Spinal rehab is key to a safe recovery after surgery - learn what to expect and how to choose the best program in this comprehensive guide. Fill out the form to download our free guide.
Spinal cord injuries and chronic back pain can affect every aspect of a person’s life. Spinal surgery and intensive inpatient rehabilitation help many patients return to independent, fulfilling lives.
Spinal surgery is an extensive medical procedure. Proper planning before and after the hospital stay is key to achieving the desired treatment outcomes. Here are some key facts to understand when planning to undergo a procedure:
There are many types of spinal surgery. Here's what they entail:
While spinal surgery procedures are generally safe, some patients may encounter complications. Many occur immediately after an operation, but others may not emerge until months after the surgery. You can recognize issues and address them promptly by learning about spinal surgery risks.
Though these risks may sound overwhelming, they can be minimized with proper care and the right approach to recovery.
Not all spinal surgery rehab programs are created equal. To maximize your chances of a full recovery, you should know how the weeks following surgery impact your treatment outcomes. Here’s what to know about the crucial period after surgery. Pain, stiffness, muscle cramps, fatigue, sleep problems, and feeling discouraged or depressed are the most common symptoms patients experience after spinal surgery.
Some symptoms can indicate a more serious issue. You should contact your physician immediately if you experience any of these symptoms:
Spinal surgery will bring significant relief to most people. Achieving full recovery requires a comprehensive rehabilitation program consisting of exercises, physical therapy, and occupational therapy to strengthen muscles and tissues.
Cervical and lumbar fusion surgery recovery occurs in stages. You'll need to stay in the hospital for two to four days post-op and devote time to work on your recovery over the next few months. Here’s an estimate of an average recovery timeline for most cases:
You’ll likely have a neck or back brace that needs to stay on until your surgeon advises you to remove it. A physical therapist will help you sit and stand on the edge of the bed within 24 hours of the operation. You’ll receive intravenous pain medications and have the dressing at the surgical site changed and the wound inspected for signs of inflammation and infection.
You’ll focus on resting to allow your spine to heal and the discs to fuse. Your range of activities will be limited during this time.
You’ll begin your physical therapy exercises to strengthen your neck and back muscles so they can better support your spine. You can perform movements and activities such as bending and twisting but should refrain from lifting heavy objects. You should also get plenty of rest during this stage to support healing.
The focus of your recovery will change around week 10, where you’ll increase your activity levels with the help of a physical therapist in a post-surgical rehabilitation program. You’ll perform stretching and cardiovascular exercises, but you should continue to refrain from lifting heavy objects.
When your orthopedist confirms that the fusion is successful, you can return to all activities.
Fusion of the spine will continue until 18 months post-surgery and may take up to two years for the nerve damage to heal. You’d be considered fully recovered at this stage and can resume most of your daily activities.
Proper planning and preparation are essential to successful spinal surgery recovery. For example, you should stop smoking and drinking alcohol before the surgery to prevent issues with healing, which can prolong your recovery.
In particular, pain control is a major concern for many patients. You should discuss pain relief options with your surgeon. Pain control is also critical to ensure that you can follow your rehabilitation program and perform the necessary exercises to speed up recovery.
These guidelines can help reduce post-operative pain and improve treatment outcomes:
You may need narcotic pain medication immediately after surgery, but your physician should gradually reduce the dosage as tolerated to prevent dependence and addiction.
Although opioids are effective pain control medication, dependence can occur within a short time of taking the drugs. The longer an individual takes an opioid, the higher their tolerance levels become, requiring an increase in the dosage to feel the drug’s effects.
Some people will continue to experience severe pain after spinal fusion and develop Failed Back Surgery Syndrome (FBSS). Addiction may occur if doctors prescribe long-term narcotic pain medications to help control the pain.
Now that you have a good idea of the types of surgery and risks involved, let’s examine how recovery looks for different types of procedures.
Your back surgery recovery depends on many factors, including your overall health, symptoms you had before surgery, and the type of procedure you underwent.
Here’s what you need to know about recovery from different types of back surgery and how to optimize your rehabilitation.
As mentioned previously, recovery from back surgery occurs in gradual stages and can take anywhere from a few weeks to a year. This process is a balancing act: While you should perform movements and exercises, you shouldn’t go too fast and risk injuring yourself again.
