Spine surgery is a major undertaking, and rehabilitation is an important part of helping patients get the most possible benefit from their surgery. Essentially, rehabilitation (physical therapy, exercise) can help patients recover from spine surgery as quickly and completely as possible.

It can be thought of as alignment and balance for your body. If you buy new tires for your car, they won't last as long if they are not aligned and balanced and the new tires will be a waste of money. Your spine surgery is like new tires, and a physical therapist's role is to do the alignment, balance, and engine tuning to make sure that the effects of the surgery are as positive as possible.

There are several ways that a physical therapist typically will work with a patient to help him or her get back into good physical condition and heal from the injury and back surgery.

1. Pain Control after Spine Surgery

A physical therapist is trained to help manage pain following back surgery. Controlling pain is an important first step in allowing patients to regain their strength, as it is very difficult to complete a rehabilitation program if one is in a great deal of pain.


While a certain amount of pain is common in the recovery process, there are several means that a physical therapist may use to help minimize pain, such as:

  • Ice application
  • Certain positions of the spine
  • Certain types of movements
  • Electrical devices (e.g. TENS units)

Many of the techniques for back pain relief are simple and easy to learn and can be done at home or at work throughout the day. For many patients, it is surprising to learn how much simple use of ice packs and/or changes in movements and positions can help alleviate post-operative pain.

See Ice Packs for Back Pain Relief

Ideally, a physical therapist will also provide information and education to improve a patient's overall health and recovery after spine surgery through lifestyle changes, such as drinking enough water throughout the day and finding a comfortable sleeping position.

2. One-on-One Training after Spine Surgery

The therapist will typically develop a training program tailored for the patient, taking into account the patient's specific surgery, body type, and tissue conditions.

Therapists focus on muscle facilitation with areas where the muscles may need special retraining to gain strength and provide stability following the back surgery. This type of exercise therapy may focus on:

  • Muscles in the incision area
  • Muscles that may have been weakened by nerve problems before the surgery
  • Small muscles that work around each vertebra and help stabilize the spine. Most people (even those without spine problems) do not use these muscles very often. However, if these small muscles are trained properly, they can provide excellent stabilization that can protect the spine and protect the newly operated area to prevent future problems.

See Lower Back Stabilization Exercises for Back Pain

Individualized physical therapy may also help with areas where the patient's mobility and flexibility has been limited by spine surgery. Many spine patients have problems with restrictions in their hips or shoulders or other areas of the spine. In these cases, the therapist can help the joints and the muscles involved regain the movement in relation to an individual's body type and physical activities, and will work in the best way with the newly operated spine.

Physical therapists are trained to be sure to select movements that can be done safely around the spine surgery.


3. Exercise for Recovery after Spine Surgery

Exercise is vital to getting better after spine surgery. It is the key to eliminating fatigue, getting patients back to activity safely, and avoiding re-injury. Ultimately, exercise is critical both in helping the body heal from the original injury and in preventing (or minimizing) future episodes of back pain.

A physical therapist develops an individually tailored exercise program based on knowledge of the exact type of spine surgery, and the forces that are most beneficial for the patient's spine under different conditions. Patients will typically learn the exercises with the physical therapist and then do them on their own at home.

See How a Physical Therapist Can Help with Exercise

There are many choices of exercise available for patients. If a therapist and patient work together, they can find alternatives that will greatly benefit the patient's physical condition and capability for resuming activities to almost any level.

Patients often wonder if and when they can return to certain activities after spine surgery. A lot of that depends on how they respond to exercise and can prepare the muscles to protect the spine during that activity. The patient/ therapist team works well in this situation, as the therapist has the opportunity to observe the patient's movement and force tolerances over time.

4. Education about Exercise following Spine Surgery

With one-on-one physical therapy sessions, patients have plenty of opportunity to ask questions of the therapist. Therapists can explain exactly what changes have occurred as a result of the patient's specific surgery, and what can be done to maximize the benefits from that surgery.

Many patients ask the same types of questions about back surgery, so the therapist will usually have enough knowledge to be able to answer most questions right away. Often, if the therapist doesn't know the answer to a question, he or she can speak with a spine surgeon to get the answer. Most therapists will encourage patients to ask as many questions as possible.

Any patient's success in recovery from spine surgery depends on his or her willingness to work hard at home as well as with the therapist. Ideally, the surgery will take the patient a great deal of the way on the road to recovery, and then the patient and therapist team can work together to make the recovery the best possible.

Dr. Carol McFarland is a physical therapist with more than 40 years of therapy experience. She specializes in spine rehabilitation, especially for post-surgery patients, as well as injury prevention and sports injuries.

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