How to spend the postoperative period after removal of the uterus? How long can you not sit after removal of the intervertebral hernia. Postoperative period, what to do

After surgery to remove the hernia, a period of rehabilitation begins. And this time is the most difficult and responsible for both the patient and the doctors. After all, successful recovery depends not only on the experience of the surgeon, but on the desire of the patient to fight the disease to the bitter end.

Problems in the first weeks

Modern surgery has made some progress. Now, after the removal of a hernia of the spine, the patient does not require long-term hospitalization. The patient goes home for 2-5 days, receiving the doctor's recommendations. During this period, many questions arise that may not be immediately covered. So rule number one - have a phone number or others available funds communication with your doctor if you are going home after surgery. This is the key to your peace of mind.

The first weeks at open operations very heavy. The patient experiences pain that is not associated with pinching of the nerve, but with surgical procedures. Therefore, apart from medicines The patient needs moral support. Family people should rely on loved ones, and lonely people should notify their friends about the operation - someone should be nearby during this period.

Any activity is carried out with the permission of a specialist. Basic rules: minimum loads, their gradual increase, no sudden movements. During operations on the bone part of the spine - strict observance of the requirements of the doctor and instructor in therapeutic exercises.

The initial period is fraught with the appearance of some reactions that bring pain and discomfort, but are not dangerous to health. For example, spinal anesthesia may cause headache 2-3 days after the operation. The pain syndrome is caused by the loss of CSF through a puncture in the hard shell. To prevent this phenomenon, it is enough not to get out of bed for a day after the operation and drink plenty of fluids. By the end of the week, the patient may experience "old" pain in the back and lower extremity. With hernias of the cervical region, pain radiates to the hand. As a rule, this is not a recurrence of the disease, but postoperative edema. For its relief, analgesics (ketanov, oxyten), drugs for removing fluid (detralex, L-lysine aescinate) are used. By the seventh day of rehabilitation, the symptoms go away on their own.

When should you call the doctor?

1. When the temperature rises. If the numbers on the thermometer are 37.5, this is not a cause for concern. But a fever above 38 indicates the development of a serious complication and requires immediate examination by a specialist.
2. In violation of the function of organs and limbs. Some complications or incorrect actions of doctors can provoke paralysis. If you have these symptoms, be sure to go to the hospital.
3. If redness and discharge appear in the area postoperative wound. Sometimes it is enough to turn to an outpatient surgeon to correct the treatment. But it is better when infectious complications are seen by the operating doctor.

Fixation

Rehabilitation after removal of a hernia is carried out with the obligatory fixation of the problematic department. We will talk about the timing and indications for wearing a corset or orthosis below.

The correct corset is a retainer with rigid metal inserts 30-35 cm wide. It takes on the entire load, supports the muscles of the lumbar and sacral department. Recovery of soft and bone tissues will not be complete without such a bandage.

The latch must be put on in a horizontal position. The best option is a corset with additional fixation straps. They allow you to change the tension force of the orthosis. These recommendations are relevant for vertebral hernia lumbar. What to do during neck surgery? The Philadelphia-type orthosis will help to keep immobility.

You can stand and walk in a corset for a short time. The main rule is to increase the load daily with a long rest. If you start with 15 minutes a day, by the end of the week your vertical activity time should be 35-40 minutes. Between them pauses on a horizontal plane (about an hour).

Wearing a corset does not preclude washing it. Usually in the postoperative period, patients have increased sweating. In this case, stock up on two orthoses.

Exercise after surgery

Exercise therapy during the recovery period is applied from the third day of surgical treatment. Therapeutic gymnastics is performed in the supine position and helps to activate the muscles. Exercises are performed slowly, calmly, breathing should be even (inhale through the nose, exhale through the mouth). Therapeutic gymnastics is performed in 4 poses:

• exercises lying on your back;
• abdominal exercises;
• side exercises;
• quadruple exercises.

The basic rules of exercise therapy during the recovery period: the absence of pain during movement, smooth execution, regularity. So, from the third day, you can do the following exercises:

complex on the back

• arms extended along the body. The palms are facing down. Hands push off from the horizontal plane for 2-3 seconds. Then relaxation. Repeat several times (1-2) daily increasing the number of repetitions to 15. This recommendation applies to any exercise;
• lying on the stomach, we unbend our head, clench our fists and pull the toes of both feet. We return to the original position;
• bend your knees and spread out to the sides. We tilt the knee so as to touch the opposite heel;
• hands are spread out to the sides. We take out the opposite shoulder with the palm;
• we squeeze our palms on our chest in the “prayer” position. We hold the effort for 2-3 seconds;
• brushes "on the castle". Effort unclench the "lock";
• make a bicycle with one foot. The second is bent at the knee. We alternate limbs;
• end with pelvic lifts. Inhale up, exhale down.

Abdominal exercises

Charging in this position is not carried out in the first days of recovery. Exercises are used closer to 3 weeks after surgery:

• arms spread apart, raise one leg up, return to its original position. Repeat with the other limb;
• hands are spread out to the sides. Raise the shoulders and chest. We go back;
• we crawl in a plastunskin place;
• lying on your stomach, raise your knees, using the work of the muscles of the buttocks. The toes of the feet rest on the floor;
• raise your legs bent at the knees. After we straighten the joints. We return to the starting position.

Complex on the side

• the right arm is bent at the elbow and placed behind the head. Left we rest on the floor. We pull our knees in ourselves, straighten our legs again. Next, change sides;
• raise the leg up, first one, then two at once.

Complex on all fours

• with the right knee we take out the left elbow, then we change sides;
• we stretch the right arm and left leg parallel to the body, change limbs;
• we sit on our heels, the back arches.

Sitting problem

Sitting down in the postoperative period should be very careful. After microdiscectomy and laser vaporization of the intervertebral hernia, you can sit in the first hours after surgical intervention. Other surgeries that involve more trauma have different requirements in this regard.

Sitting is only allowed after 3 weeks. You need to sit down only for a short time when getting out of bed. After the third week, you can sit for 15 minutes a day, increasing the time to an hour by the first month. The chair for sitting should have a back and a deflection forward in the lumbar region. In the absence of such a modification, place a roller or rolled up blanket under your back.

