We have summarized the frequently asked questions of low back pain patients in outpatient clinics, from which we have selected some easy-to-understand ones in the hope that they can be of some help to low back pain patients.
1.Is it better to stand or sit when I have low back pain?
The load on the lumbar region should be reduced as much as possible both during and between episodes of low back pain, and this can be achieved to a certain extent through posture and postural adjustment. The impact of body position and posture on the lumbar spine load can be summarized as “sitting is better than standing, standing is better than upside down”, which means that the load on the lumbar spine is greatest when sitting and least when lying down. Specifically, if the pressure within the disc in the standing position is regarded as 100%, then the pressure within the lumbar disc in the supine, lateral and sitting positions is 25%, 75% and 140% respectively, 150% in the slightly forward leaning standing position, 185% in the slightly forward leaning sitting position, 220% in the forward leaning standing position and 275% in the excessive forward leaning position. Yang Yan Yan, Center for Rehabilitation Medicine, Peking University Third Hospital
Regardless of the position or posture, it is not good to last for too long. Because in any position or posture, there will be corresponding muscles and ligaments in a state of tension, which will cause fatigue of these muscles and ligaments if it lasts too long, thus decreasing the stability of the lumbar region and eventually leading to an increase in the load on the lumbar spine. Therefore, in daily life or work or try to avoid maintaining a certain position or posture for a long time. If the work has a need for posture (such as software engineers), it is best to ensure regular rest, if necessary, you can use a small alarm clock and get up regularly to do relaxation exercises, etc.
2.What do patients with low back pain need to pay attention to in their daily life?
One of the characteristics of low back pain is recurrent attacks, so in a sense, prevention is more important than treatment. In the daily activities, patients with low back pain need to pay attention to the following matters.
(1) correct sitting posture: when sitting, try to keep the lumbar muscles relaxed to reduce the pressure on the lumbar disc on the basis of the lumbar vertebrae being as convex as possible, if possible, you can keep the lumbar vertebrae physiologically convex with the help of the back pad roll or leaning backwards on the seat back, which ideally can reduce the pressure in the disc by 300%. But even so, prolonged sitting is still detrimental to the lumbar bones and soft tissues. It is generally recommended that about 1 hour of continuous sitting must get up to carry out activities in all directions of the waist, so that the muscles are fully relaxed and timely rest.
(2) Correct standing posture: head up, mild convexity of the waist, abdomen, no hunchback. In the queue, waiting for the car, often people are accustomed to weight on one foot, in the long run may also lead to the spine, lower limb muscle imbalance, should be consciously adjusted.
(3) the correct transfer method – rolling log transfer method, meaning the so-called overall transfer, refers to the torso in a straight line when turning over, moving on the bed surface and sitting up from the supine position.
(4) The correct posture when carrying heavy objects: stand close to the heavy object, bend the knees, bend the hips, that is, keep the waist upright state squatting, after using the strength of the legs to rise and lift the heavy object, stand straight, move the legs and turn around to avoid twisting the waist.
(5) Posture to be avoided: Avoid any posture that will cause increased pressure within the intervertebral discs such as repeated forward bending, weight bearing and twisting of the lumbar spine, especially during the acute phase of low back pain, which is essential to reduce the symptoms. It is generally recommended to avoid lifting or carrying heavy objects over 4.5kg during the acute phase of low back pain, and gradually increase the weight thereafter according to the patient’s response.
3.Why do patients with low back pain need to sleep on a hard bed?
It has become a common sense that patients with low back pain should sleep on a hard bed. What is the rationale? This is mainly related to the pressure load on the lumbar intervertebral disc. As mentioned earlier, the lumbar discs are subjected to the least load in the recumbent position, mainly because the weight of the upper body no longer exerts pressure on the lumbar spine. In addition, the bones, muscles, ligaments and other soft tissue tension also affects the load due to the lumbar spine to some extent. Too soft mattress is not suitable for patients with lumbar pain, because at this time the patient’s spine is in a state of scoliosis, muscles, ligaments are also in a state of imbalance, do not get sufficient rest. Therefore, regardless of back and leg pain patients or healthy people, it is recommended to sleep on a soft and firm bed to reduce or prevent the occurrence of back and leg pain.
