Rehabilitation treatment after spinal surgery. Features of rehabilitation after removal of hernia of the lumbar spine. Principles and main goals of rehabilitation

Spine surgery is one of the most difficult surgical procedures. Therefore, after any type of spinal surgery, serious rehabilitation is required. Typically, these types of treatments are performed in microsurgery.

It does not matter where exactly the intervention was - in the lumbar or cervical, there is still a huge risk of serious complications. But, if you properly undergo rehabilitation after surgery on the spine, then this risk is reduced to zero.

Rehabilitation after spinal surgery: recovery phase

Operations on the cervical or lumbar spine can be performed for a variety of indications. Therefore, the rehabilitation plan after spinal surgery should be selected purely individually.

But, any period of rehabilitation after spinal surgery, as a rule, has 4 main goals:

There are no general methods of rehabilitation after surgery for the lumbar spine (or cervical spine). The doctor himself determines the patient's problems and, on their basis, draws up a plan of postoperative rehabilitation.

The main goal of the attending physician is not just to "remove" painful sensations and completely restore the spine, but also to improve the patient's future life, to make it as convenient and comfortable as possible. Therefore, it is important to take into account the lifestyle of a particular patient.

For example, if a surgical intervention was performed in the cervical region, then after its completion all movements can be extremely painful. The doctor will select the optimal postures for the patient, and also show how to relieve body tension as much as possible.

Rehabilitation after surgery is also based on the nature of the damage to this part of the body. But, quite often all programs for such restoration include the same means. Let's consider them in more detail.

Modern techniques and tools used during the rehabilitation period after spinal surgery

A recovery program after any intervention on the spine (cervical or lumbar) can last from a couple of weeks to several years. The earlier the patient starts the correct period after surgery, the less time it will take.

It is not uncommon for a patient to start a recovery program with a break of several years after surgery. But, they also gave good results, although they took more time.

What rehabilitation programs are used most often

Rehabilitation after surgery on the spine (lumbar or cervical) must necessarily include physiotherapy exercises. This is one of the most harmless, but very effective methods of recovering from many diseases.

Correctly selected exercises will help you quickly get back to normal, relieve pain, and improve the motor functions of the body. They will also improve blood flow, which will help you regain shape even faster.

Physiotherapy

Implies using:

	Cold and warm
	Electric current
	Ultrasound
	Magnetic field
	Sound waves
	Etc.

Physiotherapy has a positive effect on the recovery processes of the body, and also "removes" fatigue, improves mood, and improves blood microcirculation in body tissues and internal organs.

Recovery training on special simulators

If you need to quickly restore the cervical spine, then you can use special simulators. Today there are just a huge number of them and you can easily find the one that is suitable for the rehabilitation of your injury.

Massage

It is used both in the postoperative periods and for various injuries. It has a beneficial effect on the entire body and allows you to quickly cope with pain, discomfort, and improve the blood supply to the body.

Perhaps, no rehabilitation program is carried out without massage and professional massage equipment. Therefore, the choice of a masseur and additional devices must be approached extremely responsibly.

Ergotherapy

After any operations and traumas suffered, a person has to again get used to the outside world, and often change his lifestyle. Therefore, if you need to learn new motor skills or "remember" old ones, doctors recommend taking a course of occupational therapy.

This technique has been known since the Second World War and is actively used in a variety of postoperative rehabilitation programs.

Psychotherapy

Any spinal injury can drastically change his life. Therefore, such patients often require the help of a professional psychotherapist. It will help to regain the lost balance of life, improve the way of thinking and help to adapt to the "new" world.

Rehabilitation after removal of a lumbar intervertebral hernia includes the period after the end of the operation until the spinal functions are fully restored. All actions of the doctor and the patient are aimed at avoiding possible complications of the rehabilitation period and maintaining the function of the spine. After the end of rehabilitation, the muscle corset holding the spine should be fully restored.

The recovery period after surgery for a spinal hernia has 3 distinct stages.

Early

The first 2 weeks after surgery refer to the early period. At this time, the efforts of doctors are aimed at relieving the patient's swelling and discomfort:

For this, intensive medication is used. The patient is prescribed anti-inflammatory and analgesic drugs. The patient is in the inpatient unit.
To prevent possible postoperative complications, orthopedic corsets are required. They reduce the stress on the operated organ and promote faster healing.
Physical therapy is carried out at an early stage. It is necessary to prevent the development of atrophy of the muscles of the lower back. All therapeutic exercises are performed only in the supine position.

Late

The period from 2 to 6 weeks after the intervention is late. At this time, a scar has already formed and the person is already at home. He strictly adheres to all the recommendations given by the doctor at discharge. An indispensable condition for a person's recovery after the intervention is the strict implementation of physiotherapy exercises. It is better if all physical exercises are supervised by a rehabilitation therapist.

The task of the late rehabilitation period is to help the patient adapt to the new capabilities of his body.

After all, some patients could not perform normal movements before the operation and suffered from physical inactivity.

At this stage, patients learn to serve themselves. The patient pulls his leg, but after a few weeks this phenomenon disappears.

Due to the fact that psychological rehabilitation occurs in the late period, some patients may require the help of a psychologist.

Deferred

This period continues throughout a person's life. In the long-term rehabilitation period, a person must strengthen the muscles of the back in order to finally resume the functions of the spine.

The task of this period is to prevent relapse, i.e. re-formation of an intervertebral lumbar hernia.