Patients spend most of their working time sitting. When going to work, this causes a complication of the disease, as the load on the operated spine increases. To prevent problems, there are a number of simple rules that must be strictly observed:

1. You can not sit for more than 60 minutes. The rehabilitation period ends in 2-3 months. And the patient returns to his usual activities. In order not to provoke a complication after the operation, get up from your chair every 45-50 minutes and do a small set of exercises.
2. You can't drive for a long time. The patient returns behind the wheel only 1.5-2 months after the operation. Take care of the comfort of the chair (roller under the back or orthopedic pads). If you have a long trip, then every hour you need to stop (you can unload your back with the help of charging).
3. Seating positions must have armrests, which should be supported before landing.

Aquatherapy

Swimming is a unique way to tone your back muscles. In water, the load on the spine is significantly reduced. But swimming after surgery on the intervertebral hernia is a lesson for the second month. The patient's rehabilitation potential is higher by this time, and the scar in the back area is fully formed. Therefore, the risk of infection is minimal.

So, what subtleties should be considered when exercising in the pool?

• the postoperative wound must heal completely;
• physical therapy precedes classes in the water;
• an instructor is constantly in the pool with the patient;
• swimming can be alternated with elements of exercises in the water.

Horizontal bar

The rehabilitation period after surgery on the intervertebral hernia lasts quite a long time. After 3 months protective regime you can return to your normal lifestyle. However, some restrictions remain for life. These include gymnastics on the horizontal bar. Most experts advise to abandon such physical activity with an intervertebral hernia. And after the operation, exercising on the horizontal bar is categorically contraindicated.

Why can't pull-ups be used for muscle rehabilitation after a herniated disc? Few can withstand charging on the horizontal bar. For proper pulling and hanging, you need strong arm muscles. But any activity on this projectile is associated with significant effort and jerk. It is difficult to perform the exercise gently and smoothly without preparation. Sudden movements are strictly contraindicated for sick people. If the patient does not control his spine, then you can get injured or complication of the disease. Therefore, with hernias, avoid horizontal bars, especially if you are overweight.

Any surgical intervention on the spine can hardly be called simple. In this regard, the question of how to behave after spinal surgery becomes relevant, because it may not recover immediately, this will take some time. The rehabilitation program is compiled by the doctor in each case individually. But there are general rules of conduct after any surgical intervention on the spinal column, because life after the operation cannot be called “sweet”.

What is not allowed

After the operation, much is impossible, but not everything can be hidden behind such a word. A person who is not related to medicine may not even suspect that he is harming himself by certain actions. The first thing to remember is that after the operation it is strictly forbidden to get out of bed, even if there is no pain, bed rest is indicated until the doctor gives permission. If the operation on the spine was successful, then the doctor allows you to get up on the second or third day after the intervention, if the pain syndrome has not begun to increase.

Also, after removing a protrusion or herniated disc or any operation on the spine, a high pillow and a soft mattress are prohibited. The bed of the operated person should be flat and with a hard mattress. Water should not get into the wound and after 2-3 days after the removal of the stitches. This kind complications can occur after a bath, when a person who has not bathed for a long time satisfies his need.

What can

The postoperative period consists not only of prohibitions, there is also something that can be done without fear that an exacerbation may occur. It is allowed to carefully, without sudden movements, make turns to the side. You can perform simple actions in bed, do breathing exercises, make movements of the joints of the arms and legs.

When a doctor allows a person to get up, then this must be done carefully. First, a roll is made to one side, and then reliance is placed on a nearby chair and knees, the back should be straight.

When the goal is achieved and the patient has taken a vertical position, in order to avoid sharp pains after spinal surgery, it is necessary to stand for several minutes. You need to lie down carefully, without sudden movements, the back should be straight. Such actions for the first time will suffice.

After three or four standing up according to the above method, you can walk a little. By this time, the patient has some sense of confidence.

What happens after the operation

When everything went as planned, the spine is fully able to withstand the load. Special designs make it more resistant to the external environment. Recovery largely depends on the person himself and his willingness to follow the recommendations of the attending physician.

A patient after surgery can close his sick leave very quickly. In the absence of complications for 10 days, a scar is formed, its maturation ends by the end of the third week. During this period, the operated person is not much different from the rest, provided that his condition does not worsen.

Activity for the patient will only benefit, but it makes no sense to spare oneself, and in some situations it can even bring harm. Active rehabilitation begins in the period from 4 to 6 weeks after the operation. If you work on yourself during this period, then the chances of recovery will increase significantly, a person will be able to return to a full life and usual work.

After the operation was performed to remove the hernia, then you can start working (but not physical) a few weeks after the intervention. For physical labor, a certain time will be required, during which a full rehabilitation will take place.

After surgery on the spinal column, the doctor may recommend a corset with stiffeners. You will need to wear it for a month or even two in order to reduce the load on the operated segment. During rehabilitation, the actions of the doctor are aimed at restoring health to the patient. In this regard, magnetic resonance imaging (MRI) may be contraindicated when certain metal alloys are placed during surgery.

In some situations, especially when the goal of surgery is to fuse the vertebrae together, active movements are contraindicated. Restrictions are necessary for the fusion of the vertebrae among themselves, and unnecessary movements can easily disrupt this process.

Subsequently

Surgical intervention on the spinal column largely does not lead to consequences over time. In the future, you should not expect mobility restrictions, it is better to live as you used to before, and not worry about the condition of the spinal column. Rumors about the dangers of surgery in many ways have no scientific justification. The operation allows a person to forget about his disease as soon as possible or prevent the consequences of injuries of the spinal column. It does not affect pregnancy and its course in any way, only the load on the spine will have to be reduced significantly.

In the early rehabilitation period after intervention on the spinal column, you should not be very zealous with recovery and overwork your back. You need to sit, stand or walk for as long as recommended by your doctor. Why is it necessary? Yes, because zeal can cause pain. If in a standing position pain is disturbing, but there is no possibility to lie down, then it is better to walk a short distance for some time. After that, the pain will become less, and may even disappear.

In the early recovery period after surgery on the spine, discomfort may disturb while sitting. In this case, a pillow is placed between the back and the surface on which the support falls. If this is not possible, then you can do what women often do when pregnancy is on long term they put their hand behind their back.

