Spine Health & Spinal Hygiene

Taking it slow after spinal surgery is recommended to optimize a full recovery. What usually happens is that an individual starts feeling normal/better, so they begin to engage in a few daily activities. Then pain presents, letting the individual know that they have done too much too soon. The pain does not necessarily signal re-injuring the area, but recovery should be treated seriously. More than 50% of patients have successful spine surgery, but repeat surgeries do not tend to be quite as effective. Doing too much too early during recovery can result in severe re-injury or creating new injuries. So when can an individual get back to everyday life? 

Surgery Recovery

Recovery after back surgery is different for everyone. Low back lumbar fusion surgeries usually require more recovery time than lumbar non-fusion surgeries, like:

• Laminectomy - when the lamina portion of a vertebra is removed.
• Microdiscectomy - the removal of abnormal disc material
• Cervical spine surgeries.

Individuals who have undergone a procedure where two or more vertebrae have been surgically fused should expect a longer recovery. A typical timeline for lumbar fusion usually involves around three months. What happens is individuals want to get up and move, doing household activities almost immediately because they feel so good, but this is because of the pain medications. Strong pain medication use ends by four to six weeks. It is not until after 12 weeks or three months with post-operative chiropractic rehabilitation and physical therapy that individuals are encouraged to engage in specific physical activities that will optimize the healing process.

Taking It Slow With Certain Activities

Specific activities should not be engaged in after lumbar fusion surgery, as it requires a higher level of caution during recovery.

No Bending, Lifting, and Twisting

Bending, lifting, and twisting all require the direct use of the back muscles. Performing these movements can cause serious damage and hinder proper healing. Therefore it is recommended not to bend, lift, or twist for six weeks.

No Taking Baths or Swimming

Taking showers can be done right away with protective plastic or a sponge bath for a few days after surgery, but it is advised not to take baths or go swimming for three weeks.

No Cardiovascular Exercise

While the back may be feeling better after the spine surgery, cardiovascular exercise is not recommended for at least six to 12 weeks as it is too strenuous on the back. Light walking is fine, but the doctor and a chiropractor and physical therapist will develop a controlled, progressive exercise program for the individual. The program usually starts between 6 weeks and three months after surgery. This can include working out on an elliptical machine, a stationary bike, or easy treadmill walking.

Listening to The Body

The doctor will be clear about what can and can't be done immediately following back surgery. Therefore it is crucial to follow the instructions to avoid any complications and listen to the body. Don't push through activity or try taking on too much. Give the body and spine time to heal, taking it slow. There is time to get back to normal activities, but if re-injury or new injuries occur, rehabilitation/recovery could become the regular activity.

Body Composition

Malnutrition

Malnutrition is defined as deficiencies, excesses, or imbalances in an individual's energy intake and/or nutrients. Protein-energy deficiency is one of the most common forms of malnutrition, and this health condition has an immediate and negative impact on body composition. The deficit wreaks havoc on skeletal muscle mass as the body progressively goes into starvation mode, breaking down the protein stored in the muscle for fuel.

Micronutrient deficiency is a lack of minerals and vitamins that support vital bodily processes like cell regeneration, immune system health, and eyesight. Common examples include iron or calcium deficiencies. Micronutrient deficiency has the most significant impact on normal physiological functions, processes and can happen in conjunction with a lack of protein-energy. This is because most micronutrients are obtained from food. Nutritional deficiencies of specific micronutrients can affect processes like building and repairing muscle; protein deficiency has a more pronounced effect on body composition because lowered protein intake can lead to muscle mass loss. Malnutrition and nutritional deficiencies in adults include:

• Not enough energy to get through the day.
• Unintended weight loss.
• Physical function, including handgrip strength and physical performance, diminishes.
• Serious medical conditions can result from fluid accumulation like edema.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Daniell, James R, and Orso L Osti. “Failed Back Surgery Syndrome: A Review Article.” Asian spine journal vol. 12,2 (2018): 372-379. doi:10.4184/asj.2018.12.2.372

April Hermosillo enjoys participating in fitness classes and following good lifestyle habits. She describes herself as a work in progress that loves getting into a variety of physical activities. However, due to a little too much activity, April began to experience neck pain and back pain.

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Before and after spine surgery the surgeon and medical staff prepare you for recovery. The recovery process can take a long time and be extremely challenging.

Pain after spine surgery is normal, but how to tell if it’s beyond the typical pain during recovery?

What indicates that the surgery failed?

Chiropractor Dr. Alex Jimenez has dealt with this issue throughout his career and discusses symptoms associated with failed back surgery syndrome (FBSS, also known as failed back surgery (FBS) or post-laminectomy syndrome).

Back Pain the most common symptom

Chronic back pain is the most common symptom from failed back surgery.