4, low back and leg pain can “lie well”?
Some young patients are very impatient during the acute phase of low back pain and always want to move and start various functional exercises as early as possible. Unbeknownst to them, rest itself is a primary and necessary treatment for patients with low back and leg pain. In the acute stage of low back pain, it is generally recommended that patients rest strictly in bed for 2-3 weeks, which can effectively reduce the pressure of weight on the lumbar disc, promote the absorption of local inflammation, reduce the stimulation of nerve roots, and thus reduce pain or even make the pain disappear. Therefore, low back pain patients “lie well” is not just talk.
So, is it better to “lie on your back” (supine position) or “lie on your side” (lateral position)? For the pressure on the lumbar intervertebral disc, in the hip flexion supine position, the lumbar muscles are more relaxed, can make the lumbar intervertebral disc pressure further reduced; and hip extension supine position is due to lumbar muscle tension and to a certain extent increase the local pressure; prone position, lumbar convexity increases, pulling the muscle, will also lead to increased load on the lumbar intervertebral disc. However, for patients with low back pain, the muscles of the lumbar region are often already in a state of imbalance, and the lumbar discs may already have pathological changes such as bulging and herniation, so the general rules may not necessarily apply. At this time, according to the patient’s response to decide the position, simply put, is “how comfortable how to lie”, because “comfortable” is actually the bones, muscles, ligaments and other soft tissue is more relaxed state.
5, back and leg pain can “lie down well”?
In addition to lying, “lying down” is also a good posture treatment for patients with low back pain. A very famous therapy for low back pain – McKenzie therapy (McKenzie therapy) is from “lying down”. There is a little story here: Robin McKenzie. McKenzie (Robin McKenzie) was a doctor in a small town in New Zealand in the 1950s, and he had an “old patient” – Mr. Smith – who had recurrent back and leg pain due to a herniated disc. One afternoon, when Mr. Smith again holding his back, supported by people into Dr. McKenzie’s clinic, Dr. McKenzie is busy, they casually pointed to a treatment bed, so that Mr. Smith temporarily lying on it waiting for him. Who knew that when he was done turning back to Mr. Smith, he had disappeared. It turns out that Dr. McKenzie with the finger of the treatment bed is a patient to other patients after treatment has not had time to lower the end of the bed, the “V” shaped bed. The pain was so severe that Mr. Smith had no way to lie on it, who knew that lying on his back, the pain actually disappeared. Since then, the “regular” basically do not patronize the small clinic, because whenever he had an attack of back and leg pain, will be at home according to the position in the clinic at the time to lie down for a while, the pain will be relieved. Dr. McKenzie was inspired by this, it created the famous McKenzie therapy.
In fact, for the general public, “lying” on the waist is also a good health action. The human body every day from the opening of the eyes, washing, toilets, dining, driving, sitting at a desk at work …… statistics down, a day of bending movements as many as 3000 to 5000 times, while the back of the spine is only 60 to 70 times, which is a set of extremely unbalanced data, is also one of the reasons for the unbalanced force on the spine . Therefore, lying on the chat, watching TV not only can be cute, but also effective treatment and prevention of low back pain!
6, low back pain patients need to wear a waist?
The main principle of the waist is the use of elastic material wrapped around the torso, the pressure on the bone and soft tissue, and improve the intra-abdominal pressure, thereby reducing the load on the bones, muscles, ligaments and other soft tissues, and limit the movement of the spine, so as to relieve the pressure in the intervertebral space to a certain extent, in a relaxed position to reduce the burden of ligaments around the lumbar spine, to ensure that the local tissues get sufficient rest, and ultimately to reduce or eliminate The purpose of reducing or eliminating pain, delaying the course of the disease and improving the quality of life. Most patients with lumbar pain can be relieved in the acute stage by wearing a peri-waist. For patients with large herniated lumbar discs or lumbar spondylolisthesis, wearing a peri-waist during long-distance bus and airplane rides can help enhance lumbar stability and prevent acute trauma.
However, for patients with chronic lumbar pain, long-term application of the peri-waist is never advisable. This will cause a decrease in muscle strength and joint mobility of the low back due to “use in and out”, thus causing disuse muscle atrophy and making the patient dependent on the peri-waist.
