Rehabilitation after spine surgery
In many cases, changes to the spine are so advanced that they require surgical intervention. It is important to remember that physiotheraputical proceedings do not end with surgery. On the contrary, physiotherapy will allow us to regain full strength faster. Adequate rehabilitation has a crucial meaning for sustaining the long-term results of a surgical procedure.
The guidelines described in this article for patients after surgical procedures are very general, the final decision on rehabilitation proceedings must be made by your doctor and physiotherapist. Do not perform any exercises which were not recommended by the person supervising your recovery. Selection of the techniques, types, and order of exercise depends on your condition, type of surgical procedure, and recovery pace.
The majority of surgical procedures are successful: pain is decreased and full mobility/activity is restored. A significant improvement is felt even in the moment waking up from the anaesthesia, but complex rehabilitation and invested effort will result in sustaining this improvement. It is important to start rehabilitation as soon as possible, and perform simple activities. However, we must keep in mind spine protection: increase your activity slowly, but systematically. Depending on the surgical technique, the patient spends 1-2 days in hospital for minimally invasive procedures, and even several weeks in more serious operations.
If there is no contraindication (after surgical pain), and the doctor has no objections, the patient might try to sit even the second day following the procedure. Your physiotherapist should instruct you how to do it safely and without pain. It is important to sit and move, especially in patients suffering from varicose veins, as staying in a lying position can cause blood clots.
When you are released from the hospital, you will get 2 copies of your information card, medical certification for sick leave, and prescriptions for all necessary medication (including painkillers). You should not feel pain which prevents you from normal functioning. In the information card you can also find post-surgical recommendations. You must return to hospital for the control visit after 10 days, and your stitches will be removed (if you had any).
Keep your bandage clean and dry: do not get it wet in the bath. You can have a short shower after 4-5 days. Change your bandages every 2-3 days. If you notice any alarming changes around the wound (such as reddening) contact your doctor immediately.
Prior to surgery make sure your home is a friendly environment to return to following treatment. Think about what could be an obstacle when moving, and remove all the things which might cause you to trip and fall. Ensure easy access to everyday items (move your clothes and hygiene products to a mid-level shelf so you do not need to either bend low, or reach too high). The support of your relatives or close friends will be required. Remove all dangerous rugs from the bathroom, and get anti-slip mats for the bath/shower and bathroom floor. If your procedure requires a longer recovery period, think if it is worth installing rails next to the toilet and bathtub. Make sure you have a wash cloth on a long handle so you can take care of your personal hygiene alone. If you are not feeling 100% comfortable make sure you are using a bench in the bath, do not close the bathroom doors, and make sure someone is home in case of a fall or when you need help. If you cannot bend after surgery, ask your physiotherapist for advice enabling you to go to the toilet.
How can you help to relieve yourself
Cold compresses are recommended in the first few days following surgery, as they help to shrink blood vessels and reduce possible inflammation and post-surgical pain. Warm compresses cause blood vessels to expand, and increase oxygenation and nutrition of damaged structures. This speeds up the recovery pace.
Rest and relax
Follow the doctor’s recommendation on orthopaedic support collars, corsets, and do not strain yourself. Try to keep in a good mood, as overcoming stress decreases tension and pain, and speeds up recovery.
Think about the correct body posture
If you did not pay enough attention to your posture before your procedure, then you need to remember about it after. It will decrease the possibility of condition reoccurrence, and also decrease pain. Immediately after surgery you will know which position is the most comfortable. However, it is worth consulting a physiotherapist in order to avoid muscle contraction and atrophy caused by prolonged periods in one position. Support your back and limbs – you can use pillows or special rollers to decrease the pressure on the operated area.
Proper motion pattern
Move carefully, but do not avoid moving the operated area in order to avoid creating an improper motion pattern and putting extensive strain on other structures.
How to lie down
Avoid positions causing twisting or bending of the spine, on a reasonably hard mattress. A good solution is to sleep on an orthopaedic mattress which adjusts to the body and ensures correct spine positioning during sleep. Support yourself with pillows when necessary, and do not let your limbs hang. When getting up, roll to one side, sit up carefully, drop your legs down while supporting yourself using an arm, making sure your position is symmetrical and spine immobilized. While rolling, make sure your whole body is stiff, and do not leave your hips in the previous position. When you want to lie down, reverse this process: sit down, lie down carefully on your side while supporting yourself with an arm and pulling your legs up.
How to sit
The best way to sit is exactly the way you did before the procedure – with a straight back, support in the lumbar area, and on a hard chair while avoiding hunching. Avoid soft sofas and cushy armchairs. Remember not to sit up for too long – only 30-40 minutes in the beginning. Then get up and walk a little, and do a couple of loosening exercises (your doctor or physiotherapist can recommend some).
How to bend
Once your doctor allows you to bend (it is not recommended in the immediate period following the procedure), keep your back straight and only bend in the hip joints. Bend only when you really need to – when you need to pick something up from the floor, squat and keep the object close to you (not with straight arms!)
You can exercise by yourself after surgery, but only by performing exercises recommended by a doctor or physiotherapist, and only at a frequency defined by them. Certainly you will receive detailed information on how to exercise at home. Trust your doctor and you can avoid painful strains along with a faster recovery. Rehabilitation after surgery requires your full engagement. You will receive a complete improvement plan to be carried out on your own. You will be able to get back to work several weeks after surgery, but you will still have to remember to keep the correct balance between work, relaxation, and activeness.