If you need to lift the load, the back should be straightened. During a long static posture, you need to change it for some time. AT without fail during the recovery period, corsets are used to help reduce the load on the spinal column.

Medicines

After surgery, medications are often used to prevent complications or pain from developing. Often these are non-steroidal anti-inflammatory drugs. Appropriate medications fight swelling, chondroprotectors restore cartilage. Means for improving tissue regeneration, vitamins, as well as drugs for activating blood flow are also shown. Which drug to choose, the doctor decides, self-medication in this matter can be fatal.

Physiotherapy techniques

When prescribing physiotherapy methods, indications and contraindications should be taken into account. In some cases, pregnancy or a metal alloy that is installed in the form of an implant can become an obstacle. Physiotherapy can improve blood circulation, reduce pain, eliminate inflammation, and accelerate tissue regeneration. Techniques shown:

• electro - and phonophoresis;
• magnetotherapy;
• shock wave therapy;
• reflexology;
• paraffin applications;
• electrical stimulation;
• spa treatment.

All methods are prescribed in parallel with medications, it is recommended to repeat physiotherapy after six months.

Gymnastics

At any stage of rehabilitation treatment, gymnastics is indicated. There are complexes designed for each department of the spinal column. With their help, the muscles will become stronger, the spine will be more stable. Complexes also largely depend on the time that has passed since the moment of surgery. However, there are some execution rules that should be followed.

Classes should begin as early as possible, but only after acute pain has been eliminated. If the movement causes pain, then it must be abandoned and move on to the next one. It is worth remembering that any gymnastics originates from a simple one and gradually moves to a more complex one. There is the concept of "adequacy of physical activity", when the time that has passed since the surgical intervention matters. Movements are performed slowly, initially in a supine position and under the supervision of a specialist.

Do not skip classes, and the result will not be long in coming. What matters is the systematic execution of exercises every day, breaks are completely excluded.

Proper breathing

After any surgical intervention in the lungs, congestion may occur. Therefore, immediately after a person comes out of anesthesia, a course of breathing exercises is prescribed, which also helps to strengthen the diaphragm and chest muscles. Proper breathing helps to saturate the blood with oxygen, improve gas exchange and prevent possible complications.

Kinesiotherapy option

This is a kind of therapeutic gymnastics, which acquires in last years increasing popularity. The essence of the technique is to use certain forces of the body with the help of special exercises. Movements during execution are dosed in amplitude and intensity. The program is compiled individually, and simulators may be required. The task of exercise therapy, like kinesitherapy, is to strengthen the muscles and make them more resilient.

Massage technique

The technique shows its effectiveness already after the first days after the surgical intervention. At the initial stage, the impact is carried out on healthy tissue, and when the wound heals, the massage therapist can move to the operated area. Massage, especially after surgery, is easy, this eliminates the appearance of acute postoperative pain. It all starts with stroking followed by rubbing, later kneading can be used, which is carried out as actively as possible.

It becomes clear that after a person has undergone surgery on the spine and no matter in which department, a full course of rehabilitation is shown. A person must impeccably follow the recommendations that the attending physician gave him. You can talk with him about how to live on after surgery on the spinal column, and in order to avoid complications, it is better to listen to what are the limitations. Any physical activity is excluded, especially on the back. It is strictly forbidden to lift weights, sharp exercises, long walking and especially sitting are also contraindicated.

The stage of treatment does not end with the operation, since the person still needs rehabilitation after the operation to remove intervertebral hernia. The time interval that it occupies is 3-12 months.

Need for rehabilitation

As a rule, rehabilitation after removal of a spinal hernia is based on the selection of exercises for each patient separately and the determination of the types of procedures for different stages recovery. During this period, the doctor is obliged to conduct a comprehensive monitoring of the patient. Recovery occurs with the correct and precise observance of all prescriptions given by the surgeon, rehabilitation specialist and neurologist. And, of course, prevention of the appearance of new hernias is mandatory.

The first feelings after the elimination of the intervertebral hernia are the relief of the condition and the disappearance of pain associated with the withdrawal of swelling and the elimination of compression of the intervertebral discs. However, this effect is short-term, and if you do not listen to the doctor and start to lead a correct lifestyle, then complications will appear. It is not for nothing that rehabilitation after removal of an intervertebral hernia is also called a period rehabilitation treatment- it is curative (working capacity increases) and prophylactic (prevents the formation of new hernias) in nature.

If the previous surgical intervention was aimed at eliminating the cause of back pain, then the goal of rehabilitation can be considered:

• to achieve a stable condition of the patient;
• tidy up the muscles of the back;
• remove restrictions on self-service;
• get rid of pain and restore neurological functions;
• remove restrictions on physical work;
• restore the functions of the musculoskeletal system, make the spine mobile and restore the biomechanical functions of the vertebrae.

recovery program

First of all, the program of rehabilitation measures is determined by the type of operation performed. For example, with a traditional discectomy, the fusion of two adjacent vertebrae takes place within 6 months (rehabilitation lasts about the same time). Minimally invasive methods significantly reduce the recovery period and rarely lead to complications (method of endoscopic discectomy, microdiscectomy, puncture vaporization with a laser). They play a big role physiological features sick. For example, age and the presence of other diseases. The program also depends on the severity of the course and the duration of the progression of the disease before surgery.

Effective recovery can be achieved by observing the following points:

• drug treatment;
• exercise therapy (complex of physiotherapy exercises);
• physiotherapy procedures;
• Spa treatment;
• kinesitherapy and hydrotherapy.

Recovery conditionally takes place in 3 periods. At an early stage, within 2 weeks, measures can prevent and eliminate pain, get psychological help. In the late phase, which lasts 2-8 weeks, the patient tries to adapt to self-care in everyday life. In the delayed period (2 months after surgery and then throughout life), the program is aimed at restoring the biomechanics of the back, preventing relapses.

What is forbidden to do?

In the early recovery period, you can not sit, wear heavy objects from 3 kg and above, do physical exercises without a bandage or corset, drive a car, bus in a sitting position, wear a corset for more than 3 hours, move sharply (tilts back, forward and sideways) , smoke or drink alcohol, undergo a massage course, play sports (football, ice skating).