Postoperative restrictions

Restrictions depend on the time of the rehabilitation period. The first two weeks, the patient is prohibited from:

be in a sitting position;
lift weights (any movements should be smooth and unsharp);
remove the corset (it does not allow twisting movements);
independently prescribe medication for yourself;
independently choose the methods of manual therapy.

At this time, the patient must regulate food.

In the later period, the restrictions are somewhat different:

it is forbidden to fix the body in one position, because at this time only one part of the back is unnecessarily loaded;
you cannot make sudden movements: they are performed only after the muscles are well warmed up;
the time of a person's stay in transport is limited (due to shaking and vibration);
lifting weights over 5 kg is prohibited;
the patient should wear a spine corset for at least 4 hours a day.

After every 4 hours, you should lie down for about 20 minutes. This measure guarantees complete relaxation of the spine.

In the early and late periods, alcoholic beverages and smoking are strictly prohibited.

Rehabilitation methods

The main rehabilitation measures after surgical treatment of the spine take place at home.

Drug therapy

Medication is aimed at reducing pain and inflammation. It is necessary to eliminate the depressive state associated with surgery.

To reduce the intensity of pain, the patient is prescribed anti-inflammatory nonsteroidal drugs. Such means are Nimesil, Aertal, Movalis. With numbness of the limbs, Sirdalud, Midocalm are prescribed.

Physiotherapy

Kinesotherapy (treatment with passive and active movements) is indicated to eliminate functional disorders of the spine and restore its motor activity. Special physical exercises are performed daily in a supine position. There should be a small cushion under the head to cushion movements.

The list of the most effective exercises after hernia repair:

Pulling the legs towards the body while raising the legs.
Pulling the knees to the chest (at the same time, the person should feel some tension in the gluteal region).
Bending the knees and raising them.
Knee reaching to the opposite foot without lifting your shoulders from the bed.
Alternating inclination of the legs to the sides.
Stretching straight arms forward (the pelvis is in a stationary position).
Raising the pelvis several times in a row (this movement must be gentle).
The exercise "Bicycle" is carried out in a supine position. It will be useful for training almost all muscle groups.
Raising the body while lying on the stomach, resting on the hands with the chin. This movement must be done due to the work of the gluteus muscle.

All exercises after surgery are performed smoothly and slowly. It is forbidden to make sudden movements. Only in this case, therapeutic exercises are beneficial.

Physiotherapy

The most useful are the following physiotherapy procedures:

Mud wraps. They help to cope with inflammation and pain in the operated area.
Electrical stimulation. The most frequently used interstitial methods of spinal stimulation using a weak induced current. Helps to normalize metabolic processes in tissues, improve blood circulation and nutrition of nerve fibers.
In the course of quantum therapy, the operated area is exposed to laser and magnetic radiation. This treatment stimulates blood circulation in the affected area of \u200b\u200bthe spine.
Electrophoresis facilitates the transport of medicinal components into the spinal tissue. Moreover, the medicine is delivered where it is needed.
Massage is an effective way to restore the mobility of the spine. Only the most gentle methods of affecting the back are used. Self-massage in the recovery period after surgery is not allowed, so that the patient does not accidentally injure his back.
Hydro procedures have a powerful stimulating effect on the spine. Swimming is useful for the patient.
Acupuncture is aimed at biologically active points of the body using special thin needles. They enhance metabolic processes in the back, relieve pain, irritation and inflammation.

Bandage

A bandage (corset) is a prerequisite for restoring the functionality of the spine.

Wearing a bandage provides the following effects:

Prevention of unnatural mobility of the vertebrae.
Relief of excess pressure on the discs.
Prevention of traumatic injury due to physical impact.

Bandages are:

rigid (they have additional metal clips);
semi-rigid (do not have a large number of additional inserts, which means that they moderately restrict movement);
soft (used to prevent injury to the spine during intense physical exertion).

Diet therapy

For some time after surgery, you should adhere to a special diet. The diet is aimed at the earliest possible restoration of the spine and the fact that the recovery processes are normal. The menu should contain more vitamin products containing essential amino acids.

The diet should also contain more foods that contain calcium. Dairy and lactic acid products meet this requirement. You should enrich your diet with fish, cabbage. All dishes containing agar-agar are useful: jelly and marmalade.

In the early recovery period, it is shown to additionally adhere to the following diet:

refusal of solid food;
the use of low-fat broth;
introduction to the menu of fruit jelly;
the use of rice broths, dried fruit compotes.

This diet helps to avoid increased stress on the digestive tract and to strengthen the body.

It is necessary to follow the drinking regimen to avoid dehydration. The patient needs to drink at least 2 liters of liquid per day.

Prevention of the disease

Herniated disc prevention includes the following:

physical therapy classes;
compliance with the rules of drug treatment of the spine;
adherence to the diet;
introducing foods high in calcium and gelatin into the diet;
quitting smoking and drinking alcohol;
avoidance of hypodynamia (lack of movement);
limitation of weight lifting, correct lifting of objects from the ground;
wearing a corset if necessary to maintain the physiological position of the spine.

Rehabilitation after removal of a hernia of the lumbar spine is a long process. The consequences of surgery will be lifelong. To prevent the development of a new hernia, you need to start every day with light preventive exercises. During the rehabilitation period for up to six months, it is unacceptable to sit down and load the back. It will be necessary to exclude low temperatures and drafts. To make the rehabilitation period more successful, the patient is prescribed physiotherapy, medications, exercise therapy.

After the intervertebral hernia of the lumbar spine is removed, the treatment cannot yet be called complete. Surgical intervention was performed, but the patient may still experience unpleasant symptoms for a long time: deterioration in sensitivity, pain. The nerves are still irritated, the inflammatory process has yet to go away, and therefore a set of actions is needed to restore the patient.

