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How does exercise help with pain?

LovinggardenerLLovinggardener Posts: 494
edited 06/11/2012 - 8:29 AM in Back Surgery and Neck Surgery
I went to my first PostOp appointment and saw the nurse practioner at my surgeon's practice. When I told her about my pain, she advised me to increase the walking to 20min. three times a day.

How does exercise help to relieve pain?


  • The reason walking in particular is so valuable beyond the usual reasons (drawing blood to the area, providing better oxygen to the body, etc.) is that it stretches the nerve that was compressed and keeps scar tissue from settling in hard around the nerve.

    I just had this conversation with my surgeon a couple days ago. I asked if I could swim, and he said "sure...you can swim, but you MUST walk" and then he explained that walking is the very best exercise for stretching the nerves in the way they need to be stretched.

    It may not help relieve pain at the beginning, but it helps you heal and makes it so that the nerve will regain its stretch and not atrophy.

  • hi! :H unless we keep moving we will not be able to move. :? it is a difficult fact that we have to balance our movements and our pain levels. a little pain will go a long way to improve your recovery. of course she did not mean for you to overdo. if you find the pain too much, then stop by all means!!!! call your doctor or your nurse practitioner!! :-C you will find it will get easier and you will feel better as you "move" along! =D> good luck and take it easy!! :D Jenny
  • Exercise helps the body start to generate it's own natural endorphins. Narcotic pain meds tend to shut that down and getting it restarted is very important to post op pain control.

  • How far should one walk in a day? I'm walking 1 1/2 miles at 2 weeks post op. My pain is horrible yet.
  • Nicole,

    My surgeon told me I could walk as far as I was comfortable. I slowly increased from roughly 1/4 mile one week post-op to 4-6 miles per day by week 5 (combined from 2 walks per day).

    After the swelling went down in week 8 and I had increased pain, the doctor told me to stop walking as much - he felt I may have been overdoing it a bit.
  • Well, I walked the recommended walks yesterday, but I noticed an increase in pain this morning which was a little alarming. One thing I didn't do was ice my back after the second and third walk.

    While I am lying on ice, I am hoping today will be a better day.
  • One more really good reason for walking --

    People wonder why the inflammation of back surgery or an angry nerve doesn't just "go away" the way inflammation in other parts of the body do. Think of having a sprained finger or ankle -- in a matter of days you can get the swelling to go down.

    The problem with nerve inflammation in the spine, for example, is that there is not a clear avenue for the waste products from the soft tissues to drain away like there is in other parts of the body. If we are sedentary, things are sluggish. When we exercise, walk, the movement increases blood circulation and helps remove the toxic waste from muscle and soft tissue. This will help reduce inflammation which will speed up the healing process.

    You may not be able to walk as far as the PA suggested to you at the beginning. If you have increased pain after your walk and it lingers, cut back on your walk. Also, pay attention to how you are walking. You might want to shorten your stride a bit and walking fast is not necessary. Several shorter walks are more beneficial than one long one and are usually easier for our bodies to handle as we heal.
  • Thank you, Gwennnie! You give the best advice and logical explanation. I just read your suggestion, so next time I walk I will pay attention to kind of strides I am making.

    Today I noticed that I am a little sore surrounding my tailbone. which is a new pain. I really want to return to work next Monday, but I have been taking my pain pills again.
  • My Dr said he would rather me walk several times a day and do short walks than one long one. He says circulation is so important. Just dont overdo. I quit when it starts to bother me. If you do too much, you take one step forward and two steps back. I like my shorter walks. Gives me a chance to take the dog with me. And the warm weather has been great for those of us that had surgerys in Dec in Iowa!! Goood Luck.
  • I have a Proform Exercise Bike. I am walking around quiet a bit, but there is still some pain in the area around the incision. Anyone using an exercise bike to get the additional stretching? I will ask my doctor when I go back on the 26th for second follow up, but just wondering until then. Seems like it would actually be better than walking. I live along a busy highway, and can only walk up and down my driveway.
  • I read one doctor's instructions for post-fusion patients--and he insisted they purchase an exercise bike. I suppose it varies from doctor to doctor.
  • I have been told by a variety of specialists that riding a bike is not better than walking. Actually, nothing is better than walking as walking is the best exercise to stretch out the nerves. Biking is good for building up your endurance and for over-all conditioning, but it is a repititious action that works the muscles and soft tissues the same way. Walking provides more variation as you naturally shorten and lengthen your stride (even ever so slightly) and you put your feet down differently to adjust to the change of surface as you move along. This is also why walking on a treadmill is less valuable than walking outdoors or through a shopping mall as some of us northerners are forced to do during the winter! :O
  • don't know what happened to my last response, but today I am going to walk shorter distances and more often. Once I get going, the pain lessens.

