Cody Leeworthy PT, DPT
Having a spine surgery used to be considered one of the scariest major surgeries a patient could have. Nowadays, with the skill of OSC spine surgeons, incredible advancements in surgical technique and pain management, OSC patients can go into our ambulatory surgery center in Newport News, VA and walk out several hours later to recover at home. Just years ago, that would have involved a hospital stay of days or perhaps a week and a long convalescence of mostly lying-in bed. Today, patients are encouraged to rest and heal, but to maintain some activity and slowly build upon it, especially through Physical Therapy.
Most patients who need spine surgery tend to be somewhat deconditioned because their issue has been going on for some time. They may have a bulging disc pressing on a nerve, or spinal stenosis which narrows their spinal canal and presses on their spinal cord. These issues can be very painful, and typically cause pain away from the spine, towards the limbs, like down the arms or legs. When first diagnosed, patients are often prescribed oral steroids or an epidural steroid injection before coming to Physical Therapy as a way of reducing inflammation near the spinal nerve to make exercising easier. Physical Therapy is almost always prescribed to see if the patient will respond positively, because evidence shows they often will.
However, if conservative treatment is not successful, the pain typically worsens and dysfunction may occur, making exercise more difficult to bear. If the patient and physician decide that surgery is the right treatment option, a Physical Therapist may be asked to show the patient how to get in and out of bed after surgery, by demonstrating a maneuver called “the Log-Roll”. We can also train the patient on the proper way to get in and out of a chair while wearing a neck or back brace, get on and off the toilet, put on clothing and other activities of daily living. Pre-Surgery Physical Therapy is always a great idea to prepare the patient for the rigors of surgery.
After the patient has had spine surgery, a Physical Therapist may come to visit them at their home. The PT will check to see how the patient is moving in the house, make sure there are no obstacles or hazards that need to be removed, will ask the patient to do certain exercises to get them moving and to start building strength and increase range of motion. If there are stairs in the home, the patient may be asked to go up and down stairs or to demonstrate their stability in getting in and out of a chair. The patient will also be asked to do certain exercises on their own between PT visits.
After the patient’s two-week follow-up visit, if needed, they will typically be released to outpatient Physical Therapy at our clinic. The patient will have access to a much broader range of exercise equipment and our Physical Therapy team can use a wide variety of modalities to help with healing and reduction of swelling and inflammation after surgery. A specific exercise program will be tailored to the patient, based on their general health, condition, lifestyle, goals, and progress thus far. The program will be updated based on patient performance and feedback to the Physical Therapist.
Most of the initial activities in physical therapy are typically focused around gaining spine mobility due to post-surgical stiffness. These are combined with strengthening activities to the muscles involved in the surgery, whether it be the neck or low back. We also address the other areas that have been impacted by nerve impingement, including the arms and legs, as well as address any functional limitations that the patient may be experiencing. These exercises are typically focused on what activities to which the patient wants to return, whether it is only basic self-care activities, yard work or even more vigorous activities, including sports. It is truly a tailored effort by the patient and the therapist to come up with an appropriate plan of care for the best functional outcome.
Make an appointment with our Physical Therapy Team or an orthopaedic spine specialist by calling our office at (757) 596-1900 or completing the form by clicking the button below.