Postoperative rehabilitation exercises for lumbar disc herniation

Lumbar disc herniation is a syndrome caused by degeneration of the intervertebral disc, rupture of the fibrous annulus, and protrusion of the sacral nucleus tissue to irritate and compress the nerve roots. The main manifestations are lumbago and sciatica, which may be accompanied by limitation of lumbar movement and changes in sensation, movement and reflexes in the area innervated by the affected nerve roots. Non-surgical treatment and surgical treatment are often used. Non-surgical treatment methods: absolute bed rest, pelvic traction, massage, physiotherapy, epidural closure; surgical treatment methods: open window medullary nucleus removal, etc. Functional exercise program from the first day after surgery Phase I: (3-5 days) ①Straight leg raising exercise in supine position and lower limb flexion and extension exercise: prevent nerve root adhesions, starting from 30° for the first time, holding time from 15 seconds gradually increase, 10 times/group, 2-3 groups/day. (2) Ankle dorsiflexion and plantarflexion exercises: hold each movement for 10 seconds, repeat 20 times/group, 3-4 groups/day. Phase 2: (mainly do lumbar back exercises) ① 5-point support method: (5-7 days after surgery) Lie flat on a hard bed, use head, feet and elbows to support at 5 points, lift the hips up and raise the buttocks as high as possible. Hold for 10 seconds, repeat 20 times/group, 2-3 groups/day. ② 3-point support method: (7-9 days postoperative) Lie flat on a hard bed, support with head and feet at 3 points, hold the hips up, and lift the hips as high as possible. Hold for 10 seconds, repeat 20 times/group, 2-3 groups/day. ③ 4-point support method: i.e. arch bridge support method (9-10 days postoperative) Lie flat on a hard board bed and support your body with both hands and feet all the way up in the shape of an arch bridge. Hold for 10 seconds, repeat 20 times/group, 2-3 groups/day. ④Flying swallow point water method: (10-15 days after surgery) lying prone with the hard board bed, head, both upper limbs, both lower limbs posterior extension, abdomen touching the bed area as small as possible, in the shape of flying swallow. Hold for 10 seconds, repeat 20 times/group, 2-3 groups/day. Phase 3: (Starting 30 days after surgery) Instruct the patient to use the waist girth correctly to avoid twisting the spine when moving around. Choose a waist brace that corresponds to the patient’s body type, usually up to the upper rib arch and down to under the iliac crest, and should not be too tight. Practice getting out of bed with the lumbar girth on, i.e. standing with feet shoulder-width apart, hands crossed at the waist, chest up and abdomen out, so that the lumbar back muscles contract. When walking with correct posture, head up, chest up and abdomen in, sitting position must be upright, do not bend over. Discharge health education ① Continue the exercise content learned in the hospital after discharge, selective implementation, the number of times time depends on the specific situation, the amount of exercise gradually, a certain interval in the exercise, to avoid excessive strain on the waist. ② Do not use waist brace continuously for more than 3 months to avoid muscle wasting atrophy. ③ Avoid strenuous activities and lifting heavy objects within 3-6 months, avoid sitting for as long as possible, running, jumping, avoid sleeping on a soft bed, take a bending knee and squatting posture when lifting heavy objects from the ground to extract, establish a good life style, change sitting posture frequently, strengthen lumbar back muscle exercise for more than six months to enhance lumbar muscles and spinal stability. Reduce the onset of chronic low back pain, prevent lumbar injury and review of lumbar disc herniation. ④Strengthen nutrition and maintain a good state of mind. ⑤ Pay attention to keep warm and avoid cold stimulation.