According to the Agency for Healthcare Research and Quality, about 500,000 lower back surgeries take place in the United States each year. Adding procedures on the middle and upper spine to this tally brings the total number of spine surgeries closer to 1 million annually.
“A considerable number of people opt for spine surgery each year to help tackle their chronic or acute back and neck problems,” says Yalamanchili, a physical therapist and Director of Rehabilitation at Atlantic Spine.
“Whether their procedure was a discectomy, laminectomy, fusion or another type of spine surgery, most of these patients would benefit from physical therapy afterwards to help them fully regain their mobility and ease their transition back to everyday activities,” he adds.
What PT involves
The biggest goals of postoperative PT are to help you manage any lingering pain and limit inflammation that can prolong that discomfort. On a broad level, then, PT aims to strengthen and stabilize your back and neck muscles by teaching you to move in safe ways and boost muscle function, Yalamanchili says.
“You may even start PT during your hospital stay, learning the safest ways to get out of bed or a chair, get dressed, or eventually lift and carry things,” he explains.
Once you’ve been cleared for a full course of postoperative PT – which typically occurs 2 to 6 weeks after surgery – your physical therapist will perform a complete evaluation to decide exactly what you need to move forward. This evaluation will include taking a medical history, particularly of any surgery-related complications; a postural assessment that looks at your spine while standing and sitting; range-of-motion and flexibility tests; and strength assessments of back, abdomen, hips and thighs.
Then, the real work starts. A regular schedule of PT appointments that continue for weeks (months) will include individualized exercises – both stationary and aerobic – based on your type of spine surgery and movements deemed to most benefit your back and neck.
Your physical therapist may also ease any lingering pain by applying ice to key spots; moving you into certain positions; and using special electrical devices such as TENS (transcutaneous electrical nerve stimulation) units to send stimulating pulses across skin and nerves. The goal of this phase is to overcome the fear of moving safely.
“Ultimately, PT will teach you exercises and movements that are best for you by using weights, machines and your body’s own mechanics,” Yalamanchili says. “These exercises don’t just promote flexibility and strength, but help you regain energy while avoiding re-injury.”
Reaping the benefits
Research shows that those who exercise after back surgery end up with better outcomes than those who don’t, Yalamanchili notes. “It’s clear that postoperative PT is vital to help you get to a place of comfort and strength and maximize your surgery’s goals as well,” he says.
During the first 6-8 weeks it is important to apply careful loading to the healing tissues to make them strong and prevent re-injury. But it’s up to you if you want to reap the full benefits of PT, since PT isn’t always easy. “PT is a place to work hard and sometimes push through discomfort and exhaustion,” Yalamanchili says.
“Treat your physical therapist as a much-needed coach who wants to see you at your best,” he adds. “Complete recovery from spine surgery depends on you investing in your outcome by working both in PT sessions and at home.”
Sridhar Yalamanchili, PT, MSPT Cert.MDT treats a variety of spinal and upper and lower body musculoskeletal disorders as lead clinician in outpatient physical therapy at the Atlantic Spine Center. www.painandrehab.com