“Clinical studies indicate that patients who engage as soon as possible in stretching, conditioning exercises that help strengthen back muscles and who participate in low-impact, aerobic exercises like walking, biking or swimming actually return to their normal, daily activities more quickly,” Dr. Liu says.
He suggests patients start the recovery process by walking short distances during the first couple weeks after surgery and then gradually build endurance until they can walk two miles to three miles a day.
“Endoscopic microdiscectomy is the modern approach to repair of herniated discs,” Dr. Liu states. “Because the procedure is minimally invasive, it results in less tissue destruction and, therefore, leaves fewer reasons to restrict a patient’s activities following surgery.”
He refers to a study, published July 2017 in the journal, BMC Musculoskeletal Disorders, which indicated that patients who did not limit their activities during the healing process actually returned to work sooner than those who adhered to specific restrictions.
Endoscopic microdiscectomy is usually performed in the lumbar (lower) region of the back after the failure of more conservative therapeutic measures, such as light exercise, medications, hot or cold compresses, physical therapy, spinal manipulation and epidural injections, to relieve the nerve pain of a herniated disc, according to Dr. Liu.
The procedure involves a surgeon making small cuts in the patient’s back and then, while peering through a lighted endoscope, carefully removing herniated tissue or portions of the offending bone protecting a nerve root.
Spinal discs are gel-filled capsules located between the spine’s bony vertebrae. They prevent vertebrae from rubbing together and help maintain spine flexibility. Herniation can occur due to back injuries, undue spinal stress from heavy lifting or participation in sports and even the normal aging process, when spinal discs dry out and become more brittle, forcing a disc’s outer membrane to crack and its inner core material to ooze out.
A herniated disc may cause pressure on a nerve, resulting in intense pain in the buttocks and hip area and radiating pain, numbness and weakness in a leg – a condition called sciatica.
“Research has shown that microdiscectomy has a success rate as high as 90 percent in alleviating nerve pressure and eliminating pain,” Dr. Liu says. “Patients leave the hospital on the same day or the day following the procedure and can begin recovery immediately.”
Maintaining spinal mobility is a key to the healing process, but Dr. Liu cautions that, during the first couple weeks following surgery, patients should avoid repeatedly bending or twisting, lifting anything heavier than five or six pounds, driving, or performing tasks like lawnmowing, sweeping, shoveling snow or dirt, doing the laundry, running, jogging or other activities that can overly tax back muscles.
However, “it’s important that patients get ‘back in the game’ as quickly as possible,” Dr. Liu says. For that reason, he offers the following post-surgery tips:
· Don’t be a “couch potato.” Move around.
· Stay hydrated. Drink plenty of water.
· Talk to a physical therapist about “gentle exercises” to perform during the early postoperative period. Exercise about a half-dozen times daily for six weeks or more after surgery.
· Start taking short walks around the house or the yard; climb stairs if you can do so without pain.
· Extend your walking distance gradually; engage in other aerobic exercises like riding a stationary bicycle if you have access to one at home or at a local fitness center and can do so without pain.
· Resume driving when you can turn your head and look over your shoulder without pain.
· Return to light work duties when you are able.
“The bottom line: use common sense. Everything in moderation. The ‘no pain, no gain’ adage does not apply,” Dr. Liu says. “Do what’s comfortable. If you try to work through pain, you could be causing yourself more harm than good and risking recurrence of herniation.”
Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. www.atlanticspinecenter.com, www.atlanticspinecenter.nyc
Bio: Kaixuan Liu, MD, Phd, is a board-certified endoscopic spine surgeon who is fellowship-trained in minimally invasive spine surgery at Atlantic Spine Center.