I am always amazed at how doctors and patients alike feel physical therapy after spine surgery is optional. Sure, patients always have the choice, but why go through a major surgery not to do EVERYTHING you can to recover better and faster?

Going to therapy 3 days after surgery may be aggressive. BUT after 1 month of recovery, therapy is certainly appropriate. A 2016 meta-analysis (the highest level of research) reports those who attended physical therapy 4 weeks after surgery had significantly LESS pain and NO increase risk of adverse events. Why then do more individuals following back surgery not go to therapy? (After 9 years in practice, I have seen a very small proportion relative to the number of spine surgeries. AND I live in an area with a high rate of spine surgery).

Why does advice from surgeons on therapy vary? Ask your (potential) surgeon about this. From a physical therapist’s perspective, the answer on physical therapy after spine surgery is…ALWAYS YES. After any surgery, whether “minimally invasive” or not some trauma to the muscles and tissue elements in that area happen. This is especially true for low back surgery. The initial problem(s) may be “fixed”, but the trauma from surgery is real and must be addressed. While there is a need for a period of relative rest as prescribed immediately post surgery, return to normal life is not as simple as just walk it off.

Studies (Here, HERE and more HERE) show muscle atrophy (and development of fatty tissue within once healthy tissue) does not spontaneously resolve after surgery. The muscles have been found to look like a piece of poor quality fatty steak. You cannot allow that to happen.

Research reports reduced strength and endurance in low back muscles that persist years afterward, even in individuals who completed an exercise regime post surgery. Studies and even doctors recommendations suggest individuals who do nothing after surgery tend to develop secondary issues years later. There is NO need for this to happen.

So what should one do to avoid these issues?

Really question your surgeon on why or why not they think therapy is or isn’t necessary. If they do not offer physical therapy, then let them know you wish to attend anyway. If they do recommend physical therapy, then check with them if they recommend any with experience or expertise in treating these types of issues. I will tell you; though my opinion is biased, not all physical therapists are equal. And some will not admit their lack of experience or knowledge.

If you had back surgery years ago, help is still available. You do not have to suffer any more. If you feel that your back is not as strong as you want. OR if you notice some daily limitations, then talk to your surgeon, PCP, or even a physical therapist you may have seen in the past for guidance. It is never too late to improve the strength, flexibility, and control of your back to enable greater function and independence in your daily life. The only wrong answer is to do nothing.

If you are looking for some tips to ease your back pain today then click HERE. These tips may be able to start you down the right path. BUT there is no substitute for hands-on 1-on-1 care.