The time you need for recovery from back surgery and the pain level you experience will depend on factors including your age, weight, overall health and fitness, your condition, and the type of operation you’ve had.
Recovery after back surgery depends on the type of procedure. There are two main categories of lower back surgery: decompression and fusion, and the type of procedure will affect your back surgery recovery time.
During lumbar decompression surgeries, your surgeon will remove a small amount of the bone over the nerve root or disc from under the nerve root to relieve pain caused by nerve root pinching.
There are two types of decompression surgery.
A microdiscectomy treats radicular leg pain (sciatica) caused by a herniated disc.
A laminectomy relieves leg pain and/or weakness from spinal stenosis, often caused by changes in joints, discs, or bone spurs.
Meanwhile, lumbar fusion surgeries relieve pain and reverse disability caused by lumbar degenerative disc disease or spondylolisthesis. Your surgeon may use a bone graft to eliminate motion at a painful vertebral segment.
It typically takes three months to one year to recover from a laminectomy or foraminotomy, and most patients can resume normal activities after two to six months.
Your medical team will discharge you from the hospital a few days after surgery. They’ll give you a prescription for strong painkillers and perhaps medication to make going to the bathroom easier.
You should avoid strenuous activities to protect your spine from damage during the first four weeks post-op. However, some movement is necessary to help shorten the recovery time for back surgery. A physical therapist at an inpatient rehab facility can help you strike the right balance.
You can expect an all-clear to drive again within eight weeks after surgery, as long as you’re not taking strong, opioid-based painkillers.
You may also consider newer alternatives to traditional surgeries for spinal stenosis. These minimally invasive techniques are less painful and require a shorter hospital stay and recovery time.
Back fusion surgery recovery is a long road. Your vertebrae segments will begin fusing during the first few months, but the healing process can last up to a year.
Young patients in good physical condition can probably drive one month after spinal fusion, get back to an office-type job within six weeks, and return to a fairly regular routine within six months.
However, back fusion surgery recovery for patients who are older or underwent more complicated procedures is slower. It can take as long as six months to return to work for those with a manual job.
If your surgeon anticipates a complicated recovery process, he or she may refer you to an inpatient rehab facility that offers post-surgical therapy programs. In this environment, you’ll receive around-the-clock supervision and have access to a multidimensional therapy team to support your recovery process.
If you’re concerned about back fusion surgery recovery time, discuss a newer technique called total disc replacement with your surgeon. It tends to cause fewer complications that could derail your healing process.
During an artificial disc replacement surgery, your surgeon will remove a failing disc and insert an artificial one. This new technique is less painful and will result in a more flexible spine that feels more natural.
The procedure also has fewer complications. You can walk around within a day, get back to work within six weeks, and achieve complete recovery in three to twelve weeks—depending on your health, age, and fitness level. Your surgeon will likely recommend physical therapy to support the recovery.
A slow recovery from lumbar surgeries prevents you from resuming normal activities while increasing the chances of developing complications.
Staying inactive can increase the possibility of deep vein thrombosis (DVT). Blood clots in the leg can travel to the lungs and lead to pulmonary embolism. That's why medical professionals recommend patients start moving as soon as possible after spinal surgery.
Slow recovery may increase the possibility of cerebrospinal fluid (CSF) leaking out of tears in the membrane around the spinal cord. This complication can cause symptoms such as dizziness, headaches, and seizures.
Additionally, slow or poor recovery can increase the likelihood of infection at the surgical site and lead to recurring symptoms like chronic pain. You may also risk damage to the nerves, muscles, or tendons that stabilize the spine.
A post-surgical inpatient rehab program can help you accelerate recovery while reducing the risks of post-surgery complications and injuries. It should be an integral part of your preparation for spinal surgery.
Various factors can affect your recovery from back surgery. Avoiding or addressing these risk factors can help you manage the healing process and get back to normal activities sooner:
Most surgeons recommend spinal surgery patients support their healing process with a rehab program to shorten their back surgery recovery time.
A study on lumbar back surgery patients concluded that:
Exercise programs starting four to six weeks post-surgery seem to lead to a faster decrease in pain and disability than no treatment. High-intensity exercise programs seem to lead to a faster decrease in pain and disability than low-intensity programs.