In the late rehabilitation period, you can not jump from a height, lift more than 5 kg, supercool your back, sit for a long time and wear a corset, do physical work without warming up your muscles. Regardless of which stage the patient goes through, it is recommended from time to time during the day to give the spine a rest (lie down on the bed for 25 minutes). You also need to control your weight, do not expose the body to stress.

Rehabilitation after surgery for a hernia of the spine is based on a light restrictive mode with a consistent increase in the load on the body to its usual state.

Therefore, the doctor's control over the patient and the development of an individual recovery program are so necessary.

Therapeutic procedures and kinesitherapy

Kinesiotherapy is a complex of special dosed movements, selected individually for a person. As a rule, orthopedic simulators are used in recovery, allowing the spine, joints and muscles to slowly take on the load by stretching. As a result, the hernia “vacuumizes”, excess pressure in the nerve roots disappears.

Over time, with a smooth, dosed effect on the muscles, a so-called corset around the spine is formed. It turns out that the blocked immobile vertebrae are compensated by the mobility of adjacent joints. This is how stretching occurs naturally, which leads to the restoration of power to the discs and the correct location of the vertebrae relative to each other.

The most common physiotherapy procedures:

• electrophoresis - used to penetrate drugs through the skin;
• phonophoresis - drugs are administered with the help of ultrasound, the procedure is similar to non-contact massage, it helps to relieve swelling;
• ultrasound - makes the rehabilitation process fast and stimulates cell growth;
• magnetotherapy - activates the exchange process by exposure to a low-frequency magnetic field;
• mud treatment;
• interstitial electrical stimulation - regenerates pinched nerves, relieves pain and improves tissue nutrition;
• EHF-therapy - puts in order the muscle tone, has an anti-inflammatory effect.

How does exercise and medication help?

After the operation, the patient may complain that his back hurts. It happens due to inflammation. spinal nerve, which for a long time was squeezed by a hernia. Another cause of pain can be trauma to the ligaments and tissues from the operation. The doctor prescribes drugs that can suppress inflammation and relieve pain.

The type of medication, dose and frequency of administration is determined by the attending physician, taking into account the nature of the pain, the presence of other diseases and contraindications. Paracetamol, NSAIDs, strong and weak opioids may be prescribed.

The types of exercises for physiotherapy exercises are determined by the doctor. Sample exercises:

1. Lie face down on the floor. Put your palms under your chest, spread your legs. Further, leaning on the toes and palms, it is necessary to raise the torso and arch the back up. The head should be lowered, the pelvis should be higher than the head, the legs and arms should be straight. After that, it is necessary to lower the pelvis to the floor, and leave the legs and arms in the same position.
2. We accept the initial position, as in the first exercise. Further, when the pelvis is raised and the back is arched, you need to turn the pelvis to the left, dropping sideways as low as possible, the left leg remains motionless. We do the same to the right. Arms and legs are straight. You need to do the exercise slowly.
3. It is necessary to sit on the floor and spread your arms, transferring the load to them, bend your legs slightly. Now you need to raise the pelvis so that the load is on the arms and legs. Recommended this exercise do intensively, first 7 times, gradually increasing to 20 times.
4. Lie on the floor face up, arms out to the sides, legs straight. Then bend your knees and pull them to your chest, clasp your hands. After that, we try to push off from the hips and knees, but at the same time we continue to hold our legs with our hands. Hold this position for 5 seconds. Repeat 3-4 times.

Spa treatment and hydrotherapy

Often, underwater traction is included in the rehabilitation program. In another way, it is called traction therapy. The purpose of its implementation is to stretch the elastic tissues and joints of the spine under the person's own weight.

Often used such hydroprocedures:

• herbal baths - help relieve tension and pain;
• turpentine baths - have an anti-inflammatory effect, are able to dissolve postoperative scars and remove adhesions at the seams, activate the rehabilitation process, improve blood circulation;
• radon baths- have a beneficial effect on blood circulation, relieve pain and inflammation, improve neuromuscular conduction;
• sulfide or hydrogen sulfide baths- improve muscle contraction, blood circulation and accelerate metabolic processes.

Spa treatment is carried out at a late stage of rehabilitation, since the patient after the operation needs to avoid adaptation to a new place and climate change. In special sanatoriums, therapeutic mud, massage, gymnastics, various baths (sulfur, turpentine, radon), paraffin treatment, proper nutrition, physiotherapy, acupuncture, etc. can be offered.

The main task of the patient is to continue treatment in the postoperative period and follow all the doctor's instructions.

1 month after surgery:

Most of the time during this period you spend in the position of "standing" and "lying", and it is preferable to walk rather than stand. Wearing a corset during this period is mandatory. You can not sit, for 2-3 weeks of the first month after the operation, you can sit down for a minimum time, 15-20 minutes, only during meals. It is important not only how much, but also how to sit. In a sitting position, it is necessary to maintain the shape of the spine with forward deflection in the lumbar region. For sitting, it is better to use a chair with a small seat and pronounced support under the lower back (computer chair), the height of the chair is such that the knees are lower than the hip joints. We sit on a chair and rest our hands on our knees or on the arms of the chair. When sitting, we shift the buttocks as far back as possible, so that the back of the office chair rests against the lower back (the difference between the office chair and the director's chair is the presence of a gap between the back and the seat, often even the metal back holder is bent in this place) with insufficient support under the lower back, put a pillow. We maintain this position, with the most straightened back and forward bend, for the entire period of sitting. When standing up, do not bend the spine, but move to the edge of the chair and stand with your legs up, and not forward, preferably with your hands resting on your knees or in the arms of the chair. We increase the time in the “sitting” position gradually, adding 5-10 minutes every day. The task is to reach 45-60 minutes of "sedentary" load by the end of the month, which will allow you, having gone to work, to establish a physiologically correct mode - we sit for 45-60 minutes and walk for 5-10 minutes.
Exclude forward bends from your movements, especially for the first 2-3 weeks, by the end of the month, light bows are allowed, like a famous artist, not like a serf begging for freedom. Basically, the need to lean forward occurs when putting on shoes. Destroy lace-up shoes in your wardrobe and get a shoe horn with the longest handle. If necessary, take a half step forward and squat with a straight back.
Remember to properly get out of bed, only now you can simplify this process. To get out of bed, you must first make a few simple warm-up movements with your arms and legs to stretch, then turn on your side, bend your legs at the knee jointsso that the shins and feet hang from the bed and, pushing off with the elbow of one hand and the wrist of the other hand, sit down. And already from a sitting position, get up, trying to keep your back as even as possible, without making sudden movements.
Home physical activity this period is physiotherapy exercises and walking. We start with 0.5-1 kilometers a day, the duration of walks must be increased slowly. At the beginning of the walk, you may feel tension when walking, but gradually on the first 100-200 meters, this feeling recedes and a feeling of confidence and relaxation comes. Under other conditions, do not rush to increase the time and distance of walks. By the end of the first month after the operation, walking 2-3 kilometers a day is good, especially if and with healthy spine You didn't take those trips. Remember that when you again feel discomfort and slight pain in your lower back, this is a sign that you have gone enough and you need to lie down or sit down, which obliges you not to go far from home and plan your way there and back in advance.

