]. Common side effects include drowsiness, nausea, dizziness, and, most notably, constipation [1.6.1, 1.6.5]. There is also a significant risk of dependence with long-term use [1.6.5].

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for Inflammation

NSAIDs work by reducing inflammation, which is a primary source of post-surgical pain [1.2.4].

Common Examples: Ibuprofen (Advil, Motrin), naproxen (Aleve), and celecoxib (Celebrex) are frequently used [1.2.3].
Use in Fusion Surgery: The use of NSAIDs after spinal fusion surgery can be controversial. Some evidence suggests that high doses may interfere with bone healing and fusion rates [1.7.1]. For this reason, surgeons may limit their use or prefer COX-2 inhibitors like celecoxib, which may have a lower risk [1.3.3, 1.2.5]. Always follow the surgeon's specific instructions regarding NSAIDs.

Muscle Relaxants for Spasms

Muscle spasms are a common and painful issue after spine surgery due to tissue retraction during the procedure [1.9.4].

Common Examples: Cyclobenzaprine (Flexeril), baclofen, and diazepam (Valium) are often prescribed to control these spasms [1.2.2, 1.9.3].
Side Effects: The primary side effects are drowsiness and dizziness, which can increase the risk of falls, especially in older adults [1.6.1, 1.9.1]. Due to these effects, they should be used with caution [1.9.1].

Medications for Nerve Pain (Neuropathic Pain)

Surgery can sometimes irritate spinal nerves, leading to neuropathic pain, often described as burning, tingling, or shooting sensations [1.6.5].

Common Examples: Gabapentin (Neurontin) and pregabalin (Lyrica) are anticonvulsant medications widely used to calm damaged nerves and reduce these symptoms [1.8.1, 1.3.3]. They are often started before surgery and continued post-operatively [1.7.4].
Side Effects: Drowsiness, dizziness, and fatigue are common side effects [1.6.2, 1.6.5].

Essential Supportive Medications

Other medications play a critical role in managing side effects and providing baseline pain control.

Acetaminophen (Tylenol): This is a foundational, non-opioid pain reliever that is effective for mild to moderate pain. It is not an NSAID and does not interfere with bone healing, making it a safe baseline analgesic to use in combination with other medications [1.2.4, 1.3.3].
Stool Softeners and Laxatives: Opioid-induced constipation is an extremely common side effect [1.6.1]. To prevent this, patients are almost always instructed to take a stool softener like docusate (Colace) and/or a gentle laxative like senna (Senokot) as long as they are taking opioids [1.11.1, 1.11.4].

Comparison of Post-Spine Surgery Medications


Medication Type	Primary Use	Common Examples	Key Side Effects	Cautions
Opioids	Severe, acute pain	Morphine, Oxycodone, Hydrocodone [1.2.3]	Drowsiness, constipation, nausea, dependence risk [1.6.5]	Short-term use only; high risk of side effects.
NSAIDs	Inflammation, mild-moderate pain	Ibuprofen, Naproxen, Celecoxib [1.2.3]	Stomach upset, bleeding risk [1.2.4]	May be restricted after fusion surgery [1.7.1].
Muscle Relaxants	Muscle spasms	Cyclobenzaprine, Baclofen [1.9.1]	Drowsiness, dizziness, dry mouth [1.9.3]	High risk of sedation; use with caution in older adults [1.9.1].
Nerve Pain Agents	Burning, tingling, shooting nerve pain	Gabapentin, Pregabalin [1.8.2]	Dizziness, drowsiness, swelling [1.6.5]	Effects are dose-dependent [1.8.3].
Acetaminophen	Mild-moderate pain, fever	Tylenol [1.2.3]	Liver damage in high doses [1.6.4]	Safe baseline analgesic; often combined with opioids [1.2.3].
Stool Softeners	Preventing constipation	Docusate (Colace), Senna (Senokot) [1.11.4]	Mild cramping [1.11.4]	Essential to take while using opioid medications [1.11.1].

Conclusion: A Partnership for Successful Recovery

The medication regimen after spine surgery is a complex and highly individualized plan designed to control pain from multiple angles. The modern multimodal approach enhances comfort, reduces the need for high-dose opioids, and helps patients engage in physical therapy sooner. Open communication with your surgical team about your pain levels and any side effects you experience is essential for a safe and successful recovery. Always follow your doctor's specific instructions for taking, tapering, and stopping medications.

For more information, you can visit this authoritative resource on post-surgical pain management from the Mayo Clinic: https://www.mayoclinic.org/pain-medications/art-20046452

Frequently Asked Questions

Most patients are able to transition off strong narcotic pain medications within a few weeks, with a goal of stopping them by six weeks post-surgery as acute pain resolves [1.6.5, 1.11.3].

Constipation is one of the most common side effects, particularly from opioid medications. Drowsiness, dizziness, and nausea are also frequent [1.6.1, 1.6.5].

Muscle relaxants are prescribed to control painful muscle spasms that can occur due to the muscle dissection and retraction that happens during the surgical procedure [1.9.4].

You must check with your surgeon. Some studies suggest Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen might interfere with bone healing, so their use after a fusion is often restricted or avoided [1.3.4, 1.7.1].

Nerve pain is a burning, tingling, or shooting pain caused by irritated nerves. It is often treated with medications like gabapentin (Neurontin) or pregabalin (Lyrica) [1.6.5, 1.8.1].

Opioids are known to cause significant constipation. Taking a stool softener and/or laxative preventatively is crucial to avoid this uncomfortable and potentially serious side effect [1.11.1, 1.11.4].

A PCA is a pump connected to your IV that allows you to give yourself a small, controlled dose of pain medication (like morphine) by pushing a button. It has safeguards to prevent overdose and is commonly used in the hospital immediately after surgery [1.2.2, 1.2.3].