Rehabilitation after surgery involves the following tasks:

Stabilize a person's condition, get rid of restrictions in everyday life;
Restore the normal functioning of the spine;
Eliminate physical stress restrictions;
Neutralize neurological symptoms and pain.

Two main goals: to restore the patient's performance and prevent the development of a new hernia.

The rehabilitation period can take up to a year, depending on how difficult the surgery was. The main procedures are physiotherapy, medication, physiotherapy exercises, just relaxation.

Rules and stages of rehabilitation

Gymnastics, early period

When the patient still cannot sit down in accordance with medical prescriptions, gymnastic exercises should be performed in the supine position, preferably on a special mat:

Bend your legs at the knee joint, stretch your arms to the left and right, respectively. Raise the pelvic region, hold it for about ten seconds. Increase the duration of the rise over time to one minute;
Put your hands one on top of the other on the chest area, bend your legs at the knee joint. Press the chin to the body. Straining the peritoneum, lift the body forward and hold on for ten seconds. To relax. The number of repetitions - increases to 15 depending on the patient's condition;
Smoothly bend the legs at the knee joint and press them to the sternum. Concentrate on stretching the muscles of the buttocks. Again, we smoothly relax the muscles of the buttocks, and do not release our legs into a natural position for up to forty seconds. We carefully straighten them.

Later you can move on to the following exercises:

We get on all fours, in turn raise the directly opposite arm and leg. We hold on from ten seconds to a minute, change a pair of arms and legs;
We lie down on our stomach, put our hands on the back of the head. With one smooth movement, we straighten our arms and raise the upper part of the body. Concentrate on the lumbar deflection. We do not tear our feet off the rug;
We lie on our stomach, put our palms under the chin. Raise the leg slightly, keeping it straight, gently lower it back. We repeat the movement with the other leg. Make sure that the pelvic region remains motionless.

Rehabilitation measures after surgery on the spine begin immediately. The rehabilitation program is selected only individually: taking into account the type and complexity of the surgical procedures performed, the patient's weight and age, a history of concomitant diseases. With careful observance of all medical recommendations and prescriptions, the operated person is recovering at a dynamic pace and at the end of postoperative treatment returns to a full life.

If stabilization of the lumbar spine is used, then rehabilitation becomes even more urgent.

However, with inaccurate adherence to the rehabilitation program prescribed by the doctor or in the complete absence of an extremely necessary special therapeutic and physical regimen, the risk of developing certain complications increases many times over, and recovery moves at a very slow pace and does not occur on time.

Dear patients, since postoperative therapy plays no less significant role in the treatment of the spine than the operation itself, we devote this article to the main issues of rehabilitation after spinal surgery. The material below is for informational purposes only! You should understand that the development of rehabilitation and health-improving measures, their correction, extension or cancellation should be dealt with exclusively by a specialist who is personally familiar with your clinical case.

Rehabilitation goals after spine surgery

Surgical interventions in one of the most important parts of the musculoskeletal system are prescribed in the most extreme cases: if conservative therapy does not help or has no therapeutic value, as well as in the presence of a threat of spinal cord injury, the risk of damage to nerve endings and associated complications. That is, an operation in such situations is a vital measure.

Surgery is most often used when diagnosing a hernia of the spine and with other consequences of osteochondrosis, fractures and various injuries. By the way, in about 50% of cases, protrusions and hernias occur at the intervertebral levels of the lumbar spine, therefore, it is in this area that most surgical treatment is performed. This can be microdiscectomy, endoscopic surgery, some kind of nucleoplasty, for example, laser or cold plasma vaporization, radiofrequency plasty of the nucleus pulposus, etc.

Often, specialists use special metal clips during a certain operational process. Operations with metal structures provide for reliable stabilization of the operated section. Sometimes artificial implants are implanted if a particular biological element cannot be restored. Intervertebral discs on the cervical spine are mainly subject to replacement; interventions to remove discs with subsequent implantation on the remaining segments of the spinal axis are less common. There are also operations, when the vertebrae of the thoracic region, which have collapsed against the background of osteoporosis, trauma or tumor, are filled with bone cement.

That is, as you understand, there are many types of surgical assistance, and after each of them, even the most minimally invasive, a person must definitely receive high-quality and full-fledged rehabilitation. Otherwise, complications (paralysis, infection, etc.), disability, possibly even death. The final result of your physical recovery directly depends on what kind of rehabilitation you will have. In general, the recovery period after the intervention on the spine with spondylolisthesis or any other disease involves the following goals:

reliable prevention of all possible postoperative complications;
prevention of early and distant relapses of the same pathology;
elimination of painful phenomena and edema;
the return of self-service skills;
correct and productive restoration of the functions of the operated department;
strengthening and increasing the endurance of the ligamentous-muscular system;
teaching correct postures, correcting posture and gait;
normalization of the entire musculoskeletal system;
full or maximum possible restoration of the lost quality of life.

It is important to understand that a fundamental role is played by physical rehabilitation in full, which includes exercise therapy for each individual patient and a certain set of physiotherapeutic procedures. It is important to understand that high-tech operational assistance can be provided to you at a first-class level, but if it is not followed by comprehensive physical rehabilitation, then you can not count on a successful outcome of such treatment.

Recovery Techniques After Spine Surgery

So, as we said earlier, rehabilitation begins immediately, even after an operation to remove a hernia of the lumbar spine, even after using any other technology. We emphasize that manipulations with the use of metal structures on the cervical spine and other parts of the spine are the most traumatic, requiring a longer immobilization of the patient and longer periods of recovery.