The recovery period may be accompanied by a temporary return of pain. If you experience back pain, first of all take a horizontal position and reduce the load for the next few days. It is necessary to take analgesics (Katadalon, Baralgin, etc.), anti-inflammatory drugs (Diclofenac, Nise, Movalis, etc.), muscle relaxants (Sirdalud, Mydocalm, etc.). About what drugs to take in case of recurrence of the pain syndrome, agree in advance with your doctor. If the pain does not decrease within two to three days, if there is numbness in the legs and perineum, weakness in the legs, difficulty urinating, body temperature rises, redness of the skin in the area of ​​the postoperative scar appears, you should immediately consult a doctor.

2-3 months after surgery:

The period of outpatient treatment ends and it's time to go to work. Before going to work, you need to come for a consultation with a vertebrologist, orthopedist. It is advisable to do an MRI and a study of the biomechanics of the spine, which will help the doctor to objectively assess the effectiveness of surgical treatment and develop recommendations for preventing the progression of spinal disease.

Sitting is allowed 1 month after surgery. Remember that it is important not only how much, but also how to sit. We repeat once again: in a sitting position, it is necessary to maintain the shape of the spine with a forward bend in the lumbar and. For sitting, it is better to use a chair with a small seat and pronounced support under the lower back (computer chair), the height of the chair is such that the knees are lower than the hip joints. We sit on a chair and rest our hands on our knees or on the arms of the chair. When sitting, we shift the buttocks as far back as possible, so that the back of the office chair rests against the lower back (the difference between the office chair and the director's chair is the presence of a gap between the back and the seat, often even the metal back holder is bent in this place) with insufficient support under the lower back, put a pillow. We maintain this position, with the most straightened back and the deflection of the lumbar forward, for the entire period of sitting. When standing up, do not bend the spine, but move to the edge of the chair and stand with your legs up, and not forward, preferably with your hands resting on your knees or in the arms of the chair.

You can drive a car in 1.5-2 months. If your journey to work by car is more than 1 hour, then you need to take breaks. Stop, take your time, get out of the car, just walk around and do some warm-up exercises with backward bends to the sides, do a few squats with a straight back - “on toes”. Ride on public transport is fraught with another danger, uncontrolled movements, so a corset for the duration of the journey is a must.

During the first months after returning to work, you should not engage in heavy physical labor (lifting weights, digging the ground, etc.). You can apply this calculation: a month after the operation, you can lift 1 kg for each arm, every month it is allowed to add 1 kg for each arm. But remember, and in the future, try to follow the rules of the safety instructions for movers, which determines that when carrying heavy loads, the maximum permissible load is: for male adolescents from 16 to 18 years old - 16 kg; for men - 50 kg. For women - 10 kg, up to two times per hour, when alternating with other work and 7 kg - when lifting weights constantly during the work shift. Since 2008 Weight Limit, allowed to be lifted by airline loaders in the United States, is limited to 35 kg, while a semi-rigid corset is part of the loader's mandatory overalls.

All this knowledge of correct behavior, movements, work had to be applied from childhood in order to prevent the formation of a hernia, but if everything happened, now apply this knowledge to prevent new exacerbations

Information from the site

A surgical procedure to correct the pathological displacement of the gelatinous substance (nucleus) in the intervertebral space is prescribed to patients when any of the methods of conservative treatment has not brought the desired results.

Since dystrophy of the vertebral tissues and the violation of their integrity are more prone to lower section back - the lower back, therefore, in this area, most often the fibrous rim (ring), inside which the gelatinous mass is located, is torn. Thus, a through passage is formed in the ring, through which the nucleus leaves its location, filling the free areas outside the fibrous rim and exerting serious compression on the intervertebral structures.

As practical statistics show, the dominant percentage of people need a hernia operation in the lumbosacral region. A little less often - in the cervical segment, and isolated cases require surgical intervention in the thoracic regions. This trend is associated with vulnerability to disease in certain areas of the spine. Surgery is used in exceptionally severe cases, since there is a risk of complications, therefore the main approach of doctors is always based on sparing therapy at first by conservative treatment of the hernia.

Before a verdict is made on the surgical treatment of a hernia for a patient, a special commission is assembled by doctors to consider an individual case. At the medical meeting, the latest data from such examinations as: magnetic resonance imaging, myelography, blood tests and electrocardiograms will be studied. In the event that specialists establish that the pathogenesis is critical and threatens the life of the patient, the latter will be recommended corrective therapy through surgery. So, the main reasons for the appointment of an operation to remove a herniated disc are:

• the last stages of the pathology - sequestration - complete prolapse of the hernia into the spinal cord;
• the presence of problems in the genitourinary system and pelvic organs - uncontrolled bowel movements of urine and feces, infertility, erectile dysfunction;
• a pronounced neurological syndrome - impaired blood flow, atrophic signs in the limbs (loss of mobility, weakness, lameness), cardiac dysfunction, long and severe pain manifestations (unbearable burning sensation and backache in the limbs, pelvis, back);
• long-term hernia treatment (4-6 months) without positive dynamics.

Surgical techniques for the treatment of intervertebral hernias

At severe forms spinal lesions caused by a hernia, one of the ways to eliminate critical consequences is the use of surgery. Today, there are several types of techniques used in surgical treatment for hernial formations in the intervertebral areas, among them:

• percutaneous nucleoplasty method;
• hydrodiscectomy method;
• microdiscectomy;
• laser surgery;
• endoscopic surgery;
• discectomy method;
• method of laminectomy;
• destruction method;
• method of intraosseous blockade.