7.What kind of peri-waist to buy? Hard or soft is good?
Spinal orthoses can be divided into hard, semi-rigid and soft, the people say “waist” generally refers to soft spinal orthoses, that is, canvas, mesh nylon fabric or other elastic fabric as the main material, with the addition of elastic support to enhance the product. In general, the poorer the lumbar stability, the more prominent the bony problems, the more appropriate to choose a rigid waist, while muscle, soft tissue problems or mild lumbar disc herniation, lumbar spine slippage and other causes of lumbar pain to choose a general soft waist. The choice of perioperative peri-waist should follow the opinion of the surgeon and orthopedist, and be replaced in a timely manner according to the progress of the disease and rehabilitation training.
8.Why should I exercise the lumbar and abdominal trunk muscles?
The human body is like a machine, which is prone to strain and problems after years of use. The lumbar and abdominal muscles have a vital role in maintaining the stability of the entire spine, as we age, the strength of the lumbar and abdominal trunk muscles gradually weaken, this role will become less and less, the spine, especially the lumbar spine problems will ensue. According to statistics, after the age of 50, muscle strength will decrease at a rate of 15% every 10 years, and after the age of 70, it will decrease by 30% every 10 years. Therefore, not only patients with low back pain, but also healthy people should start early to perform the necessary lumbar and abdominal trunk muscle strength exercises to enhance trunk stability and reduce or prevent the occurrence of low back pain.
Patients with low back pain should pay particular attention to the strength exercises of the trunk muscles of the lumbar abdomen, and also pay attention to the targeted selection of exercise programs. Studies have shown that chronic low back pain patients often have late postural atrophy of the transversus abdominis muscle, and a herniated intervertebral disc can lead to atrophy of the multifidus muscle when it compresses the nerve root. Therefore, low back pain patients in addition to exercise the strength of the large lumbar and abdominal muscles, the training of small muscle groups is also essential, so as to improve overall lumbar stability and reduce the additional mobility of the damaged segments.
9.Can community fitness equipment be used to exercise the lumbar and abdominal trunk muscles?
With the continuous improvement of community facilities, many communities have placed a variety of fitness equipment, some of which are beneficial to the strength of the lumbar and abdominal trunk muscle exercises. However, for people who have experienced back and leg pain, when applying equipment exercise must be measured, do not be too hasty to cause injury. For example, there is a fixed hands, feet standing on a disk twisted around the equipment, the lumbar and abdominal rotational muscle groups have a good exercise, but because the equipment itself can not limit the range of activities, if not properly controlled, that may be too much range of activities lead to lumbar sprain, the author has encountered such cases in the clinic.
10, lumbar and abdominal trunk muscle strength exercises are always missing the effect is how?
Muscle strength exercises do not work often from improper training methods, not enough strength or not enough time.
The abdominal muscles and lower back muscles have upper and lower fibers. Which part is the weak part? Or is it the rotator muscle group? Before starting training, it is best to go to the hospital for a systematic evaluation by a physician or therapist and choose a targeted training method based on the results. Many patients say, “I know, I know, I’m a swallow flyer!” as soon as they hear the doctor tell them to train their low back muscles. .”. Unbeknownst to them, a simple swallow fly can have several different movement designs, different movements can be divided into different training patterns such as isometric or isotonic training, and different training patterns can have several different exercise prescriptions. Therefore, different “swallows” to choose different “flying” method, in order to make training to play a multiplier effect.
How to control the intensity? Classical plyometric training emphasizes the principle of “overload recovery”, which means that during sports training, the level of movement decreases during training due to fatigue, and then recovers during rest. Interestingly, the level of movement does not stop when it returns to the pre-training level, but continues to “recover” and improve on the original level, that is, “over-recovery”. If you can do the same exercise training again during the “over-recovery” period, the level of exercise can be so repeatedly improved. People’s sports training is very difficult to strictly follow the principle of over-recovery. However, at least to do is to train to fatigue, the interval between training should not be too long. It is generally recommended to practice 1-2 sets per day and to stick to daily or every other day practice.
