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Do You Need Physical Therapy after a Discectomy?

Written by The Barricaid Team | Mar 15, 2024 10:35:00 AM

Recovering from a discectomy, a surgical procedure aimed at relieving pressure on the spinal nerves caused by a herniated disc, is often a challenging journey. While the surgery itself may alleviate the symptoms associated with a herniated disc, such as back pain, sciatica, or numbness, the postoperative phase is crucial for ensuring a successful recovery and preventing future complications. Physical therapy is commonly recommended as part of the rehabilitation process following a discectomy, but is it always necessary? In this article we will delve deeper into the role of physical therapy in post-discectomy recovery and explore the factors that influence its necessity.

Understanding Discectomy 

A discectomy involves the surgical removal of part or all of a damaged or protruding disc in the spine. This procedure aims to relieve pressure on the spinal nerves, alleviate symptoms, and restore mobility and function. Discectomy may be recommended for individuals experiencing debilitating pain, weakness, or loss of sensation due to a herniated disc that does not respond to conservative treatments such as medication, physical therapy, or injections.

Immediate Post-Surgery Period

In the immediate aftermath of a discectomy, patients are typically advised to rest and limit physical activity to allow the surgical site to heal. Pain management, often achieved through medication prescribed by the surgeon, is essential during this phase. While rest is important, gradual movement and gentle exercises prescribed by physical therapists may also be introduced early on to prevent stiffness, promote circulation, and facilitate healing.

Potential Complications

Although discectomy is generally considered a safe and effective procedure, there are potential complications that can arise, particularly during the recovery period. These may include nerve damage, infection, excessive bleeding, or recurrent disc herniation. Physical therapy can play a crucial role in minimizing the risk of complications by promoting proper healing, restoring mobility, and addressing any residual weakness or imbalance.

Role of Physical Therapy

Physical therapy is an integral component of post-discectomy rehabilitation for many patients. The primary goals of physical therapy following a discectomy include:

  • Restoring mobility – Physical therapists employ various techniques to increase flexibility, range of motion, and overall mobility in the spine and surrounding muscles.
  • Strengthening core muscles – Strengthening the muscles that support the spine, particularly the core muscles, can stabilize the spine and reduce the risk of future injuries.
  • Managing pain – Physical therapists utilize a combination of manual therapy, modalities such as heat or ice, and therapeutic exercises to alleviate pain and discomfort.
  • Improving functionality – By addressing movement patterns, posture, and body mechanics, physical therapy aims to improve overall functionality and quality of life.
  • Preventing recurrence – Through education and personalized exercise programs, physical therapists empower patients to adopt healthy habits and reduce the likelihood of recurrent disc herniation or other spinal issues.

Individualized Treatment Plans

It is important to recognize that the need for physical therapy following a discectomy varies from person to person. Factors such as the severity of the herniation, the individual’s overall health and fitness level, and the presence of any underlying conditions may influence the necessity and duration of physical therapy. Additionally, the type of surgical approach used (e.g., traditional open surgery versus minimally invasive techniques such as microdiscectomy) may also impact the postoperative rehabilitation process.

Early Mobilization Techniques

Physical therapists often employ early mobilization techniques to promote healing and prevent complications such as stiffness and muscle atrophy. These may include gentle stretching exercises, range of motion activities, and controlled movements to gradually reintroduce mobility without exacerbating pain or causing strain on the surgical site.

Core Strengthening Exercises

Core strengthening exercises are particularly important in post-discectomy rehabilitation, as they support the spine and reduce the risk of future disc herniation or instability. These exercises may include pelvic tilts, abdominal bracing, plank variations, and lumbar stabilization exercises tailored to the individual’s specific needs and abilities.

Flexibility and Range of Motion

Maintaining or restoring flexibility and range of motion in the spine and surrounding muscles is essential for optimal recovery following a discectomy. Physical therapists may incorporate stretching exercises, joint mobilizations, and gentle traction techniques to increase flexibility and alleviate stiffness.

Pain Management Strategies

Effective pain management is a key component of post-discectomy rehabilitation. Physical therapists employ various strategies to alleviate pain and discomfort, including manual therapy techniques such as massage and manipulation, modalities such as heat and cold therapy, and therapeutic exercises aimed at improving posture, reducing muscle tension, and promoting relaxation.

Gradual Progression

Gradual progression is essential in post-discectomy rehabilitation to avoid overexertion and minimize the risk of complications. Physical therapists work closely with patients to monitor their progress, adjust treatment plans as needed, and gradually increase the intensity and complexity of exercises and activities as tolerated.

Monitoring and Adjustments

Continuous monitoring of progress and adjustments to the treatment plan are essential for optimizing recovery following a discectomy. Physical therapists collaborate with patients and other members of the healthcare team to ensure rehabilitation goals are met and any emerging issues or concerns are promptly addressed.

Alternatives to Traditional Physical Therapy

While traditional physical therapy is beneficial for many individuals undergoing post-discectomy rehabilitation, alternative rehabilitation methods may also be considered. These may include aquatic therapy, which offers buoyancy and resistance in a low-impact environment, and yoga, which focuses on increasing flexibility, strength, and mindfulness.

When Physical Therapy May Not Be Needed

In some cases, physical therapy may not be necessary following a discectomy, particularly if the surgery was minimally invasive and the individual experiences a swift and uncomplicated recovery. However, it is essential for patients to consult with their healthcare providers to determine the most appropriate postoperative rehabilitation plans based on their specific needs and circumstances.

Consultation with Healthcare Providers

Ultimately, the decision regarding the necessity of physical therapy following a discectomy should be made in consultation with healthcare providers, including the surgeon and physical therapist. These professionals can assess the patient’s condition, discuss his or her goals and preferences, and develop a personalized rehabilitation plan tailored to optimize recovery and long-term outcomes.

Physical therapy plays a vital role in post-discectomy recovery for many individuals by promoting proper healing, restoring mobility and function, and reducing the risk of complications. However, the necessity of physical therapy may vary depending on factors such as the type of surgery, the patient’s overall health and fitness level, and their specific rehabilitation goals. It is essential for patients to work closely with their healthcare providers to determine the most appropriate rehabilitation plan for their needs and to actively participate in their recovery process for the best possible outcomes.

Even though a discectomy 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 procedures or even spinal fusion surgery. 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.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.