Post-surgical rehabilitation is a short-term, inpatient program where you will receive high-quality, comprehensive care from a team of surgical rehab specialists. These programs are personalized to meet all your physical, pain management, and wound care needs. Also, round-the-clock access to medical professionals helps prevent complications that can delay healing and recovery.
Rehabilitation after back surgery can help you improve functioning, reduce pain, and shorten recovery time. You must plan your post-surgical care carefully to start physical therapy and mobilization exercises at the right time.
However, there’s no one-size-fits-all formula for back surgery rehabilitation. What you need will depend on the type of surgery you’ve had and other factors that impact recovery, which we discussed earlier.
Microdiscectomy and spinal fusion are often used to treat lumbar disc radiculopathy, with symptoms such as low back pain, leg pain, and numbness/tingling of the leg or foot.
Lumbar microdiscectomy is a minimally invasive procedure during which your surgeon will remove part of the damaged disc to ease the pressure on the nerve and eliminate the low back and leg pain. It’s usually performed as outpatient surgery, and most patients can start mobilization and rehabilitation exercises on the day of the operation.
The intensity of the exercises varies and depends on what you can tolerate. Your physical therapist will work with you to increase the intensity gradually to enhance mobility, build strength, and reduce recovery time.
Patients with spinal instability issues from conditions such as scoliosis or spondylolisthesis often require lumbar disc fusion surgery, which is a more complex surgery and can be performed as a minimally invasive or open spine procedure.
The North American Spine Society (NASS) recommends cardiovascular exercises, motor control, strengthening exercises, and patient education as part of postsurgical rehabilitation programs for spinal fusion surgery.
You can start patient education, nerve glide exercises, and a walking program before the surgery and continue during the hospital stay. Most patients will start formal physical therapy rehabilitation 12 weeks post-op, but some who had minimally invasive procedures may begin sooner.
It’s important not to begin exercising too early, as most patients will need 12 weeks for the muscles and incision sites to heal to prevent further injuries or complications.
An anterior cervical discectomy with fusion has been the gold standard treatment for degenerative disc disease, but it often limits a patient’s range of motion. On the other hand, cervical disc arthroplasty replaces the entire damaged disc with a prosthetic disc, preserving the range of motion in the neck.
Early mobilization and rehabilitation are recommended for patients undergoing minimally invasive and open cervical spine surgery. Your medical teams will aim to have you walking two hours after arriving at the post-anesthesia care unit (PACU).
Minimally invasive spine surgery, which replaces the damaged disc with a prosthetic one, has gained popularity in recent years as it causes less tissue damage than traditional open procedures. Patients can start rehabilitation sooner and reduce their back surgery recovery time.
Patients can usually get up and walk on the same day as their surgery, shortening hospital stays and recovery times—which is important because early and safe mobilization is a critical component of a successful recovery.
Considering how important rehabilitation is to reducing recovery times, it’s wise to understand what to look for in a spinal surgery rehab program.
Rehab therapy is key to supporting spinal surgery recovery. You can speed up healing and regain mobility faster by combining the right approach, the latest technologies, and a determined mindset.
A reputable rehab facility should provide a multidisciplinary orthopedic care team experienced in caring for spinal surgery patients. Your care team should include:
These professionals will collaborate and design a therapy plan that addresses your circumstances, needs, and objectives. They will monitor your recovery and fine-tune the plan as you progress.
A good therapist will form a close and trusting relationship with you and your loved ones. They will explain the best recovery and coping strategies, outline the treatment program, answer your questions, and help you avoid activities that may hamper your recovery.
Orthopedic therapy, which involves a combination of physical therapy, occupational therapy, speech therapy, and mental health therapies, is often used in an inpatient rehab facility to help spinal surgery patients:
Let’s look at the main types of orthopedic therapy you may encounter during spinal surgery care.
Physical therapy is a major component of any spinal surgery recovery program. It starts in the hospital and continues at an inpatient rehab center. The program will help you speed up healing, reduce complications, and recover as much mobility as possible by strengthening the muscles, bones, and joints you need to perform daily activities.
Your physiotherapist will assess your physical condition and needs by examining your ability to move, your pain level, and your medical history. They may give you a quick test to check how easily you can bend, grasp, move, reach, and walk. The results will help them design a personalized therapy plan for you.