One more point, many procedures are performed due to pinching of nerve endings, after decompression they still need to recover, so the neurological symptoms may persist for a short period. It should be understood that nerve tissues have been under pressure for a long time during the course of the disease and now, after the removal of the damaging factor, the inflamed roots that have been released will take some time to return to normal. In addition, pain in the initial stages is a natural physiological reaction of the body associated with intraoperative trauma to soft tissues.

Further, we suggest that you familiarize yourself with the existing methods of rehabilitation benefits offered to a patient who underwent surgery on the ridge. They will facilitate and significantly accelerate the recovery process.

Drug treatment

After the intervention, everyone, without exception, is prescribed a course of antibiotic therapy, which will prevent the appearance of an infectious-purulent focus in the vertebral and paravertebral structures. Along with antibiotics, the patient is recommended anti-inflammatory and pain relieving medications to relieve swelling, inflammation and pain at the site of the manipulation. To prevent thrombus formation, drugs with anticoagulant properties are prescribed. Additionally, they can prescribe a vitamin-mineral complex and drugs to strengthen bone-cartilaginous structures, for example, medicines based on calcium, glucosamine and chondroitin.

Physiotherapy

The patient is recommended a complex of therapeutic exercises, individually selected by the surgeon in conjunction with the rehabilitation therapist. These measures are aimed at preventing congestion, correct development and training of the muscles of the back, neck, abdominal girdle, lower and upper limbs. In addition to the usual physical activities, special simulators for mechanotherapy are also used.

A highly qualified specialist in exercise therapy instructs and supervises the correctness of the implementation of restorative physical education. Classes begin in the hospital, after discharge you will need to continue to study in the rehabilitation department of the clinic, in a specialized center for the orthopedic profile or at home. The latter option is highly undesirable, since any inaccuracy in movements is fraught with serious damage to the operated part of the back.

Physical activity in the early period is minimal, while at first, if the operation was difficult, the rehabilitation doctor can help with his hands to make movements with various parts of the body, for example, head turns, leg flexion-extension, etc. As the patient's condition improves perform assigned tasks independently, of course, under the close supervision of an instructor. The load is increased gradually and with extreme caution, avoiding the increase in pain.

Exercises for the first time are done in bed - in the supine position and stomach. A little later, if the doctor deems it necessary, tasks are included that will need to be performed while standing or on all fours. Sitting for about 2 weeks or more is not allowed in most cases. Torso bends are prohibited until complete recovery. In the later stages, a visit to the pool is shown, since swimming is the best way to help the spine to get stronger in the most gentle way. After the completion of the rehabilitation course, remedial gymnastics is performed regularly throughout life.

Important! Physiotherapy is one of the most effective methods of physical recovery, which is responsible for the normalization of muscle tone and elasticity, metabolic processes and blood circulation, the development of flexibility and mobility of the musculoskeletal frame, stabilization of the activity of internal organs and systems. In general, all this will allow you to quickly return to work capacity and avoid dangerous consequences.

Physiotherapy procedures

Physiotherapy is another main and integral part of the rehabilitation program, which is based on:

electromyostimulation;
iontophoresis;
heat and magnetic therapy;
diadynamic therapy;
laser therapy;
neurostimulation.

The advantages of all of the above tactics are local selective action and the ability to produce a therapeutic effect on deep tissues. These methods have an immunostimulating, anti-inflammatory, analgesic effect. In addition, physiotherapy activates local blood circulation, lymph drainage and metabolism, optimizing the delivery of oxygen and important nutrients to problem tissues, due to which the operated area heals faster and the surgical wound heals in a short time. In the middle or at the end of rehabilitation, sessions of massage, manual therapy, and acupuncture are prescribed.

Orthopedic corsets

Wearing orthopedic braces is an important requirement for patients who have undergone a surgical procedure on the spine. Their use will ensure successful rehabilitation by unloading and protecting the weak section from possible damage at the time of physical activity. But you need to wear immobilization devices strictly according to the time set by the doctor (no longer), usually 3-6 hours a day, since too long immobilization of a specific area can provoke muscle atrophy. The duration of the use of corsets is different for all people, it all depends on the severity of the surgical session. After major interventions, it may be necessary to use such a product for at least 6 months, and after simple operations - on average 1-2 months.

Rehabilitation after removal of the protrusion

Slowly getting up and walking after removing the hernia, as the reviews show, is allowed early enough, often already the next day. As for the main rehabilitation measures, we have already talked about them, but only the attending physician should recommend the mode of physical activity, medication and physiotherapy. There is no single postoperative treatment regimen that is equally suitable for everyone. How long, specifically days, further recovery will last, is also decided by a specialist, based on clinical data and individual criteria of the ward. Therefore, for our part, we can only voice the main restrictions at the time of rehabilitation, which must be impeccably observed by a patient who has had an intervertebral hernia removed. In the postoperative stages, it is strictly prohibited:

sit, adhere to sitting restrictions for at least 3 weeks, in some cases 6 weeks;
linger in a sitting position for a long time when it will be allowed to sit;
walking, stooping or arching your back;
lift weights weighing more than 3 kg;
bend over, rotate the body, make sharp turns of the body;
run, jump, swing legs, pull up;
to force the intensity and duration of any type of exercise therapy;
arbitrarily cancel exercises or introduce new ones;
deal with if a pain syndrome has arisen or discomfort has intensified (you urgently need to notify the doctor!)
getting behind the wheel of a car, this prohibition is lifted only by a doctor.