Since in pathology there are lesions of the spinal segment that are different in form, the surgical procedure will be selected taking into account the most effective method in a specific case. In order to approximately understand what is the meaning of each of the surgical techniques, let's briefly consider each of them.

Percutaneous nucleoplasty method

The essence of this method: with the help of cold aggregate substance, supplied through a puncture needle to the focal area, to carry out a destructible effect on the hernial formation. Due to this, there is a decrease in hernia, the release of bone-cartilage and nerve structures from strong compression, and the instant elimination of pain symptoms. This method is quite fast and takes about half an hour. The surgical procedure does not require the patient to go to the hospital. Everything happens within the outpatient clinic.

Method of hydrodiscectomy

The principle of hydrodiscectomy is to conduct a special fluid through a medical tube and wash out the nucleus pulposus from the structures affected by pathogenesis. By such surgical measures, the development of avascular necrosis is prevented, pain is eliminated. This procedure is used quite rarely, as it has a number of limitations, among them: the presence of infections in the paravertebral tissues, tumors of various types, significant damage to the collagen fibers of the annular formation, hernia size of more than 0.6 cm.

Method of microdiscectomy

This is an effective method based on the use of microsurgery. Through microdiscectomy, it is possible to completely excise the pathological protrusion of the fibrous nucleus within the intervertebral space, including the disc affected by herniation. At the time of the operation, special surgical devices and optical equipment are used. Technique for performing the method:

• using a scalpel, an incision is made in the zone of pathogenesis;
• then the path to the bone-cartilaginous structures of the intervertebral plate is cleared;
• that side of the disk, which suffered from the exit of the nucleus pulposus and clamped the nerve terminal apparatuses, is resected;
• if necessary, implants are inserted;
• at the end, to enhance the protective forces, laser therapy is performed, after which sutures are applied to the dissection site.

I would like to note that before undergoing the procedure, the patient should undergo the necessary examinations: magnetic resonance imaging, check with a resuscitator and an anesthesia specialist. In addition, 8 hours before surgery, the patient needs to completely stop eating. Postoperative rehabilitation will take a total of 60 days. During the recovery period, supporting devices for the spine (bandage, corset or belt) are used, and the first month implies the absolute exclusion of physical activity.

Laser surgery

One of the most common procedures for removing a hernia is the laser correction method, the main action of which is aimed at reducing the hernia formation through a powerful stream of light waves. The laser source of the beam flux passes through a special needle, which is introduced into the affected area through the outer skin of the body, bypassing the nerve endings. Thus, a beam of light is focused on a disk, as a result of which a thermal evaporation process occurs. At the same time, fluid comes out of the affected osteochondral element, the plate is compressed, the nerve structures are released from the compression effect, the nucleus pulposus is retracted, and the hernial protrusion is eliminated. The procedure is performed under anesthesia local action, and after a couple of hours a person can leave the hospital.

Endoscopic surgery

Through the endoscopic apparatus, control is exercised over the operation in the intervertebral structures. First, the surgeon makes a section in the soft tissues, after which the paths leading to the affected disc plate are released. Next, an optical tube is installed, with the help of which the course of the surgical procedure will be recorded on the monitor of the device. The main task of endoscopy is to excise the hernia and remove the gelatinous mass. Finally, the area that has undergone surgical manipulations undergoes the process of laser therapy.

The duration of surgery for excision of a hernia depends on the complexity of the pathology and ranges from half an hour to 2 hours. Further rehabilitation is carried out within the hospital. After 3 days, a hospitalized person can leave the hospital with the obligatory requirements: limit intense physical activity for 45-60 days. It is allowed to return to the habitual way of life for a person no earlier than after 1.5 months, when the recovery processes have reached the final stage.

Discectomy method

Surgical measures are carried out in a stationary medical facility. The discectomy-based procedure is performed strictly under general anesthesia. The essence of the operation: complete removal affected disc herniation. This technique is used in certain situations when intervertebral pathogenesis has a serious form with the presence of severe complications, for example, with sequestration of a hernia - the movement of the nucleus pulposus into the spinal cord.

Such an operation is resorted to only in the absence of positive dynamics in therapy with the use of medical, physiotherapeutic methods and if it is impossible to remove the hernia by other methods due to their inefficiency in a particular case. Such a framework for the use of discectomy is associated with a high likelihood of clinical crises: fusion of adjacent vertebral bodies, serious blood loss, spinal cord injury, infection.

Absolute resection of a structural element of the spine - - is accompanied by the establishment of a transplant body, which will functionally replace the removed disc. Such replacement is required to preserve the motor abilities of the vertebrae. The graft is made of heavy-duty material - titanium. As well as after any operation, the type in question requires a sparing regimen in the movements of the operated patient and fixation of the spine with an orthopedic corset for 1-1.5 months.

Method of laminectomy

This kind of surgery is partial resection a certain bone element of the vertebral system or thickened bone and cartilage tissue due to degenerative-dystrophic transformations in the musculoskeletal system. Thanks to laminectomy, the intervertebral space is freed from unnatural formations and the elimination of nerve clamps, the restoration of blood flow and metabolic processes in bone structures relief from pain syndrome. The main appointments include vertebral hernias and spinal injuries.

Since the operation involves direct intervention in the vertebral system and it is performed under general anesthesia, the patient remains under the supervision of specialists in an inpatient medical institution for about a week.

Destruction method

The destructive method is applicable in the most severe forms of pathology, when the hernia has reached large sizes, in violation of the integrity of the nucleus pulposus with the release of its fragment into the spinal canal, and also if the pathogenesis has affected the structure of the nervous tissues of the genitourinary system. The purpose of destruction is to remove the focus of pain by inserting a thermal probe into the spinal canal. The entire course of the procedure is displayed on the x-ray machine. Due to the effect of the high temperature of the electrode device on the neurons, the blocking of nerve conduction is carried out, which eliminates the painful symptoms.

The destruction method has both advantages and disadvantages. Thus, this operation is performed without incisions, does not require general anesthesia, is performed within the outpatient clinic, is safe and rapid therapy, the positive effect occurs instantly. But after its implementation after a certain period of time pain may resume, as a result of which there will be a question of re-appointment of the procedure.