A good exercise training program will take time to see results. Muscle strength is a gradual process, after mastering the correct and effective method must be long-term, persistent practice to get good results. In general, even if the method is appropriate, outpatients often need to adhere to the practice of 2-3 months to see more obvious results.
11.For the lumbar spine, are traditional exercises such as taijiquan and five-animal play better or fashionable exercises such as yoga and Pilates?
As a traditional Chinese sport, taijiquan and five-animal play can be described as profound and profound, and is a very good aerobic training program. Taijiquan training requires a neutral stance, a false spirit, and a drooping coccyx, which can effectively adjust the posture of the spine, as well as requiring the movement of rigidity and flexibility, continuous, and full of internal strength in a soft and slow movement. It helps to strengthen the trunk muscles of the lower back and abdomen or improve the mobility of the lumbar spine.
Yoga, Pilates and other fashionable exercises can also be tried for patients with low back pain. However, some of these movements require isometric contraction at the limit position, that is, hold for a while, if the muscle strength is not enough to maintain the posture and may lead to muscle strain or even aggravation of lumbar pain. Therefore, before exercise to warm up, exercise to remember the strength of the line.
12.What sports are suitable for patients with low back pain?
After suffering from low back pain, it is necessary to make appropriate adjustments to sports and recreation programs. Swimming is the first choice, because the buoyancy of water can effectively remove the load of weight on the waist, which is a very good “weight reduction” exercise. In addition to swimming, walking in the water is also a good exercise, forward, backward, lateral walking can exercise to different muscle groups, while the water “strong is strong” characteristics can provide different resistance to exercise at different speeds. In addition, badminton, dance and other projects that require trunk stretching are also good choices.
Patients with low back pain often ask if they can still play golf, tennis, table tennis or other sports that require the lumbar spine to bend and twist in the future, the answer is yes, but only on the basis of good preparation. For this type of sports with high local stress on the lumbar spine, it is important to have a physician assess the mobility and stability of the relevant spinal segments before returning to sports, and according to the results of the assessment, the movements required for the special sports are incorporated into the rehabilitation training and simplified and decomposed, so that the three-dimensional movements are first decomposed into two dimensions, that is, movements on a plane, and then combined into an actual sports movement after good practice. Then gradually increase the difficulty and volume of movements, and eventually return to special sports.
Post-operative rehabilitation related.
13.Is it better to lie down for a month or two after lumbar spine surgery to facilitate recovery?
Many patients think that “it takes a hundred days to break a bone”, so they should lie down in bed to recuperate after surgery. In fact, prolonged bed rest can be harmful to the recovery of the disease. For local tissues, whether bone tissue or muscle, ligaments and other soft tissues, proper stress stimulation is more conducive to tissue growth and healing. On the contrary, prolonged bed rest may lead to postural hypotension, deep vein thrombosis, pressure sores, osteoporosis and other complications, which may eventually cause adverse consequences and may even endanger life. Therefore, in the early stage after lumbar spine surgery, we advocate that patients overcome their fear early, actively carry out various rehabilitation training within the safety range, and get out of bed as early as possible, which is more conducive to functional recovery.
14.What is “nerve pulling”?
After lumbar spine surgery, in order to avoid nerve root adhesions, it is necessary to start movement exercises for the sciatic and femoral nerves as soon as possible within a safe range. Studies have shown that this allows the nerve roots to move 2-6 mm within the nerve root canal and can be effective in preventing or relieving local adhesions. During the exercise, take care to keep the spine in a protected position and gradually apply pressure to the nerve root, holding it for 6-10 seconds in the position where the nerve root pain occurs, and then relaxing. Each group of exercises can be performed 2-3 times, and should not be repeated or over-stimulated.
15.How long can I sit up after lumbar spine surgery and how long can I walk down to the ground?
Strictly speaking, this question needs to be answered by the surgeon. Generally speaking, patients who have undergone surgery for lumbar disc herniation or lumbar spinal stenosis can begin sitting and standing exercises immediately after surgery, even if they have undergone fusion surgery. However, it must be emphasized again that each patient’s intraoperative condition is different, and even for the same surgery, the process of postoperative sitting and standing training may be affected by the patient’s local bone density condition, intraoperative operation problems, etc. Therefore, the official start of sitting or standing training must be approved by the surgeon.