Initial physical therapy will focus on strengthening the neck and back muscles through twisting or bending motions. Then, you will start stretching and cardiovascular exercises. Physical therapy after spinal surgery also includes pain management, using techniques like electrotherapy, massage, thermotherapy, and ultrasound to relieve discomfort.
A good physical therapist will use various techniques, games, and gadgets to make the process as interesting and motivating as possible. They will also help you practice movements that support everyday activities like:
Discuss your routine and the tasks you need to perform to support your lifestyle with your therapist. They can then identify exercises and activities to help you yield the most long-term benefits.
Immediately after a spinal cord injury, treatment is focused on protecting vital functions and preventing further spinal cord damage.
Treatment for spinal cord injuries begins with admission to the hospital, where the medical team will try to stabilize the patient’s neurological state. After the emergency treatment phase, which often involves spinal surgery, patients will require ongoing, multidisciplinary care.
Rehabilitation for spinal cord injury survivors includes physical therapy to support spine and disc rehabilitation to prevent and manage stiffness and tension in the limbs and joints. Most recovery will happen during the first 18 months of recovery.
Spinal cord rehabilitation requires a comprehensive and holistic approach. Inpatient rehabilitation, where a dedicated care team helps patients with their transition from hospital to living independently, is often the most effective option.
Occupational therapy is another essential component of spinal surgery care. It helps you regain the mobility to perform everyday activities by focusing on the whole person instead of a specific problem. You’ll improve fine motor control for typical daily tasks like:
Besides relearning to perform these essential activities, your occupational therapist will help you adapt if your condition limits your mobility so you can live your life with as few restrictions as possible.
Some patients experience difficulty swallowing following spinal surgery. Most recover within a few days, but others may suffer problems for weeks or months afterward. The issue can make eating a difficult and unpleasant experience and affect breathing. You may need to work with a speech therapist if you don’t quickly regain swallowing control.
Spinal surgery may also cause changes in your voice. The symptoms should clear up for most people within a few days. You may require speech therapy if you experience a weak or hoarse voice or lose it completely for a prolonged period.
While most people associate spinal surgery care with physical problems and treatments, many overlook the mental health aspect of spinal surgery recovery.
A spinal injury can be a traumatic experience, and the surgery and rehabilitation process can be tough. Some patients may face mental health issues such as post-traumatic stress disorder (PTSD), depression, anxiety, and even cognitive problems.
A comprehensive inpatient orthopedic rehab program should provide psychological counseling to support you throughout your recovery. It may use mental health solutions like cognitive behavioral therapy (CBT), psychotherapy, and counseling to prevent conditions like depression from developing. It should also arm you with techniques to handle stress, pain, reduced mobility, and altered life circumstances.
Understanding the different types of physical therapy for back surgery recovery can help you find the appropriate support to aid recovery from back surgery. Learn about the most common types of physical therapy after back surgery and how they can support your healing process:
Exercise is the most common type of therapy for back surgery recovery. The American Academy of Orthopedic Surgeons recommends that patients start exercising for 10 to 30 minutes one to three times daily to build up their strength.
Your physical therapist will guide you to perform various exercises to regain mobility and reduce pain. These include core and hip strengthening, cardiovascular, flexibility, and posture control routines.
Bodyweight exercises are ideal for strengthening muscles while minimizing the risks of re-injury. Equipment such as body balls and resistance bands can help you build strength and increase range of motion at your own pace.
Aerobic exercises can increase blood flow to the spine, transporting nutrients to accelerate healing. Your therapist may also use biofeedback machines to help you achieve proper alignment and range of motion to prevent future injuries.
Messages can loosen back muscles and increase blood flow to the spinal area. A scar tissue mobilization massage can help relieve tightness around the incision site. Your therapist may show you how to perform massage at home regularly by yourself or with help to reduce tissue scarring. If regular massage therapy isn't accessible, you can achieve some of the benefits with stretching and flexibility exercises.
Painkillers are often prescribed during the initial phase of recovery, but getting off these medications can be challenging for some. Physical therapy can ease the way by reducing inflammation that may exacerbate pain.
