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BACKGROUND: Low back pain is a prevalent condition, and the growing number of spinal surgeries underscores the need for comprehensive postoperative telenursing. AIM: This study aimed to evaluate the impact of telenursing on pain and disability in patients following lumbar spine surgery. METHODS: A randomized clinical trial was conducted in 2023 at Panj-e-Azar Hospital in, Iran, with 72 participants who underwent lumbar spine surgery. Participants were randomly assigned to an intervention group (received multimedia educational content and regular follow-up via phone consultations over 8 weeks) and a control group (received routine postoperative care). Pain was measured using the Visual Analog Scale, and disability was assessed using the Oswestry Disability Index at three time points: preintervention, one month and two months postintervention. RESULTS: The mean ages in the intervention and control groups were 48.37 ± 10.39, and 48.88 ± 13.53, respectively. No significant difference was observed between the two groups in terms of demographic variables. At baseline, pain levels were not significantly different between both groups. Following the intervention, the telenursing group showed a significantly greater reduction in pain compared to the control group (p = 0.001), and improvement in disability (p < 0.001) with this difference sustained at the two-month follow-up (p < 0.001). CONCLUSIONS AND CLINICAL IMPLICATION: Telenursing was found to significantly reduce pain and disability in patients after lumbar spine surgery. This intervention provides an accessible, and efficient alternative to traditional in-person and conventional pharmacologic postoperative care, especially in regions with limited healthcare access, with the potential to improve postoperative outcomes and facilitate continuous patient education and follow-up.