If not specifically instructed by the surgeon, the patient can generally begin to try to rock the head of the bed about 15° on the first day after lumbar spine surgery, gradually increasing the rocking angle and aiming to rock the bed to nearly 90° within a week (the drainage tube should be removed). After that, you can start to practice bedside sitting, starting from 5 min and gradually increasing the duration of bedside sitting, aiming to be able to maintain the sitting position for meals by 2 weeks after surgery, i.e., about 20 min of continuous bedside sitting. Adjust the seat backrest to 100-130 degrees to reduce the load on the lumbar region. The surgeon should also be asked if and what type of support (bib) is needed before bedside sitting training.
As for the standing training, it can be started at the same time as the bedside sitting exercise. Generally, you can try bedside activities, i.e., “walking on the floor”, after standing for 10 min with an assistive device such as a standing frame, walker or crutches for 5 min. Do not rush out of the assistive devices, because the proper application of assistive devices not only can ensure safety, but also can relieve the local pain in the acute postoperative period due to the reduction of lumbar stress.
16.How long after lumbar spine surgery can I do bending movements?
Patients often encounter difficulties in bending after lumbar spine surgery. Some patients refuse to bend after surgery because they were unable to bend for a long time before surgery, while others are afraid of bending because of the metal internal fixation in the lumbar region. In fact, it is better for tissue healing and functional recovery to start bending and turning training as early as possible within the safe range.
So, what is meant by “within the safe range”? It is generally accepted that weight bearing, repeated bending and twisting, and prolonged sitting should be avoided for 4 weeks after surgery. After that, you can gradually try bending, twisting and weight-bearing movements, and judge whether you can increase the intensity of exercise according to the change of symptoms. It can be considered that after 4 weeks after lumbar spine surgery, as long as the movement and intensity of movement do not cause aggravation of symptoms related to the back and legs, they are appropriate and within the safe range.
17.Does having lumbar fusion surgery mean that I don’t need to exercise my low back muscles?
Some patients think that after lumbar fusion surgery, there is no need to exercise the lumbar back muscles or it is useless to do so because there are steel plates and nails there to support them. It is important to know that after the internal fixation surgery, the metal internal fixation can take part of the stress. However, for the human body, the metal internal fixation is only a temporary scaffold before biological healing, and the human body still depends on the biological fusion of local bone and its surrounding tissues to maintain trunk balance. Surgery addresses only the bone and disc of the segment in question, and does not deal with other spinal segments and soft tissue problems such as muscles. Patients with low back pain often accumulate some lumbar flexion mobility relative to the hip, elongation of the paravertebral muscles, and shortening of the gluteus maximus or N cord muscles in their daily lives. In short, the problems of patients with low back pain are not limited to the problems addressed by surgery. Even after lumbar fusion, postoperative muscle training for lumbar stability, mobility, and related muscle groups must be performed in order to more effectively consolidate the efficacy of surgery and prevent recurrence.
For patients after lumbar spine fusion, the lumbar back muscle exercises during the healing period must take into account the different mechanical stresses on the local area, especially at the ends of the fused segments, so as not to affect the local biological healing, which is the concern of “affecting the long bones”. In general, the supine lifting of the legs is the most stressful for the internal fixation, so it should be avoided for 4 weeks after surgery. Other plyometric exercises can be judged according to the patient’s pain performance after training, that is, if the pain increases after a certain movement, it means that the exercise is not suitable for the time being.
18.Is it unnecessary to perform lumbar stability exercises after lumbar spine fusion?
Similar to the previous question, many patients believe that after lumbar fusion surgery, they do not need to perform lumbar stability exercises because they are “supported by plates and nails”. Similarly, metal internal fixation is only a temporary brace before biological healing, and the body ultimately relies on the biological fusion of the local bone and its surrounding muscles and ligaments to maintain trunk balance. Therefore, even after lumbar fusion surgery, lumbar spine stability exercises are essential.
Lumbar stability exercises must be based on the recovery of lumbar muscle strength and the basic stabilization of lumbar pain, and are generally started 4-6 weeks after surgery. Firstly, the exercises should be started from supine position, and then progressed to prone position and simultaneous hand and foot exercises.