When the disc is completely removed, an implant is often placed in the freed intervertebral cavity, fastening the vertebral pair with a stabilizing system. Titanium bolts are inserted into the spine to firmly fix the transverse stabilizer, which in turn will be responsible for the correct position of the adjacent bone bodies relative to the spinal axis. The bolts are screwed through the bow into the vertebral bodies. Modern metal construction is usually represented by dynamic bolts, which allows maintaining the mobility of the operated level as close to normal as possible. However, these patients will most likely need to spend about a week in bed. Then you will need to work very hard under the supervision of a rehabilitation therapist, flawlessly doing everything he says. Then the adaptation to the implanted implant will be successful, and you will gradually return to full activity, even be able to play sports.

Where to undergo rehabilitation after surgery

So, you had back surgery, you received early inpatient treatment, and you were discharged. By the way, after some surgical interventions, in particular after a simple minimally invasive procedure, they are released from the hospital early enough, sometimes even on the same day when the main surgical care was provided. On discharge, each patient receives top recommendations from a doctor. You can attend outpatient procedures and exercise therapy classes at the place of residence, although they are provided in domestic medical institutions at a below average level, so the prognosis for a successful outcome is 50/50. In this regard, it is better to formalize in a good rehabilitation center, which will provide you with a more literate, and, therefore, quick and uncomplicated recovery from negative phenomena. Then you will need to visit a sanatorium, about 4-6 months after the operation, in the future it is necessary to be treated in a sanatorium-resort conditions, ideally 2 times a year, in extreme cases - once a year.

Remember that incompetent manipulations with the spine can cost you too much and can lead to disability, often to an irreversible loss of motor potential not only of the back, but also of the legs or arms. We would like to warn you that today too many private clinics in Russia began to specialize in Bubnovsky's methods, and not professionally enough. Therefore, we would not advise you not to risk your health by contacting such centers, especially since such a tactic after an intervention on the spinal column is not your option. So where to go so that it is not too expensive for the price and receive truly highly specialized medical care?

Clinical institutions of the Czech Republic are universally famous, even if they are of a surgical orientation, even of a rehabilitation profile. All medical institutions in the Czech Republic, whether it is a hospital or a sanatorium, are equipped with modern high-tech equipment of the most advanced models, staffed only by selected medical personnel with a high qualification degree and rich practical experience. The level of services provided - from surgery to rehabilitation - is no worse here than in Israel or Germany. At the same time, prices for treatment programs in the Czech Republic are an order of magnitude lower than those of an Israeli or German medical service, by about 2-2.5 times! Take note, this is the only European country that is ideal for our medical tourists. In the Czech Republic, they treat according to all international standards and the cost is quite adequate.

Rehabilitation period after spinal surgery

The gradation of the main stages and the timing of the achievement of certain recovery tasks may be different. Let's try to roughly orientate how long rehabilitation lasts after common operations on the spine.

How long is the estimated recovery period after a microscope or endoscope discectomy? After both interventions, in which the intervertebral disc was preserved, it was approximately the same - on average 2-2.5 months.
After the fusion procedure, when a bone fragment is transplanted and transpedicular fixation, it will be necessary to recover from 3 months or more. Detailed rehabilitation is described on many resources. But keep in mind that this surgery technique implies a complex intervention, after which the restorative measures must be performed flawlessly under close medical supervision, and not under the guidance of online advice!
If vertebroplasty was done, reviews indicate that the further course of special postoperative therapy is usually 2 months. But even such a gentle and fast-acting surgical process, performed for compression fractures, may require an extension of the healing period, especially in the elderly.
After the procedures of vaporization of the disc with a laser or cold plasma, for a high-quality restoration of the functionality of the spine, you need to regularly practice for about 1-1.5 months. However, practical observations show that some patients need to be rehabilitated up to 3 months.
After the installation of the intervertebral disc prosthesis, in order to get used to the new artificial organ and achieve full range of motion, the main medical program should be strictly adhered to for 3-6 months.

Of course, it is very important for you that the recovery process goes smoothly, easily and without any unpleasant postoperative excesses in the form of complications. For it to be so, which we sincerely wish you, approach your rehabilitation with maximum responsibility. Do not neglect the services of professional rehabilitation therapists and follow absolutely all medical recommendations, and in case of any unpleasant sensations (pain, paresthesia, stiffness, etc.), immediately notify the doctor about it!

Bardukova Elena Anatolievna
neurologist, homeopath, work experience 23 years
✔ Article reviewed by a doctor

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Rehabilitation after removing a lumbar hernia is a rather long process. Herniated disc occurs mainly in people after 30 years. Hernia of the lumbar spine is much more common than thoracic or cervical. Surgery to treat this disease is not often required. But, nevertheless, doctors prescribe this procedure to their patients. Therefore, it is very important to know how the rehabilitation proceeds after removal of a hernia of the lumbar spine.

The rehabilitation period includes exercise therapy - therapeutic exercises, physiotherapy procedures and medication. Also, the rehabilitation course includes three restorative stages, which will be discussed in detail.

Rehabilitation tasks

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After the operation, the patient may have discomfort for a long time: decreased sensitivity, inflammation, pain. The rehabilitation period must return to return the patient's previous lifestyle and includes:

normalization of the spine;
elimination of pain syndrome;
restoration of the integrity of the musculoskeletal system;
strengthening the muscle corset;
restoration of the whole body and return to the previous way of life.

Physiotherapy

There are many methods of physiotherapy. They can be prescribed by the attending physician during any recovery period. The purpose of the procedures is to eliminate pain, swelling, muscle spasms, and normalize blood circulation.

