Low Back Herniated Discs and Strengthening Exercises

A Good or Bad Combination?

Question: I had a discectomy in June. My surgeon said it takes about 18 months to totally heal, but I am still in a lot of pain. I also have herniated lower back discs (caused by a car accident). Are there any exercises I should do to strengthen my body and help deal with the pain? I'm going to start physical therapy soon, and I want to prepare my body for that.
—Vergennes, VT

Answer: Healing after any spine surgery takes time and most patients experience post-operative pain. In your case, you mentioned you also have lumbar (low back) herniated discs. This may be a source of pain. However, only your spine specialist can determine the best course to take to treat your back pain and you should have a frank discussion with him/her about your pain. To ready yourself, have in mind answers to these questions:

1. If you graded your pain on a scale from 1 to 10, with 10 being the worst pain imaginable, what is your current level of pain?

2. Does your pain level vary day to day and during the day?

3. Is your pain less or more than before the discectomy?

4. What makes your pain worse? What type of activities, positions, or postures?

5. Does resting or anything else help reduce pain?

It is good you want to prepare and strengthen your body for physical therapy! Therapeutic exercise, under the direction of a physical therapist can help to decrease pain, increase mobility - strength - endurance and flexibility, and help you return to normal activities. However, since you have a herniated disc, I would NOT recommend strengthening exercises until you've been evaluated by a professional, like your spine doctor and/or physical therapist. Starting to exercise now can make pain and other symptoms worse!

To help you prepare for physical therapy, let me tell you what to expect. Physical therapy often combines many therapeutic procedures. Your physical therapy program may include:
Portrait of happy men and women on fitness balls exercising with resistance bands Active procedures: In the active part of physical therapy, which is the most important part of all physical therapy treatments, you receive specific therapeutic exercises for your condition. An active approach for your condition might be an evaluation and treatment following the Mechanical Diagnosis and Therapy/McKenzie philosophy.

Pool therapy: Some physical therapy rehabilitation programs offer aquatic exercise, also called pool therapy. If you've ever been in a swimming pool, you experienced buoyancy - your body felt like it weighed less. One benefit to exercising in water is it helps reduce spinal loading and stress.

Passive modalities (therapies): This includes ice/heat, massage, ultrasound, and traction. These treatments are administered while you are at rest and could help reduce your pain and get you ready for active exercise. Passive therapies should always be used in conjunction with active exercises.

Your physical therapy program will be customized to fit your needs. As you progress, your physical therapist will continually challenge you to attain greater physical function. You will also work on reducing your pain.

As part of your individualized program, you will learn exercises to do at home. A home program is extremely important and should be part of all physical therapy treatments. Your physical therapist will give you a routine that may include strengthening exercises.

Schedule your physical therapy evaluation, and soon you will find yourself on the road to recovery!

  • Tip: In most states, patients do not need to visit their doctor first to obtain a doctor's prescription to see a physical therapist. However, it is a good idea to check with your health insurance provider to make sure your physical therapy visit(s) are covered without a referral or prescription.
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