19.How long after lumbar spine surgery do I start lumbar and abdominal muscle strength exercises?
The first day after lumbar spine surgery, you can start the exercise of lumbar and abdominal trunk muscle strength. Before going to the ground, you can do isometric training in bed, that is, the training of abdominal and lumbar back muscles contracting with force, but not causing trunk movement. After that, gradually transition to double bridge, single bridge, swallow fly and other training, prescriptions from the isometric start, stability increased before you start to try isotonic training. Even during the period of wearing the girth, strength training of lumbar and abdominal muscles can be performed to prevent local muscle atrophy.
20.Do I need to exercise upper limb strength after lumbar spine surgery?
While exercising the strength of the trunk muscles of the lumbar abdomen, postoperative patients must not forget to exercise the strength of the upper limbs at the same time, which is the basis for bed activities as well as standing and walking exercises after getting off the floor. The easiest way is to apply dumbbells or leather bands and start training during the bed rest period.
21.How long do I need to wear the brace when I go to the floor after lumbar spine surgery?
There are different opinions on the time needed to wear the waist when moving around after lumbar spine surgery. Generally speaking, it is not necessary to wear the waist after simple open surgery, or to wear the waist for a short period of time (within 2 weeks) to reduce pain in the operated area; after laminectomy and decompression surgery, it is required to wear the waist for at least 4 weeks due to local trauma; patients with bone graft between vertebrae and transverse processes should further extend the time of wearing the waist to about 3 months.
Of course, the general rule stated above is only for reference, and the specific situation of each patient is different. Even for the same surgery, the local stability may vary due to the local bone condition, soft tissue condition and the different circumstances of the surgical operation. Therefore, it is up to the surgeon to decide how long to wear the girth after surgery for each patient.
In addition, it is important to remove the peri-waist in a gradual manner. First, the waist should be removed for bedside activities, then for indoor activities if there are no symptoms such as increased pain or instability, followed by removal of the waist for activities in a small area, and finally for complete removal from the waist. It should be noted that, unless under certain special circumstances, the time spent wearing the peri-waist should not exceed 3 months, in order to avoid dependence on the peri-waist and atrophy of the trunk muscles, which will eventually lead to further deterioration of lumbar stability.
22.What should patients pay attention to in their daily activities after lumbar spine surgery?
After early rehabilitation training, postoperative lumbar spine patients are generally able to carry out various activities of daily living independently in about 6 weeks after surgery. The following points need to be noted in daily activities.
(1) Rolling log transfer method, meaning the so-called overall transfer, means keeping the trunk in a straight line when turning over, moving on the bed surface and sitting up from the supine position.
(2) Avoiding any posture or movement of the lumbar spine that causes increased pressure within the discs, such as repeated forward flexion, weight bearing, and twisting, especially during the acute phase of lumbar pain, is essential to reduce symptoms. It is generally recommended to avoid all lumbar activities, including lumbar forward flexion, back extension, lateral bending or rotation, continuous sitting for no more than 20 min, lifting heavy objects over 2.3 kg, and not landing on hands and feet at the same time during the acute postoperative period (2 weeks after surgery). When the patient has to lift heavy objects, try to adopt a squatting posture and bear the load with the strength of the lower limbs to avoid an increase in local load due to lumbar forward flexion.
(3) Try not to sit continuously for more than 20 minutes at a time during the acute phase of lumbar pain or 2-4 weeks after surgery, and use lumbar back rolls or adjust the seat backrest to 100-130 degrees whenever possible.
(4) Design of protective environment and application of assistive devices: As mentioned above, postoperative lumbar patients need to pay attention to the protection of the lumbar region at all times in their daily life activities, which in many cases depends on the design of protective environment and the application of assistive devices. The former refers to the modification of the living and working environment so that it is conducive to the protection of the lumbar region, for example, the position of the items that need to be accessed daily should not be too low, and the office chair of the clerk needs to provide supportive protection for the lumbar region; the latter refers to the application of assistive devices for certain daily activities to reduce the cumulative injury to the lumbar region, for example, the application of long-handled shoe plugs and elastic shoelaces to reduce activities such as repeated lumbar forward flexion.