Drug treatment

Immediately after the operation, pain may appear due to residual disc herniation. To cope with pain and restore the body, it is recommended to take various medications.

Good follow-up article:

Massage

The massage is usually given two months after discharge from the clinic. The procedures should be gentle and improve blood flow to the back tissues. It will be especially useful for limb numbness and weakness.

Sanatorium treatment

A couple of months after the surgical treatment, the patient can go to a mud or mineral sanatorium. This is considered the best option for a complete recovery after surgery. The following procedures are carried out at the resort:

With proper rehabilitation, carried out for at least six months, it fully retains the effect of the operation and returns the person to the previous way of life.

Diet

Proper nutrition after surgery is essential. In the very first days after the procedure, food should contain a lot of fiber and be easily absorbed by the body. Intestinal problems should not be allowed so that there is no additional load on the abdominal muscles.

Healing baths

Water procedures

This type of restorative treatment has a general relaxing effect on the body. Remember that you cannot stay in the water for a long time after the operation (no more than half an hour).

Short drenching with cold water is also very beneficial, as it improves the functioning of the muscles and nerves.

Acupuncture

This method is based on the activation of biologically active points using thin needles. Acupuncture can be used one month after the operation to remove the hernia of the spine, when everything has healed. It is not recommended to use this method with procedures that have an electrical effect, such as electrophoresis.

Use of heat and cold

Exposure to various temperatures on the body can be included in the rehabilitation treatment program.

The importance of remedial gymnastics

Website readers' stories: How I helped my mother to heal her joints. My mother is 79, she worked as a literature teacher all her life. When she started having the first problems with her back and joints, she simply hid them from me so that I would not spend on medications. Mom tried to be treated only with decoctions from sunflower root, which, of course, did not help. And when the pain became unbearable, she borrowed from a neighbor and bought painkillers at the pharmacy. When a neighbor told me about this, at first I got a little angry with my mother - I asked for leave from work and immediately came to her by taxi. The next day, I made an appointment with my mother to see a rheumatologist at a paid clinic, despite her requests not to spend money. The doctor diagnosed arthritis and osteochondrosis. He prescribed treatment, but my mother immediately protested that it was too expensive. Then the doctor got into the position and suggested an alternative option - home exercise and a plant-based drug. This was cheaper than chondroprotective injections and did not even cause possible side effects. She started using the drug and doing physical therapy. When I stopped by her a couple of days later, I found her in the garden. She was tying up tomatoes, and, apparently, has already managed to do a lot. She greeted me with a smile. I understood: the drug and physical education helped, the pain and swelling were gone. " Read more »

This type of rehabilitation should be performed as soon as possible after surgery. The course of exercise therapy is selected individually by the attending physician. Physiotherapy is aimed at strengthening the muscle corset, improving blood circulation, restoring mobility and returning to a previous lifestyle.

When performing restorative gymnastics, you must follow some rules:

movements should be smooth, without abrupt actions;
if pain and discomfort appears, then the exercises should be stopped;
with constant pain that appears during exercise therapy, you should consult a doctor.

Exercise therapy should become a habit and become a part of the patient's life.You should do it constantly, or better - daily. Otherwise, a relapse will appear, which will lead to a new operation and new complications.

In the first 5-10 days after the operation, you can practice walking in limited quantities with rest breaks.

Exercise therapy for hernia of the spine

Exercise therapy in the early period

While the patient is forbidden to sit down, then gymnastics should be performed lying on a special rug.

Lie on your back, bend your knees, and stretch your arms in both directions. Next, you need to raise the pelvis up and freeze in this position for 10-15 seconds. Over time, the duration of holding the pelvic region is increased to 1 minute. The number of repetitions is 10-15 times.
Put your arms crosswise on your chest, legs should be bent at the knees. Tilt your head down, press your chin to your chest as much as possible. Straining the press, lift the body forward and freeze for 10 seconds. Then return to the starting position and relax the body. Repeat 10-15 times.
Lying on your back, slowly bend your knees and press them to your chest. Tighten the gluteal muscles. Slowly relax the muscles of the buttocks, but leave the legs in the same position for 30 seconds and then smoothly straighten them.
Lie on your stomach, place your hands under the chin. Then slowly raise the straightened leg up, low and just as smoothly lower. In this case, the pelvic region should be motionless.

In the early period of rehabilitation, physical activity should be limited. The course of remedial gymnastics should ideally be selected by a competent specialist. It is undesirable to do the exercises yourself.

Exercise therapy in the late period

This set of exercises is able to keep the spine and back muscles in good shape.

Pushups. This exercise should be done with your back straight. When lowering the body, the air must be inhaled, and when rising, exhaled. Repeat 15 times.
Exercise - Bicycle. Lie on your back, raise your legs and perform rotational movements, simulating cycling. You need to start from 10 repetitions and eventually increase to 150. The load should be regulated by increasing the leg lift.
Squats. To perform this exercise, you need to imagine that you are sitting on a chair. Deep squats are prohibited after lower back surgery. The number of squats is 10-15 times.

When doing these exercises in the morning, the spine will be ready for daily various loads. Also be aware of other doctor's recommendations.