The method of intraosseous blockade

Refers to a sparing type of surgical intervention. The main principle is to fill the affected area of ​​the bone segment with an anesthetic solution containing a large molecular liquid. Spinal puncture is performed with a special needle into the vertebral element. The therapeutic solution impregnates the tissues, after which the drug is fixed with a laser emitting infrared light. The specific composition thickens in the osteo-cartilaginous element affected by a hernia. Thus, the pain syndrome is removed for a long amount of time. On average, the patient can forget about the painful sensations in the spine for 2-4 years.

Postoperative complications

Like any intervention internal structures of the human body, surgical procedures can cause negative effects on the part of the organ on which the operation was performed. In this case, this is the spine and its elements. Possible complications include:

• shell integrity breach spinal cord and seepage of cerebrospinal fluid, which increases the recovery period several times and requires a long bed rest until the damaged tissues are completely regenerated;
• the appearance of inflammation in response to affecting bone cells;
• opening of bleeding in the spinal canal;
• damage during surgical manipulations of the nerve plexuses;
• the possibility of infection in the vertebral segment;
• after an unsuccessful excision, there is a possibility of fusion of the vertebrae and the formation of a new hernia in other areas of the spine.

Due to such a disappointing prognosis that may follow the operation, a non-conservative technique is used only in especially critical cases. And purely after a thorough study of the present pathology and concomitant diseases if there is no other way out to save a person, one of the appropriate surgical therapy techniques is selected.

Recovery period after resection of a herniated disc

The recovery period directly depends, first of all, on the complexity of the procedure. For example, if surgery was performed without incisions (laser method, intraosseous blockades, etc.) and without direct instrumental intervention, the rehabilitation period will be shorter than after complete resection of the hernia and the affected disc. The second important point is the impeccable observance of medical prescriptions. The speed of his return to a normal human rhythm depends on how responsibly the patient complies with all recommendations and restrictions.

In order to ensure a quick recovery after surgery, as well as the confidence that unforeseen complications do not occur due to one's own fault, specialists in spinal surgery strongly recommend that you follow a rehabilitation plan.

1. In the first 45 days after the operation, it is forbidden to take a sitting position.
2. Exclude physical activity for 1-2 months, all movements should be smooth and accurate - without sharp jerks and jumps. In addition, you can not twist the body, that is, turn around strongly, bend over, etc. The rehabilitator will without fail inform the patient about all physical limitations, the timing of compliance with a sparing rhythm.
3. Avoid crowded places, as there is a risk of injury in the operated area. In addition to this, it is impossible to move by any means of transport due to the presence of shaking and, again, a large number of people. This condition is required to comply with 2-3 months. In case of urgent need for transportation, you need to ride exclusively in the prone position, while wearing an orthopedic bandage.
4. You can not overload the spine with an additional load - lifting heavy objects. The maximum allowable weight for lifting is 2 kilograms, and they must be equally balanced, distributed equally on both hands.
5. The spine at the time of postoperative rehabilitation needs a measured load, so you should make sure that it is in an upright position for no more than 30 minutes. After such work, it is necessary for him to provide a little rest - lie down on a medium hard surface, relax his back and rest for 10-15 minutes.
6. For the first month, use orthopedic products that fix your back - a bandage, corset, belt. This series of devices guarantees safety in case of careless movement, and also contributes to the speedy regeneration of bone and cartilage structures after surgery. The use of fixative underwear from the medical category implies the constant wearing of the product, it is recommended to remove it only before a night's sleep or, if necessary, relax during the day.

After an operation to remove an intervertebral hernia, it is very important to take the rehabilitation process with all responsibility, since the lack of postoperative complications. After removal of the intervertebral hernia, the patient should strictly adhere to the recommendations of doctors.

Main tasks and principles

After the operation to remove a hernia on the spine, the patient must understand that for a complete recovery, there is little surgical intervention, since in this way only the causes of the violations that have arisen are eliminated. The postoperative period is the main stage of treatment. The main tasks of rehabilitation after surgery are:

• complete elimination of back pain;
• getting rid of any kind of neurological abnormalities;
• stabilization of the patient's state of health;
• restoration of the musculoskeletal system, its integral mobility;
• tone control muscular system;
• no restrictions on the level of physical activity.

To cope with the tasks, the participation of the patient himself is important, and not only medical personnel. For successful recovery, the patient must navigate the stages of rehabilitation, be aware of the rules of conduct and the necessary exercises that are indicated in the postoperative period.

Stages of the rehabilitation period

1. The first postoperative stage recovery begins immediately after removal of the vertebral hernia and lasts 10-14 days. Its goal is the complete elimination of pain and neurological symptoms.
2. The second postoperative stage - begins approximately on the 15th day after the operation, lasts up to 60 days. The goal is to return to the usual daily life without the absence of any kind of restrictions.
3. The third - two months after the operation on the spine, or immediately after achieving all the previously set goals. It consists of comprehensive measures to restore full mobility of the spine, as well as measures to prevent the recurrence of a hernia. Therapeutic exercises for this period are selected by specialists depending on the severity of the disease and the success of previous measures to strengthen muscle mass.

Rehabilitation after an operation to remove a hernia on the spine is a rather lengthy process. These are complex physical activities, procedures and other health-improving measures that the patient must necessarily perform in the postoperative period. The attending physician determines how much recovery time is required in each case, depending on the patient's condition.

Rehabilitation begins immediately after removal of the intervertebral hernia on the spine, the patient is under regular supervision of specialists. All appointments are strictly controlled by specialized doctors - a surgeon, a neurologist, a rehabilitation specialist. In the event of unforeseen complications, observation of narrow specialists is possible. For the first time after the operation on the spine, it is recommended that you take the medications prescribed by your doctor.

When the patient gets a little stronger, a course of physical procedures is prescribed. The goal is to relieve the patient of pain in combination with drugs, as well as to prevent the manifestation of complications. The postoperative period passes without complications if the patient is set for a speedy recovery.

Exercise therapy (physiotherapy exercises) - is prescribed for the purpose of complete restoration of muscle tone, as well as the return of full mobility of all parts of the spine, removing unnecessary loads from it. All restoration measures should constitute a single set of measures, and not be divided into separate stages.

