10 Dec Physical Therapy after Spinal Surgery
If you suffer from low back pain from a serious spine condition, you may require spinal surgery. Two common surgeries to relieve back pain are the laminectomy and lumbar discectomy. Additional options for relief may include a spinal fusion such as with the Inspired Spine OLLIF.
These procedures are used to decrease pressure on the spinal nerves that cause pain and associated symptoms. After spinal surgery, physical therapy is the most important aspect of recovery. If you require a surgery on your spine to manage your pain, physical therapy will be beneficial afterwards to help you return to an improved level of functioning.
The physical therapist is a specialist who is trained and educated in improving mobility, alleviating pain, and enhancing postural correction. The therapist chooses special exercises for you to improve strength and range of motion following surgery. You will meet with the physical therapist before surgery for an evaluation. The therapist will see you in the hospital after your procedure, and you continue physical therapy after going home. Research shows that physical exercise after a spinal surgery will result in better patient outcomes.
Physical Therapy Evaluation
Once you are scheduled for a laminectomy or discectomy, the surgeon and physical therapist consult regarding your treatment plan. The components of the physical therapy evaluation include:
- History taking – The physical therapist will take a verbal or written history from you. Questions in the history center around your injury, your symptoms, and any complications you have suffered from previous surgeries or the recent surgery. This also includes a past medical history.
- Postural assessment – Proper posture has a significant role in maintaining a healthy spine, so your therapist will assess your posture before and after surgery. He/she will examine your spine when you are standing and sitting. This is done to help you attain and maintain a healthy posture.
- Range of motion – The physical therapist measures your spinal range of motion using a bubble inclinometer or goniometer. This is used to get baseline readings of your spinal mobility.
- Strength – To measure your strength, the physical therapist uses a number of special techniques. If you have muscle paralysis or weakness from spinal nerve compression before surgery, the therapist makes note of this. After surgery, your strength is assessed so the therapist can devise a treatment plan.
- Scar tissue assessment – Following spinal surgery, you may have 1-3 small surgical scars on your back. The physical therapist examines the scar tissue mobility and motion restriction relate to the scarring.
- Neurological screening – This screening is used to assess spinal nerve functioning. The therapist uses a reflex hammer to check deep tendon reflexes, and light touch and pressure tests are used to check your ability to sense and feel.
- Flexibility testing – This involves evaluating ability to turn from side to side, bend up and down at the waist, and lean backwards. Muscle groups checked include the quadriceps, calf muscles, and hamstrings. The therapist checks for tightness of the sciatic nerve, as well as scar tissue formation that affects flexibility.
- Functional evaluation – The physical therapist assesses your overall function before and after surgery. Are you able to move about your home? Can you work? What are your limitations? If you are having trouble with activities of daily living, the therapist may perform a functional capacity exam.
Physical Therapy Treatment
After your spinal surgery, you can expect:
- Exercise – The physical therapist develops a tailored post-operative exercise program for you. This focuses on progressive lumbar range of motion exercises, as well as core and hip strengthening exercises. The therapist also works with you to improve cardiovascular function and endurance. Overall flexibility in the muscles is achieved using these exercises.
- Physical modalities – To control post-operative pain, the therapist will use modalities like ultrasound therapy, ice, heat therapy, and electrical stimulation. While ice decreases swelling and pain, heat will improve circulation and relax muscles.
- Scar massage – To target tightness around your surgical incisions, the therapist engages in several scar mobilization techniques. These massage maneuvers will help alleviate mobility issues and pain.