Be sure to read a good article:

Video: real feedback on the operation - vaporization of the intervertebral disc using cold plasma

Answers on questions

Website readers' stories: “I love working at my beloved dacha. Sometimes you work so hard that it is impossible to straighten your back and pain appears in the lower back - even if you cry. I don’t take painkillers because my stomach is sick. A doctor I know advised to pay attention to the newest remedy, which is specially produced only for the domestic foreign market. I ordered and applied it before bed. I felt a slight burning sensation, but then warmth spread throughout my lower back. 2 days after the use of wild back pain was almost gone, and after 2 more weeks I forgot the feeling that your back aches wildly. 4 (!) Months have passed, and the result is stable - it means that the product really works. " Read the article "

Pregnancy planning and surgery

In order to prevent a recurrence of the attack, it is not recommended to plan a pregnancy in the first year after surgery to remove a hernia on the spine. The spine and back muscles should get stronger.

Will disability be granted?

In many cases, disability is not given. The exception is the fact that after complete rehabilitation of the patient, his condition did not improve. Then a special commission is convened to decide on the assignment of the group. In general, disabled status is granted temporarily, up to 6 months. Only the attending physician will be able to give an exact answer whether it is worth counting on a disabled group at all.

How much is sick leave after surgery?

For patients without complications and with successful rehabilitation, the sick leave ends immediately after the end of recovery. This is approximately 2-3 months, after which the patient can go to work.

How long is the rehabilitation course?

In many cases, it lasts no more than three months, after which a person can return to their previous way of life.

Rehabilitation after removal of a hernia of the lumbar spine in the main cases lasts no more than 3 months

What should you tell your doctor after your surgery?

After about a week, the suture is removed. After 10 days, the incision, the length of which is from 2 to 5 cm, heals well, swelling and inflammation decreases. If the patient's condition is good, then after removing the stitches, the patient is discharged from the hospital.

Some patients may be lazy and not follow all of the doctor's orders, including the exercise therapy. If, before the scheduled examination, which happens after 1.5 and 3 months, the patient has the following symptoms, then it is necessary to come to the doctor's appointment as soon as possible:

there are problems with urination;
numbness in the limbs;
there was pain in the legs, arms, abdomen and back;
increased body temperature;
spasms appear in the muscles of the back;
the wound at the incision site became inflamed.

How to wash after surgery?

It is allowed to take a steam bath and a sauna only six months after the operation, and take a warm shower already 3 days after the surgery.

What if there is a relapse?

If a second attack appears as a result of various factors, be it the patient's negligence towards recommendations or the appearance of complications, then another operation is prescribed. With it, there is a possibility of complete removal of the intervertebral discs and their replacement with implants.

How to prevent relapse?

During the first year after surgery, the risk of hernia recurrence is very high. The physical activity that the patient came to 2-3 months after the operation, including therapeutic exercises, must be maintained for at least 12 months.

If you do not engage in exercise therapy, then adhesions may occur, due to which you will have to lie down on the operating table again. Strong adhesions in 3.5% of all cases can literally brick up the nerve roots in the spinal cord.

Real reviews of patients who underwent surgery to remove a hernia in the spine

According to statistics, after a hernia operation in the lumbar spine, pain may appear in one of the legs, as well as at the incision site. The sensitivity of the lower extremities (especially the feet) may also decrease. if pain syndromes did not appear due to complications, then they will go away on their own in 14 days. In this case, NSAIDs and stronger pain medications will help.

Andrey, 45 years old

In the fall, I had the first symptoms of a hernia, and after 2 months I began to drag my leg very much, it was very painful, starting from the buttocks and ending with the lower leg. Despite the abundant intake of painkillers and injections, he slept for a maximum of one hour a day. I went to see a doctor - they prescribed an MRI.

After examination, one large hernia was identified. They offered to have an operation. A month later, he lay down on the operating table, removed a 10 mm L5-S1 hernia. We also installed transpedicular spinal fixation (TPF). The condition after the operation was good, the pain in the leg immediately disappeared. I had to not sit down for 3 months and wear a corset. A month later, he got behind the wheel of a car. Sometimes there are minor back pains. Numbness in the leg appears only when there is pain in the spine.

Mikhail, 47 years old

I had a 12 mm hernia with compression of the nerve roots. When I was diagnosed with her, I began to be treated by a chiropractor. Of course, after each session I felt better, but with subsequent bouts of pain, the sessions began to last much longer.

I had this treatment for 2 years. Then there was a very strong attack that I could not even get up. A week later I had an operation to remove the hernia. The pain disappeared the next day. At the hospital, I was prescribed a course of exercise therapy so that I could study at home. Tips from my experience:

If you have recurring pain in the lumbar region, make an appointment and have an MRI scan. Do not listen to a therapist who will refer to osteochondrosis and stuff you with pills.
If a hernia is found in the picture, do not waste time, but make an appointment with a neurosurgeon.
If conservative treatment (usually no more than 10 days, which includes droppers, pills, injections) does not become easier, then immediately do the operation. Because if the nerve roots die off, then that's it, the end.
Be sure to walk more after the operation to restore the cartilaginous tissue between the vertebrae.
After 2 months, as the fibrous ring heals, it is necessary to start doing exercises to restore the spine, not earlier.

The main thing is not to despair - fate sends us exactly those tests that we can pass!

Maria, 38 years old

I have a 12 mm intervertebral hernia. They could not find her for a long time, they prescribed many different tests and treatment regimens, but it only got worse. In the end, I went to an MRI, where I was diagnosed with a hernia.

An urgent operation was prescribed, since the hernia began to prolapse and squeeze in the coccyx area - the so-called cauda equina. Everyone began to dissuade me, because there could be serious complications. But I made up my mind, because the pains were very terrible. The operation was performed in the city of Perm. The neurosurgeon was very surprised how I could live so much with this pain. Removal of the hernia was successful. Three days later she was able to walk, and a week later she was discharged from the clinic.