(5) Selection of activity items: Some optimistic patients think that they can do everything after lumbar spine surgery, but in fact, this is not true. The postoperative activity ability of patients is related to their age, preoperative activity level, concomitant diseases and other factors. For example, if a patient has severe lumbar spinal stenosis and has a preoperative walking ability of less than 50 meters, it is difficult to achieve a functional level of weight-bearing long-distance walking after surgery, even after lumbar spine surgery.
23.How long after lumbar spine surgery can I buy groceries and go shopping?
Postoperative lumbar spine patients must assess their activity needs and their motor ability before attempting activities such as grocery shopping and shopping. For example, grocery shopping requires a certain level of walking ability, and if the patient is not yet able to carry weight, a shopping cart can be used, so the patient can start trying a few weeks after surgery. Shopping, on the other hand, requires a certain level of walking endurance and weight-bearing ability. Generally, patients should try not to carry more than 2.3 kg (5 pounds) of weight within three months after lumbar spine surgery, so we recommend that patients try long-distance and prolonged shopping activities three months after surgery.
24.How long after lumbar spine surgery can I do housework (e.g., cooking, mopping)?
Most domestic work, such as cooking, mopping and washing clothes, requires repeated forward flexion and rotation of the lumbar region. Theoretically, activities such as repeated lumbar forward flexion, back extension, lateral flexion or rotation should be avoided within 3 months after lumbar spine surgery, therefore, it is best to start domestic work after 3 months after surgery. If conditions do not allow, such as living by yourself, and you have to start doing housework in the early postoperative period, you must control the intensity and time, and never wait until local pain appears before stopping labor, because at that time it is likely to have caused damage to the local tissues.
25.How long can I return to work after lumbar spine surgery?
Due to the accelerated pace of social life and work, there is an increasing trend of younger and younger people having surgery for lumbar pain, and many patients are concerned about how long it takes to return to work after surgery. A reasonable answer to this question can only be given for a specific patient, as it requires consideration of various factors such as the surgery, the patient’s own condition and the workplace’s demand for human activity.
Generally speaking, if surgery is performed for common lumbar disc herniation and lumbar spinal stenosis, patients should actively train for muscle strength, endurance, trunk stability, and daily life movements after surgery, and strive to resume normal daily activities within 4-6 weeks after surgery, and on this basis, strengthen functional training such as sitting, standing, or walking in a targeted manner according to the needs of the workplace, and strive to return to work from three months after surgery. At this time, office clerks should be able to insist on sitting for about 45 min, and mall sales should be able to insist on standing for about 1 hour.
However, it should be noted that whether it is office work or manual labor, the workload must be adjusted gradually from light to heavy, according to the patient’s fatigue and pain level, until the full amount of work can be resumed. Moreover, we often have to repeatedly emphasize that in the first three months after resuming work, we must always remind ourselves that we are “patients” and always pay attention to the protection of the lumbar region in the work environment, such as padding the pillow behind the waist when sitting and regular standing up to rest.
26.Can I resume sports such as table tennis, golf or skiing after lumbar spine surgery?
As people’s demand for quality of life improves, more and more patients want to resume certain sports after lumbar spine surgery. Generally speaking, regardless of whether fusion surgery has been performed, all lumbar activities should be avoided for 2 weeks after surgery, and activities such as repeated lumbar forward flexion, back extension, lateral flexion or rotation should be avoided for up to 3 months after surgery.
Sports that require lumbar activities such as golf and table tennis can be attempted to resume after 3-4 months postoperatively, but only on the basis of targeted training. For example, if a patient wants to resume sports such as table tennis or golf, if all movements in their sport appear to come from the adjacent levels of the fused segments, then specific exercises for these segments may have to be performed before resuming the sport, that is, appropriate changes in movement patterns and strengthening of muscle strength as well as stability exercises across at least these segments during the sport. For patients who need to return to skiing, it is important to ensure that all segments of the lumbar spine are moving normally before returning to sports so that the impact of the fall is absorbed more evenly throughout the spine. When the patient has maintained the current level of activity in a state where there has been no worsening of symptoms then the intensity of training can be further increased until the return to specialized sports. In the case of professional athletes, it is best for the surgeon, rehabilitation physician, therapist and athletic trainer to consult together to develop an individualized and specific training program.