Recovery and rehabilitation after surgery to remove an intervertebral hernia

Hernia removal is an emergency measure used to treat a destroyed intervertebral disc. After such an operation, the patient has significantly limited motor functions that depend on the spine, and in order to regain the ability to lead a relatively active life, it is necessary to undergo a competent rehabilitation course.

Rehabilitation goal

After surgery to remove the intervertebral hernia, the treatment process cannot be considered complete. Even despite the fact that the surgical treatment is completed, the patient may manifest neurological and pain symptoms for a long time, as well as a violation of sensitivity. This is explained by the fact that prolonged hernia pressure on the nerve endings led to the development of a tumor and irritation, which remain after the removal of the damaged part of the intervertebral disc.

For this reason, it is necessary to conduct competent rehabilitation, which will have specific goals:

• stabilization of the patient's condition and the subsequent elimination of domestic restrictions;
• restoration of the integrity of the body;
• elimination of restrictions on physical activity;
• neutralization of neurological symptoms and pain syndromes.

When choosing specific rehabilitation techniques, the doctor takes into account various factors. Depending on the complexity of the operation, the rehabilitation period can last up to 12 months.

Recovery after surgery to remove the intervertebral hernia, usually implies physiotherapeutic procedures, medication, therapeutic exercises and a visit to the sanatorium.

Principles of rehabilitation

If the recovery period is organized correctly, then the following principles should be implemented in it:

• procedures for a particular patient are selected competently, taking into account its individual characteristics;
• comprehensive monitoring of the patient's condition should be carried out, implying the participation of the surgeon who performed the operation, as well as a neurologist and rehabilitologist.

In fact, all rehabilitation measures have two main goals: restoring the person’s ability to work after surgery and preventing the formation of new hernias.

Rehabilitation after removal of the intervertebral hernia should be carried out taking into account the following factors affecting the effectiveness of recovery:

• age and concomitant diseases of the patient;
• duration of development and severity of the disease;
• type of operation that was performed.

Rehabilitation Stages

The whole complex of rehabilitation measures can be divided into several key stages:

1. Early. Lasts up to 14 days. During this period, pain is prevented and eliminated, as well as psychotherapeutic support.
2. Late. The duration of this stage can be 8 weeks. The key task of this part of rehabilitation is the professional adaptation of the patient to an independent life in everyday life.
3. Deferred stage. Rehabilitation after removal of the intervertebral hernia in this case can last a lifetime. This period begins, usually in the third month after surgery.

The main restrictions that apply to the recovery period

The early recovery phase will be successful, subject to the restrictions on the following actions and activities:

• performing physical activities without using a corset;
• weight lifting;
• manual therapy and massage;
• cycling and playing sports;
• being in any sitting position;
• deep and twisting movements in the spine, as well as sharp movements to the sides and forwards.

There are prohibitions that are relevant for the late rehabilitation period:

• long trips in any vehicle;
• physical activity (any) without a good preliminary warm-up;
• hypothermia of the operated back area;
• prolonged wearing of a corset;
• lifting items weighing more than 8 kg;
• prolonged stay in any forced position.

The basic principle in the event of limitations after surgery is to protect the spine and especially the place where the hernia was removed, from any stress and hypothermia.

Necessary actions immediately after surgery to remove the intervertebral hernia

Postoperative rehabilitation should include the following items:

• inclusion in the program of the Russian Federation (referring to physiotherapy exercises);
• recommendation regarding spa treatment;
• the use of electrophoresis, ultrasound or laser therapy to anesthetize and improve blood circulation;

• hydraulic procedures (necessary for mechanical unloading of the spine) and kinesitherapy;
• neutralization of the inflammatory process, restoration of bone tissue and anesthesia through the use of drug treatment methods.

Physiotherapeutic treatment measures

Rehabilitation after surgery to remove the intervertebral hernia must necessarily include certain physiotherapeutic procedures:

• Mud wraps. They have analgesic, absorbable and anti-inflammatory effects.
• Electrical stimulation (interstitial). Helps to restore nerves that have been impaired, and significantly improves nutrition of bone and cartilage.
• Ultrasound procedures. Their use contributes to the restoration, growth and stimulation of rapid nutrition of tissue cells.
• Magnetotherapy. With its help, mobility is restored, the risk of edema, pain and inflammation is significantly reduced. This treatment technique also helps to activate metabolic processes.

• Rehabilitation after surgery to remove the intervertebral hernia involves the use of extremely high frequency therapy (EHF). This technique is used to restore the tone of the ligaments and muscles, as well as improve blood circulation. Using EHF, inflammation and pain are effectively relieved.
• Iontophoresis. It is relevant when it is necessary to ensure deep penetration of drugs through the skin. Effective to stimulate recovery of the operated area and relieve pain.
• Phonophoresis. This is the process of introducing drugs into the body using ultrasound. To neutralize edema and inflammation, a mechanical effect is used.

Use of heat and cold

Rehabilitation after surgery to remove the intervertebral hernia may include those methods that are based on the impact on the operated part of the back through temperature.

