Now that your surgery is over, you can concentrate on the next phase - recovery. After any surgical procedure, the body needs time to restore damaged tissues and return to normal. Recovery is a process which may take some time before you feel completely healed. The recovery period, both in the hospital and at home, is necessary to rebuild your strength. The best way to approach your recovery is with a positive attitude and realistic goals.
Take Your Time
Your surgeon will give you information about what to expect after your surgery. Be sure to follow your doctor's instructions. Pushing yourself too soon after surgery may delay your recovery. Be prepared to spend some time resting. Discomfort should decrease a little each day. Increases in energy and activity are signs that recovery is going well.
Keep in mind that the amount of time required to return to normal activities is different for every patient. Recovery time is often faster for patients who are young and in good physical condition. Maintaining a healthy attitude, a well-balanced diet, and getting plenty of rest can also shorten recovery time.
Some people experience temporary bouts of moodiness or emotional letdown after surgery. Do not fear that this is a setback or will lengthen your recovery time. Emotional changes are normal and may be due to the body working hard to heal itself. They may also be due to unrealistic expectations about how long it takes to feel "normal" again. Keeping a positive attitude is important during this time. Focus on making small improvements each day with an eye toward the continued progress you will make in the future.
Pain after Surgery
It is normal to have some pain after spine surgery. Many patients experience aching due to inflammation and/or muscle spasms across the back or down the legs. You may also have pain at the site of the incision or in your hip if a bone graft was used. These are all normal after-effects of spine surgery. As your body heals, this discomfort should decrease.
Your doctor will prescribe pain medication to relieve muscle spasms and reduce inflammation. When you are ready, gradually reduce the amount of pain medication you take by increasing the amount of time between doses and decreasing the number of pills you take each time. At the same time, try other non-drug pain relief treatments such as moist heat, gentle exercise, massage, short rest periods, and frequent repositioning.
Spine surgery is a major undertaking, and rehabilitation is an important part of helping patients to get the most possible benefit from their surgery. Essentially, rehabilitation (or physical therapy) can help patients recover from spine surgery as quickly and completely as possible.
There are several ways that a physical therapist will typically work with a patient to help him or her get back into good physical condition and heal from the injury and surgery.
A physical therapist is trained to help manage pain. Controlling pain is an important first step in allowing patients to regain their strength, as it is very difficult to complete a rehabilitation program if one is in a great deal of pain.
While a certain amount of pain is common in the recovery process, there are several means that a physical therapist may use to help minimise pain, such as:
- Ice application
- Certain positions of the spine
- Certain types of movements
- Electrical devices (e.g. TENS units)
Many of the techniques are simple and easy to learn and can be done at home or at work throughout the day. For many patients, it is surprising to learn how much simple use of ice packs and/or changes in movements and positions can help alleviate post-operative pain.
Ideally, a physical therapist will also provide information and education to improve a patient's overall health and recovery through lifestyle changes, such as drinking enough water throughout the day and finding a comfortable sleeping position.
The therapist will typically develop a training program tailored for the patient, taking into account the patient's specific surgery, body type and tissue conditions.
Therapists focus on muscle facilitation with areas where the muscles may need special retraining to gain strength and provide stability following the surgery. This type of therapy may focus on:
- Muscles in the incision area
- Muscles that may have been weakened by nerve problems before the surgery
- Small muscles that work around each vertebra and help stabilize the spine. Most people (even those without spine problems) do not use these muscles very often. However, if these small muscles are trained properly, they can provide excellent stabilisation that can protect the spine and protect the newly operated area to prevent future problems.
Individualised physical therapy may also help with areas where the patient's mobility and flexibility has been limited. Many spine patients have problems with restrictions in their hips or shoulders or other areas of the spine. In these cases, the therapist can help the joints and the muscles involved regain the movement in relation to an individual's body type and physical activities, and will work in the best way with the newly operated spine.
Physical therapists are trained to be sure to select movements that can be done safely around the surgery.
Exercise is vital to getting better after surgery. It is the key to eliminating fatigue, getting patients back to activity safely, and avoiding re-injury. Ultimately, exercise is critical both in helping the body heal from the original injury and in preventing (or minimising) future episodes of pain.
A physical therapist develops an individually tailored exercise program based on knowledge of the exact type of surgery, and the forces that are most beneficial for the patient's spine under different conditions. Patients will typically learn the exercises with the physical therapist and then do them on their own at home.
There are many choices of exercise available for patients. If a therapist and patient work together, they can find alternatives that will greatly benefit the patient's physical condition and capability for resuming activities to almost any level.
Patients often wonder if and when they can return to certain activities. A lot of that depends on how they respond to exercise and can prepare the muscles to protect the spine during that activity. The patient / therapist team works well in this situation, as the therapist has the opportunity to observe the patient's movement and force tolerances over time.
With one-on-one physical therapy sessions, patients have plenty of opportunity to ask questions of the therapist. Therapists can explain exactly what changes have occurred as a result of the patient's specific surgery, and what can be done to maximise the benefits from that surgery.
Many patients ask the same types of questions, so the therapist will usually have enough knowledge to be able to answer most questions right away. Often, if the therapist doesn't know the answer to a question, he or she can speak with a spine surgeon to get the answer. Most therapists will encourage patients to ask as many questions as possible.
Any patient's success in recovery from surgery depends on his or her willingness to work hard at home as well as with the therapist. Ideally, the surgery will take the patient a great deal of the way on the road to recovery, and then the patient and therapist team can work together to make the recovery the best possible.
Recovery in the Hospital
With most spinal surgeries, patients are up and walking (if only for a short walk) within hours after their procedure. It is no longer necessary, or recommended, that you lie in bed for weeks after spine surgery. Nurses who are experienced in working with spinal surgery patients will assist you in your first few "trips" out of bed.
The easiest way to get out of bed is by raising the head of the bed as far as it will go, swinging your legs to the floor and slowly standing up. Make sure you tell the nurse if you feel faint or if you feel like you might fall. If so, get back into bed and try again in a few hours.
Your doctor will tell you when it is safe to shower after surgery. The nursing staff will show you how to keep the dressing dry and in place to protect the incision while showering. The wound should not be submerged in water (pool or bath) until it has healed and has been cleared by your doctor. The nurse will change the dressing after your shower, and again later if necessary.
Rehabilitation or physical therapy can help patients recover from spine surgery as quickly and completely as possible. It is important in helping the body heal from the original injury and the surgery, and in preventing future episodes of pain.