Your lumbar vetebrae are located at the base of your spinal column and are designed to support your upper body weight. The discs in between your lumbar vertebrae act as shock absorbers and help reduce some of the impact that is transmitted down your spinal column. These discs can be susceptible to damage due to overuse, poor posture or physical trauma. When a disc ruptures, it can cause extreme pain and hinder movement, affecting every aspect of your life. When this happens, surgery may be necessary to repair the disc or remove the damaged portion. Following surgery, rehabilitation therapy is necessary to help you return to daily life. Recovery from lumbar disc surgery can vary depending on the extent of the surgery, but rehabilitation therapy should progress in four phases. Always consult your physician to determine the correct treatment for you.
Phase 1
In the acute phase of rehabilitation therapy following lumbar disc surgery, it is important to immobilize your spinal column for several days. During this time, pain management and inflammation control are the two priorities. Ice can be used on your lower back to help control surface swelling around the surgery site. Nonsteroidal anti-inflammatory medications may also be given to you to control deep inflammation as well as provide temporary pain relief.
Phase 2
Once the initial swelling has begun to subside, you may be able to begin light range of motion and load-bearing exercises. This can be as simple as sitting up in bed or walking down a hallway. Getting your body moving as soon as your lumbar vertebrae are capable of supporting your body weight is essential in your recovery. Movement in this phase helps the healing process by bringing more nutrient-filled blood into the damaged lumbar tissues and removing any dead cells that have accumulated during the acute phase when you were immobilized.
Phase 3
After the swelling has significantly subsided and you have regained adequate mobility, you may begin physical therapy flexibility exercises. The flexibility exercises help increase flexibility in the muscles and ligaments that were affected by your lumbar disc surgery. Increasing flexibility helps you regain mobility and function. Your physical therapist may begin by stretching your lower back and the muscles around your hips manually at first, then you may progress to more active stretching. Active stretching requires that you stretch yourself under your own muscle strength.
Phase 4
As you regain flexibility and mobility in your lumbar vertebrae, you must also strengthen the muscles that support your lower spine and pelvis. After surgery, these muscles may atrophy. Atrophy is the process in which your skeletal muscles shrink and lose strength as a result of non-use. Your physical therapist may have you perform load-bearing body weight exercises to initially strengthen the muscles of your lumbar region. As you gain strength, you may progress to using external resistance, such as from a resistance band, machine or free weight.
References
- "Essentials of Strength Training and Conditioning"; Thomas R. Baechle and Roger W. Earle; 2000
- "Therapeutic Exercise: Foundations and Techniques (5th edition)"; Carolyn Kisner and Lynn Colby; 2007