The effect on the spine with the help of heat is usually carried out through paraffin baths. Such procedures can significantly improve lymph circulation and blood flow, relieve inflammation, restore the conductivity of nerve impulses and relieve muscle cramps. It is important to know that paraffin therapy is contraindicated in those patients who have been diagnosed with cirrhosis, hypertension, tuberculosis and various neoplasms.

As for the cold, then with a competent approach (a doctor’s consultation is necessary), it is used immediately after the removal of a hernia of the intervertebral disc. Using ice, you can reduce pain, relieve muscle spasm and lower the degree of inflammation (this occurs due to narrowing of blood vessels and, as a result, a decrease in blood flow).

Key exercises to recover from surgery

For those patients who survived the removal of the intervertebral hernia, in the first days after the transfer to the ward, it is recommended to perform simple exercises:

• bending and extension of the legs at the knees;
• performing circular movements with legs;
• raising and lowering the feet;
• pulling the knees to the stomach and the subsequent straightening of the legs (you need to perform several times).

Such exercises after removal of the intervertebral hernia are very useful, but when performing them, it is worth increasing the load moderately (the spine should not be overloaded).

Everyday Exercises

If we talk about the removal of a hernia in the lumbar region, it is worth noting that the recovery period after such an operation is stretched for a lifetime. Therefore, it is imperative that the patient accustoms himself to perform key daily exercises. We are talking about three main movements:

1. Push ups. This is a fairly simple exercise, but you need to perform it correctly (with a straight back). The number of repetitions is from 10 to 15. When doing push-ups, you need to inhale air while lowering the body and exhale while rising.
2. Rehabilitation after removal of the lumbar intervertebral hernia includes the following exercises: in the supine position, it is necessary to raise your legs above the floor and make rotational movements, like on a bicycle. It’s worth starting with 10-15 repetitions, increasing their number over time to 100-150. You can also change the level of load during exercise by adjusting the height of the legs above the floor.
3. Squats To perform this movement correctly, you need to imagine that you have to sit on a bench. Deep squats after surgery on the lower back are categorically contraindicated. In this case, it is also necessary to perform 10-15 repetitions.

If you perform these exercises correctly and every day, then the spine will be prepared for stress throughout the day. Do not forget about the doctor’s prescriptions.

Gymnastics after intervertebral hernia surgery

Exercises for the restoration of the spine should be made by a doctor using an individual approach, which will take into account factors such as the operated spine and the characteristics of the disease. At the same time, there are general recommendations for strengthening the spine after surgery and preparing it for household loads. This is a set of proven exercises:

• Lying on your back, bend your knees and spread your arms on the floor to the sides. After that, it is necessary to raise the basin above the floor and hold it in this position for 10-15 seconds. Subsequently, the retention time of the pelvis should be brought to 1 minute.
• Lie on your back, cross your arms over your chest, and bend your legs at the knees. The chin should be pressed to the chest. By tensioning the abdominal muscles, lift the torso forward and hold it in this position for 10 seconds. After you can take a starting position and relax the muscles. You need to perform the exercise 10-15 times, gradually increasing the number of repetitions.
• Exercises after surgery to remove the intervertebral hernia include another motion in the supine position: you need to slowly bend the legs at the knees, pressing them to the chest. In this case, the tension of the gluteal muscles should be felt. After that, it is necessary to relax the muscles of the buttocks and keep your legs bent for 40-45 seconds. Then you need to slowly straighten them.

• Take the starting position on the legs and arms bent at the knees. After that, it is necessary to simultaneously extend the right arm and left leg so that they occupy a horizontal position. Keep them in this position for 10-60 seconds. The same movement is repeated with the left hand and right foot.
• Exercise therapy after surgery to remove the intervertebral hernia also implies such a movement: lying on your stomach, bend your arms at the elbows near the head. Next, you need to straighten your arms at the same time and raise the upper body up, bending in the lower back. But you don’t have to take your hips off the floor.
• You need to lie on your stomach and place your hands under the chin. After that, it is not necessary to raise the straight leg high and slowly, and then slowly lower it (the movement is performed alternately). The pelvis should be motionless.

Healing baths

Another way to restore the spine after surgery is to use various baths that have a therapeutic effect:

• Radon baths. Actual for improving blood circulation and neuromuscular conduction.

• Turpentine. Used for resorption of scars and adhesions, as well as activating the recovery process.
• Herbal baths can relieve muscle tension and reduce pain.
• Rehabilitation after surgery to remove the intervertebral hernia will be more effective if you use hydrogen sulfide and sulfide baths, which help resorb inflammatory foci, improve blood circulation, normalize muscle contractions and stimulate tissue repair.

Water treatments

This type of procedure is part of the recovery process after surgery. Staying in the water has a relaxing effect. But it is important to take into account the fact that after removal of a hernia, prolonged exposure to water is contraindicated. Reception of a hydromassage, as well as procedures in the pool, should not last more than 15-30 minutes.

As for dousing with cold water, they are also useful, since they have a beneficial effect on the restoration of nerve endings and stimulate muscle activity. The most effective are short dousing.

As a result, it can be noted that the recovery process after removal of the intervertebral hernia is a constant and hard work, primarily on the part of the patient. If you stably and correctly perform the elements of therapeutic gymnastics and follow the doctor’s instructions, then there is every chance of a full and active lifestyle.