I walked a lot - my legs were no longer limping, the numbness was gone, there was no pain at all. In two months I could already sit and went to work. I took calcium for three months, if pain syndromes occur, I tried not to pay attention to them. A few years later, my husband also had the same hernia - we ran to this surgeon for an operation. They put me on my feet and my husband works again. Sometimes he has pains, but exercise therapy helps to cope with them. If anyone is interested, the name of the neurosurgeon is Alexander Mikhailovich Engaus.

Jeanne, 40 years old

I am 40 years old, found two large spinal hernias of 0.55 mm. She decided to do the operation at the Wooridul clinic, Seoul, South Korea. The examination took place in one day, the next day they underwent surgery using an endoscope.

The anesthesia is very good, I left him immediately. Four hours after the operation, they put on a support corset and were allowed to walk. I was, to put it mildly, in great surprise that there was no more acute pain, moreover, immediately after the procedure. A week later I was discharged and given a lot of drugs. She took off the corset after one month and started doing exercise therapy to strengthen the muscle corset. It is strongly discouraged to apply prolonged pressure on the lower back, such as sitting down.

Before the surgery, my lower back hurt, my entire left leg went numb. And now all these symptoms have disappeared, I can stand in line for many hours (and only a month has passed since the operation). What can I tell you - choose not a cheap clinic, but a quality one.

Marat, 37 years old

I am 37 years old, pain in the spine has been exhausting me for ten years. I did the MRI myself - and a large hernia of 0.70 mm was found. I turned to many doctors - I just threw away money in vain. I went to a chiropractor, he, of course, relieved acute pains, he did a therapeutic massage, set the vertebrae.

Over the years, the pain intensified, the pain began to radiate to the left leg. There were some minor problems with potency. It so happened that the manual operator fell ill. He suggested that I turn to another specialist, who immediately sent me to stretch the spine. Remember, in no case do a hernia extraction! After the procedure, I could not get out of bed. None of the drugs helped soothe the pain. Immediately after this ill-fated traction, I went to surgery. After that I could only get up on the second day. Of course, my movements became constrained, I was afraid to bend over, although the pains all disappeared. They were forbidden to sit for six months, so I either stand or lie down. I don't drink painkillers at all, the numbness in my legs is gone.

Recommendations, which they gave me after the operation: regularly do therapeutic exercises, eat right to avoid constipation. It is forbidden to sit, hypothermia and take a hot bath, too, - otherwise a hernia will come out in the same place. Avoid soda.

I talked with patients to whom this doctor performed this operation - almost everyone had no problems for many years, the main thing is to follow all the doctor's recommendations. True, there was one patient who underwent 13 operations in 11 years, and all because he simply did not follow the recommendations of a specialist. Therefore, think about whether it is worth looking for any ways in alternative medicine than to have an operation and later follow all the doctor's recommendations in order to prevent hernia recurrence.

Marina, 30 years old

I am 30 years old. I found out that I have 2 hernias in L4-L5. For a whole year I was treated in different ways - manual therapy, massages, injections, paraffin therapy, laser treatment and others. All this is nonsense! The hernia even increased in size by 3 mm!

I decided to have an operation, because I could not even walk normally - I was all twisted to one side. The hernia cut went fine. The doctor even showed what an intervertebral hernia looks like - wiry pink meat ...

Pain sometimes occurs after the operation. Rehabilitation is very important! She began to sit down only 3 months after surgery. I do exercise therapy only lying down. Then you need to go to swim in the pool, eat jelly products, for example, jellied meat. All health and believe in yourself! The operation is not such a terrible thing, believe me!

Let's summarize. Active rehabilitation after the removal of a herniated disc is a very important and long process that should be treated responsibly. This will prevent recurrence of the disease and restore the patient's previous lifestyle.

Be healthy!

Excellent continuing articles:

Conclusions and conclusions

What are our Russian doctors silent about? Why, in 90% of cases, drug treatment has only a temporary effect?

Unfortunately, most of the remedies "curing" diseases of the back and joints, which are advertised on TV and sold in pharmacies, are solid divorce.

At first, it may seem that creams and ointments help, BUT in fact they only TEMPORARILY relieve the symptoms of the disease.

In simple words, you buy a regular pain reliever, and the disease continues to develop, turning into more severe stage... Common pain can be a symptom of more serious medical conditions:

dystrophy of muscle tissue in the buttocks, thigh and lower leg;
pinching of the sciatic nerve;
development of arthritis, arthrosis and related diseases;
acute and sharp pain - lumbago, which lead to chronic sciatica;
cauda equina syndrome, which leads to paralysis of the legs;
impotence and infertility.

How to be? - you ask. We have studied a huge amount of materials and, most importantly, tested in practice most of the remedies for the treatment of diseases of the spine and joints. So, it turned out that the only new remedy which does not remove symptoms, but truly cures - this is a medicine that is not sold in pharmacies or advertised on TV! Lest you think that another "miracle cure" is being drunk on you, we will not tell you what an effective drug it is. If you are interested, you can read all the information about it yourself. Here is the link" .

List of used literature

Evgeny Cherepanov "School" Healthy Spine ", 2012;
Alexey Ivanchev "Spine. Health Secrets", 2014;
Victoria Karpukhina "Spine health. Popov, Bubnovsky systems and other methods of healing", 2014;
Yuri Glavchev "The spine is a provocateur of all diseases", 2014;
Stephen Ripple "Living without back pain. How to heal the spine and improve overall well-being", 2013;
Gally R.L., Speight D.W., Simon R.R. "Urgent orthopedics. Spine.", 1995