Heat therapy helps relax muscles, while cryotherapy (or cold therapy) can reduce swelling and tenderness around the incision site. Some therapists may perform electrotherapy and ultrasound to facilitate pain relief. Your therapist should complement an exercise program with the appropriate pain management techniques to achieve long-term results and proper recovery.
Remember, our body signals through pain that something needs attention. If pain persists, seek advice from your orthopedic surgeon to ensure your healing process is on track.
Physical therapy after back surgery is critical for preventing future injuries and issues. Your physical therapist can show you what movements to avoid and how to perform specific tasks safely. They’ll also guide you to continue your regular exercise routine and maintain proper posture.
If your job involves physical movements or exertion, your therapist can show you how to perform these functions safely. They can also show you how to set up your home environment to lower the risks of straining your muscles or reinjuring yourself as you recover.
While most people can start physical therapy four to six weeks post-op, some may need to wait longer if they suffer from complications. Your physical therapist will assess your readiness before beginning your program.
First, the physical therapist will take your medical history to understand your healing progress. They will assess your posture, range of motion, and strength, with a focus on the back, abdominal, hip, and thigh muscles.
They will also examine your scar tissues to ensure they aren't restricting your movements. They may test your reflexes through neurological screening and evaluate the flexibility of various muscle groups, including hamstrings, quadriceps, and calf muscles.
Lastly, your therapist will conduct functional assessments and determine your physical therapy goal. For example, would it be realistic to expect that you can work, drive, and engage in everyday activities after your sessions? What would a full recovery look like to you?
Based on the insights from the assessments, your therapist will design a plan and identify where you'd receive the treatment—e.g., at home, the hospital, a rehab center, or an inpatient post-surgical rehab program.
Once you understand the role of therapy in spinal surgery rehab, it’s time to examine the key components of a solid program.
Spinal rehab is key to a safe recovery after surgery - learn what to expect and how to choose the best program in this comprehensive guide.
Not all rehab programs are created equal. Knowing what essential components to look for can help you select the best facility for your spinal surgery recovery journey.
Recovering from a spinal injury is a long, complicated process. Personalized inpatient rehabilitation can go a long way in improving treatment outcomes and supporting a patient’s long-term well-being.
Rehabilitation for spinal injuries and surgery focuses on protecting and restoring as much bodily function as possible. It also manages and treats secondary conditions that can occur as a result of spinal cord injuries, including:
Spinal surgery physical therapy protocols should minimize the development of scar tissue, reduce pain and inflammation, and help relieve joint stiffness and muscle tightness. It should also include checkpoints and milestones to identify potential issues early in the healing process so the medical team can mitigate them before they turn into serious problems.
A well-designed back surgery rehabilitation protocol is your roadmap to post-op recovery. It will help you strengthen and stabilize your neck and back and improve your posture to prevent reinjuries as you resume normal activities. You will also learn about body mechanics to move around safely.
Additionally, a back surgery rehabilitation protocol lays out a phased, week-by-week approach to support your body's healing process. It prevents you from rushing into doing too much too soon and risking reinjuries.
There's no one-size-fits-all approach to spinal surgery recovery—variation in the surgical technique and the patient's diagnosis means some exercises may not be appropriate for certain people.
So how do you know if you're in good hands at an inpatient rehab facility? Here’s what to look for:
Physical therapy protocols are simply guidelines. Your therapist should work closely with your surgical team to customize your treatment plan. An experienced rehab therapist will combine proven methods with their assessment of your health condition to develop a personalized schedule to support your recovery goals.
Your personalized treatment plan must prioritize your safety to avoid reinjuries. For example, it should prevent excessive initial mobility or stress on the back muscles, avoid exercises that exacerbate the pain, and exclude excessive lifting, twisting, or bending in the first six weeks.
It will be very challenging to make progress in your rehab program if you experience pain every time you move. Your physical therapist should help you control pain so you can follow your treatment plan and perform the exercises to build strength.
Each patient heals differently—you may progress faster or slower than the recommended timeline. Your therapist should monitor your progress and assess your mobility to ensure you're hitting the milestones before moving on to the next phase of the protocol.
Your therapist should take the time to answer your questions, help you understand the physical changes you experience, and show you how to exercise correctly to support the healing process. They should also guide you to perform various exercises at home to keep improving your strength and flexibility.
