Low-back pain and disc herniations are common causes of activity limitation among people of all ages. If you suffer from chronic back pain and do not respond to rest, anti-inflammatory medications, or epidural injections, a procedure called a microdiscectomy becomes an alternative. This minimally invasive technique uses a muscle-spreading instrument to remove herniated fragments safely while reducing muscle damage and protecting the nerve roots and spinal cord. To sustain the corrective results of a microdiscectomy, you should adhere to a regular exercise program. Certain exercises are aimed at promoting post-operative healing, maintaining flexibility and function, and keeping discomfort at bay. Perform the exercises under the supervision of a medical professional or physical therapist before attempting the program at home.
Trunk Strength and Endurance Program
A gradual increase of back strength and endurance can be achieved through practice of the Sorensen test position. The position requires you to lie prone with your spine and lower extremity joints in neutral position, arms crossed at the chest, and the lower extremities and pelvis supported with the upper trunk unsupported against gravity.
A 2006 study in "BMC Musculoskeletal Disorders" explains that patients must have the isometric back/hip extensor strength to be able to attain the Sorensen position and enough isometric endurance to hold that position for 180 seconds. Begin by holding the position for 20 seconds; increase your time with every practice session.
Mat Exercises
Exercises that require abdominal and lower body movements can also help restore strength and control of the back. Start with a low number of repetitions and a higher rest period between repetitions. With each session, you should increase repetitions and take shorter periods of rest.
Among these types of movements are standing squats, lunges and modified crunches. Another move requires you to kneel on the mat on your hands and knees, raise one arm and extend the opposite leg behind you.
Stretching Exercises
To minimize muscle stiffening and minimize scarring of the nerve root, frequent stretching is necessary. Theodore M. Goldstein, M.D., says that stretching exercises should be done five to six times per day for six to 12 weeks. The most popular stretching exercise requires you to lie down on a padded surface, maximally flex the hips, and gradually extend the knee. Because hyperextension and jerking movements may cause injury, slow and controlled movements are advised to reduce risk of compromising your still-healing back.
Considerations
Prolonged bed rest puts you at risk for muscular degeneration and sub-par results of your procedure. For this reason, early physical activity will be beneficial for you to enjoy maximum long-term function and minimal discomfort in your back. As with any post-operative activity, you should first consult with your physician before pursuing a home exercise plan after microdiscectomy. Often, the doctor will refer you to a certified physical therapist who will educate you on limitations, supervise exercises, and provide you with a safe program to practice in the comfort of home.
References
- UCLA Spine Center; Discectomy/Microdiscectomy
- "BMC Musculoskeletal Disorders"; The Immediate and Long-Term Effects of Exercise and Patient Education on Physical, Functional, and Quality-of-Life Outcome Measures After Single-Level Lumbar Microdiscectomy: A Randomized Controlled Trial Protocol; David M. Selkowitz, et al.; August 2006
- Spine Health: Back Strengthening Exercises After Microdiscectomy Surgery; Theodore B. Goldstein, M.D.; 2000
- Spine Health: Stretching Exercise After Microdiscectomy Surgery; Theodore B. Goldstein, M.D.; 2000
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