    As far as biking, I hate to sit because it causes pain for me. Walking is the only option right now. I just sold my treadmill and now I wish I had it. What I really would like is an elliptical machine.
  • Be careful if you try an elliptical machine. Before surgery I could use them with no problem, after surgery I couldn't use them without causing a nasty flare.

  • As Gwennie has so astutely stated, walking helps to stretch the muscles in the legs, buttocks, and lower back. Like many of you have already voiced and experienced walking tends to reduce our pain. I believe that the circulation and movement from walking helps to "break up" scar tissue and "loosen up" potentially impinged nerves. I have noticed that the numbness in my legs is far more prevalent when I am sedentary than when I force myself to walk.

    Regarding the bike, I think that walking is far superior for recovery. For starters, walking is much more "load bearing" in that one is required to move their own body weight through "space" - While a bike supports most of your body weight because you are sitting down. In my opinion, this would not stimulate bone growth as well. One must also consider that for many people after a LB fusion sitting for prolonged periods of time can be painful. In addition, you will have a much shorter range of motion when pedaling on a bike compared to the strides one would take when walking with a normal gait. For some, if safe, taking long strides when walking will help to loosen the muscles.

    I own several pieces of cardio equipment (treadmill, bike, stairmaster, concept 2 rower, etc...) and I would rate the bike an excellent secondary choice for people during recovery. In my opinion, the best bike for the money is something like a Schwinn Airdyne where one can pedal with the feet and push/pull with the arms using the upper body handles. By having the option to work both legs and arms at the same time you would create more circulation in the body. Even more beneficial is the ability to help weaker limbs. For instance if someone has sciatica in the legs, they can use the arms to assist in the exercise. Likewise, if someone has pain and tingling in the arms the legs can lend support to the upper body.

    I think a bike could be the primary form of cardio for an individual who is unable to walk. I also believe the bike can add variety and some people just enjoy biking instead of walking. I always tell people that the best form of cardio is the one you will do and stick with. In other words, mix your routine up so you don't go crazy!

    A word about stretching and core work ...... VERY IMPORTANT. I have found since my operation that the walking helps "prime me" for some light stretching. I am unable to do any strength training yet (including core work). I do not dare until I have a clear fusion, but in the future, I would only engage these activities after warming up.

  • I have not had a fusion, but one is possibly in my future. Does anyone know how soon after a fusion you can do core exercises? It seems like these exercises would help to stabilize the core and essentially be great for a fusion. Just curious, since I do planks and variations of this exercise every day - and they have really strengthened my stomach, lower and upper back, lats, everything.

  • Oops - forgot one question... If you exercise regularly before a fusion, can you get back to it sooner after surgery? Sorry, so many questions - I'm so scared of having a fusion, but that's what the doctor is leaning toward.

  • What about stretching hamstrings? I have been stretching mine by simple standing and then putting one leg up on the third stair riser--let it stretch for 30 seconds, then the other one. Stretching my hamstrings has always relived my back pain and has done so during my recovery as well. However, I would caution not to do it too soon after surgery. I stretched mine out at week one and paid for it the next 2 months (I couldn't stand in one place without the feeling that my hamstrings were being stretched out--it was crazy). Thankfully, that issue has gone away, but I wonder if I am really helping things by stretching my hamstrings so much (I do it MANY times throughout the day). I do this and walk, walk, walk. I have found that while walking is great, it does cause later pain. I wonder if the pain it causes is worthwhile--if it is "good pain" as in pain that is causing fusion, then of course it is great. I wonder the same thing about the hamstring stretches. I asked the PA and she said to go ahead and gently stretch the hamstrings since mine are so tight. Maybe I'm just doing too much. Still in pain at 4 months. But it has gotten better, I suppose. It is hard to tell with the pain med variations.

  • I haven't done any stretching except for the ones I was taught to do while in bed. Today I have my first PostOp physical therapy. I am actually looking forward to getting some tips on stretching. I can feel the tightness all over my body. Before surgery....well... before pain started...I did yoga three-four times a week.
  • When you're cleared for more stretching there is a very good yoga DVD for back patients. It is Viniyogatherapy for the low back, sacrum and hips by Gary Kraftsow. It is the only DVD approved by the NHS and it is "designed to feature short therapeutic yoga practices designed to alleviate pain and promote health in the low back, sacrum and hips."

    It shows you have to safely perform yoga postures so that you improve the strength in you spine and do no damage.

    Check it out when you are ready for it. I think you'll like it.

    Good luck today with PT. Let us know how it goes.
    xx Gwennie
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