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How Soon Should Physical Therapy Start after Microdiscectomy Surgery?


With any type of spine surgery, patients are often advised to begin physical therapy (PT) as soon as it is possible to safely do so as part of the healing and recovery process. This is also true after having a microdiscectomy, which is a less invasive procedure. The specific recommendations vary, but physical therapy is usually performed in stages based on an individual’s unique needs and personal capabilities during microdiscectomy recovery. This article provides a general guideline for the timeline for PT after a microdiscectomy.

PT for Post-Surgery Pain Management Starts Almost Immediately

While exercise is often associated with physical therapy, there are other forms of PT that can be equally beneficial after a microdiscectomy. For instance, most patients are advised to consider physical therapy for symptom control shortly after returning home. Therapy of this nature usually involves:

• Manual therapy – This increases range of motion in the affected area and minimizes issues with scar tissue formation. Manual therapy, which can include massage therapy, also increases circulation and promotes healing.
• Pain-control modalities – Physical therapists specializing in post-surgery care often recommend ways to control or ease discomfort after microdiscectomies, which may involve heat and ice applications or electrical stimulation.
• Posture therapy – Poor posture can affect the healing and recovery process after a microdiscectomy. The purpose of posture therapy is to educate patients by offering tips and suggestions to improve spinal alignment and ease stress on the area that is healing.

Regular PT Usually Starts 4-6 Weeks Post-Surgery

Since a microdiscectomy is performed in a way that is less disruptive to tissues and spinal structures, many patients are able to start a full physical therapy treatment plan about a month or so after surgery. This is usually when the exercise portion of PT begins. It typically starts with segmental stabilization to address issues with localized weakness around the surgical site. PT for this purpose often involves:

• Exercises targeting deeper trunk muscles
• Strengthening of spine-stabilizing muscle groups
• Strength training routines that include resistance exercises

Light Walking and Stretching Starts Earlier

Lighter forms of exercise and stretching can usually start within the first few weeks of surgery. Many patients start this part of recovery less formally, primarily with guidance from their doctors. In other words, this may be something you can do on your own time and at your own pace. Activities fitting into this category typically include:

• Walking at a comfortable pace on flat surfaces
• Light mid-body stretches that do not involve bending or excessive twisting
• Hamstring stretches

Your physical therapist should be able to help you find the appropriate combination of stretching and gentle
lower back pain exercises to go along with regular walking and movement. Cardiovascular training may also be recommended before you start a formal exercise routine. The reason for taking this step is to increase stamina and endurance, which reduces the fatigue some patients experience after surgery. As activity restrictions are lifted, you will likely be advised to work with a physical therapist to ensure you do therapeutic exercises correctly and safely. 

Even though microdiscectomy surgery is a common and generally quite successful procedure, a hole is frequently left in the outer wall of the disc. In fact, patients with these large holes in their discs are more than twice as likely to reinjure themselves by having what is known as a reherniation. These reherniations often require additional surgery or even fusions. Fortunately, there is a new treatment specifically designed to close the large holes that are often left in spinal discs after discectomy surgery. Barricaid is a bone-anchored device proven to reduce reherniations, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is performed immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us at 844-288-7474.

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