Orthopedic rehab is highly effective for back surgery recovery. It combines spinal surgery physical therapy protocols with other modalities, such as occupational therapy, to help you restore mobility and motor function, build strength, and adapt to your new physical abilities.
After selecting your surgeon and learning about your procedure, you should take the time to coordinate with your physician and plan your post-operative recovery. Often, rehabilitation is not only recommended after surgery—it’s imperative for comprehensive healing.
While there’s no one-size-fits-all spinal surgery recovery protocol, an effective program should contain these components:
Discuss your post-surgical therapy plan with your doctor, compile a list of requirements, and look for a clinic specializing in spinal surgery recovery. Use this list of criteria to narrow down your options, or ask your physician for recommendations.
Once you’ve determined that a provider can provide the therapies you need for your post-operative recovery, you can evaluate additional services available at the facility.
A quality rehab facility invests in professional staff with the appropriate credentials and understands how to care for back surgery patients. If a facility offers multiple types of rehab, make sure it employs specialists knowledgeable and experienced with spinal surgery patients.
It takes a team to help you recover, and it should include these professionals:
Avoid facilities that lack a comprehensive team of qualified specialists. Missing links in the team or the use of untrained staff are two red flags to avoid when picking a spinal surgery rehab facility.
Each team member in your care team must collaborate with each other, coordinate with your physician, and partner with you to create a personalized spine rehabilitation plan and help you meet your short- and long-term recovery goals.
Avoid facilities that advertise a one-size-fits-most approach. Personalized rehab programs require ongoing pain and progress evaluations to make measured adjustments to your treatment plan.
Also, ask about the patient-to-staff ratios at a facility. This number will vary depending on the role. For example, it’s acceptable for your nurse and physician to have a higher ratio and see more patients because you’ll require less one-on-one time with them.
However, your facility should have a low patient-to-staff ratio for physical therapists so you can get a higher level of one-on-one dedicated care to ensure you’re progressing safely and at the right pace.
Spinal surgery patients require specific therapeutic movements for proper healing. An effective spinal surgery recovery plan should include three components to help you achieve the fullest range of motion possible:
Occupational therapy is another critical component of spinal rehabilitation. It helps you engage in various daily activities and transition back to your routine safely as soon as possible.
Also, look for a facility that doesn’t end your care when you walk out the door. They should have a transitional process to follow up with patients to ensure a full recovery.
Selecting the right therapist is also critical to successful recovery. Here's a checklist of questions you should ask your spinal surgery therapist to ensure your choice is a good fit:
Besides spinal surgery, consider other health conditions that may impact your recovery and ensure that your therapist has the appropriate experience and knowledge to handle them.
Your therapist should share a comprehensive, personalized treatment protocol and establish checkpoints and milestones to help you achieve a safe recovery.
Besides exercises, your therapist should incorporate massage, pain management, and injury prevention into the physical therapy protocol—which are essential for a successful outcome.
Your active participation is key to facilitating the recovery process, so make sure you have the time and resources to follow the treatment protocol to reap the most benefits.
Knowing your weekly commitment can help you set aside time and plan your daily activities around your recovery journey.
After your stay at an inpatient rehab facility, your therapist may prescribe at-home exercises and massages to support your ongoing recovery, and you may need help performing them.
Once you’ve covered these topics, you may wish to inquire more about the overall program to be sure you’re working with the best facility for you.
Your physical therapist will work with a team of medical professionals to support your spinal rehabilitation journey. Here are some questions to help you find the right rehab facility:
Most spinal surgery patients require intensive post-procedure rehabilitation. Your doctor will determine if a referral to an inpatient rehab facility is right for you and ensure you can handle the demands of your program before starting your physical therapy.
A stay in a short-term inpatient rehab after spinal surgery will provide you or your loved one with a comprehensive treatment regime carefully structured and coordinated by rehabilitative specialists to help you recover safely and swiftly.
Rehab Select offers post-surgical orthopedic rehab in Alabama that incorporates a multidisciplinary approach into a broad-based, integrated, and customized treatment plan to help shorten spinal surgery recovery while improving your treatment outcomes.
Our post-surgical inpatient rehab is provided by a team of highly skilled professionals who will tailor a recovery plan to meet your specific needs. Contact us to learn more about individualized post-surgical care at one of our Alabama locations and take charge of your recovery.