With FBSS, chronic pain in one patient can be very different from pain in another.

People with FBSS can experience a range of different types of pain based on:

• Spinal disorder
• Spinal procedure
• The underlying cause of failed back surgery syndrome

Types of back and neck pain people with failed back surgery may experience. Some may have one or more types. 

Chronic pain:

• Sustained pain that lasts for more than 12 weeks.
• Chronic pain is the opposite of acute pain, which is short-term severe pain.
• Acute pain is expected during spine surgery recovery but should fade during the healing. 

Nociceptive pain:

Localized pain that can be dull or sharp.

This is the type of pain patients may experience immediately after surgery

Example: The pain felt around where the incision was made.

When most people think of pain, nociceptive pain is the type.

Neuropathic pain (neuropathy):

Nerve-related pain is caused by damage to the nerves or spinal cord.

Neuropathic pain shoots and moves around, thus affecting large areas of the body.

Examples of this type of pain include:

• Numbness
• Burning
• Tingling
• Weakness
• Abnormal sensations (called paresthesia)

Radicular pain (radiculopathy):

A branch of nerve pain (neuropathy) is called radiculopathy, or radicular pain.

Radicular pain radiates from one area to another.

Examples include from the:

• Low back
• Down the buttocks
• Legs
• Feet

And then starts all over again, or goes in a different order.

Other symptoms:

The original symptoms return:

When the symptoms that put the patient in the surgery room return, then there is a definite possibility of failed back surgery. 

New pain presents:

New pain, meaning pain in a different part of the spine or a different type merits a discussion with your doctor.

Mobility Reduced :

It does take time to recover and that process can affect:

• Endurance
• Flexibility
• Movement

However, if mobility or limitation is different from what was talked about with the surgeon or develops after recovery, then it should be discussed with your doctor.

Example: A limited range of motion in the neck or low back.

Headaches begin to present:

If headaches were not an original part of your medical history, this may point to a nerve problem. 

Nerve Symptoms & Quality of Life

Neuropathic pain/ neuropathy or nerve-related pain is the most complex, debilitating, and difficult-to-treat.

People who experience this type of pain find it lowers their quality of life.

An online survey of 1,000-2000 patients that underwent low back surgery responded and revealed the following:

1. 94% of respondents reported post-surgery low back pain
2. 71.1% dull achiness
3. 69.8% numbness
4. 43.3% cold sensations
5. 35.3% paresthesia (eg, burning, tingling, pricking sensations)

A separate study noted that nerve-related pain suffered by people with FBSS is more life-altering than pain caused by joint and nerve disorders.

Patients with FBSS and neuropathic pain go through higher levels of pain and have less quality of life/physical function compared with people with osteoarthritis, rheumatoid arthritis, and fibromyalgia.

FBS Symptoms Emergency Treatment

After surgery, it can be difficult to tell whether the pain is within the bounds of normal recovery pain.

At follow-up appointments ask questions about the progress of your recovery and about any concerns.

Pain after surgery is normal, but there are some signs and symptoms that merit emergency attention.

If you experience any of the red flag symptoms, call your doctor immediately:

• New weakness
• Difficulty walking
• Electric pain in the lower body
• Fever
• Vomiting
• Unintentional weight loss
• Loss of bowel or bladder function

This can be a sign of a spinal nerve disorder called cauda equina syndrome. 

Symptoms of Failed Back Surgery Syndrome Are Different for Every Patient

• Every patient goes through a unique surgical experience and if it fails, patients may experience unique symptoms.
• Because failed back surgery has several possible causes, the symptoms are going to be different for each patient.
• Before you are discharged and even before you go under, ask your surgeon questions about what to expect during the recovery process.
• Educating yourself with possible expectations during recovery, you’ll be best positioned to know when things aren’t going as they should.

Back Pain Management El Paso, TX Chiropractor 

Denise was involved in an auto accident which resulted in low back pain. When she realized she couldn't sit, walk or sleep for extended periods of time without experiencing painful symptoms, Denise found chiropractic care with Dr. Alex Jimenez in El Paso, TX.

Once she received treatment for her auto accident injuries, Denise experienced relief from her symptoms and she was able to perform her everyday activities once again. Thanks to the education and care Dr. Alex Jimenez provided, Denise regained her original health and wellness.

Back pain is common, with roughly nine out of ten adults experiencing it at some time in their life, and five from ten working adults developing it every year. Some estimate around 95 percent of Americans will experience back pain at some time in their lifetime.

It's by far the usual cause of chronic pain, as it is also a significant contributor to missed work and disability. In the United States alone, acute cases of lower back pain are the fifth most common reason for physician visits and cause 40 percent of missed days off work. Furthermore, it is the only leading cause of disability globally.