Restrictions and prohibitions

The postoperative period provides for a number of restrictions. Rehabilitation after removal of an intervertebral hernia requires a responsible attitude. Strict prohibitions include the following:

• categorically it is impossible to sit down;
• ride in a car in a sitting position;
• You can not lift weights weighing more than 3 kg;
• it is forbidden to make turns of the body without the use of a special corset;
• all physical activity, as well as medications taken, must be agreed with the doctor;
• use of any means is prohibited manual therapy without the supervision of a specialist;
• wearing a corset for more than 3 hours during the day is strictly prohibited.

When an operation is performed to remove an intervertebral hernia on the spine, the first thing that patients notice is the complete disappearance of pain. To prevent such sensations from recurring, it is important to strictly follow all the recommendations and instructions of doctors, then the rehabilitation will be successful.

Each postoperative recovery period after the operation to remove a hernia on the spine is very important. It is at complex rehabilitation you can achieve the desired result and avoid relapses.

Medical treatment

This postoperative step is mandatory. It is the treatment with medicines that gives a “start” to our body for recovery and restoration of its strength. Medications are prescribed to absolutely all patients who have undergone spinal surgery. It is mandatory to prescribe medications aimed at reducing inflammation in the body; painkillers, swelling relievers, and medicines for general recovery organism.

Diet after hernia removal

An important place after the operation on the spine is given to the diet. On the first day, it is worth limiting yourself to broths from vegetables, sparse cereals. Meals should be light, in small portions, but frequent enough not to provoke constipation.

Then the menu needs to be expanded, but the food should be steamed (cutlets, vegetables). Proper nutrition should be part of your life. It is necessary to minimize the use of cocoa, coffee, to exclude alcoholic beverages, fatty foods. Regular monitoring of your weight is recommended. Excess kilograms put a huge load on the spine, it negatively affects health. Rehabilitation after spinal surgery has been performed lasts a lifetime.

Physiotherapy techniques

Physiotherapy is focused on improving blood microcirculation and increasing the tone of the back muscles. They contribute to the restoration of the structure of cartilage and bone tissue, reduce or remove bruising. Physiotherapeutic methods include: electrophonophoresis, treatment with ultrasound, laser, magnets, mud, balneotherapy, etc.

Today, there are many physiotherapy techniques that perfectly restore the body. But in each case, an individual course of treatment is selected.

Physiotherapy

Restorative therapeutic exercises are prescribed only by a rehabilitation doctor. Gymnastics must be performed for at least 6 months, since it is believed that during this period, a callus is formed at the site of the operated area, where there was an intervertebral hernia. If necessary, the course of exercises will need to be continued.

When the body gets stronger and gets used to the loads, gymnastics can be diversified with exercises on simulators, mechanotherapy. Exercise therapy is a very important step in the restoration of the body. At first, like any other treatment, gymnastics takes place in the presence of a doctor who monitors the correctness of the exercises and loads. Then you can do recovery exercises at home.

Massotherapy

Massage in most cases is prescribed a few weeks after the operation. The massage technique is selected individually, first of all, the well-being and health of the patient is taken into account, as well as what kind of operation was performed. A massage performed by a specialist helps relieve tension, swelling, and, very importantly, prevent muscle atrophy.

Water procedures

All doctors say that hydrotherapy has a beneficial effect on the well-being of a patient who has recently undergone an operation to remove a hernia. It has been proven that water procedures contribute to quick recovery spine. Most requested procedures:

• Turpentine baths improve blood circulation, relieve inflammation well, accelerate the healing process of postoperative sutures, which reduces the likelihood of adhesions.
• Hydrogen sulfide or sulfide procedures restore tissues and improve motor functions.
• Herbal baths provide an opportunity to relax, relieve stress, soothe.

Traction of the spine after removal of a hernia can be dry or underwater. This method is used to stretch the joints under the weight of the patient's own weight. Sometimes additional weights are also used.

It is worth noting that patients who have had an intervertebral hernia removed will have to work on strengthening their muscles all their lives. They are encouraged to visit the pool, go skiing, ride a bike. Hypothermia and overwork should be avoided.

The range of restorative procedures is very wide, so each patient is assigned an individual course of recovery. If all recommendations are followed, then, as a rule, the patient recovers quickly and returns to work and to normal life.

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Principles of rehabilitation after spinal hernia surgery

Surgical intervention for intervertebral hernia does not mean that a person in a few days will feel healthy, mobile and ready to do any work. Rehabilitation after spinal hernia surgery lasts up to several months and full recovery of functions lost during the illness depends not only on the professionalism of the doctor, but also on the patience and perseverance of the patient. During the recovery period, the patient must follow all the recommendations of the doctor, their observance will prevent a possible relapse and will allow you to quickly cope with the restriction of mobility.

Conventionally, the entire rehabilitation period can be divided into three stages of different duration:

1. The first stage begins immediately from the moment the operation is completed and provides for the elimination of pain syndromes and neurological disorders.
2. The second stage is the adaptation of a person to everyday life.
3. The third stage includes a set of measures necessary to restore the mobility of the spinal column and aimed at preventing the recurrence of hernias. It is important during this period to choose a set of therapeutic exercises aimed at strengthening the muscular corset.

Early recovery period

The early rehabilitation period is up to two weeks after a surgical or other type of intervention on the spine. During this period, the postoperative suture heals, the lost sensitivity is restored and the pain decreases. Not all patients experience pain and limitation of movement completely immediately after surgery - swelling and inflammation of nerve fibers and tissues disappear within a few days, after this period it will be possible to evaluate the results of surgical intervention.

In the early rehabilitation period, non-steroidal anti-inflammatory and analgesic drugs are prescribed. Patients with depressive states are shown the appointment of sedatives. Neurosurgeons do not advise staying in bed for a long time after surgery, after a day or two you can already perform simple movements and move around, the only condition for this is the use of a corset.

Orthopedic corsets will be required not only in the first days and hours after the operation, but also for several months, that is, during the recovery period when performing physical work or exercise. Rigid bandages prevent displacement of the vertebrae, prevent sudden movements, and promote rapid healing of internal and external sutures.

In the early rehabilitation period, the doctor evaluates the appearance of sensitivity in the extremities, the restoration of the function of the pelvic organs, prescribes tests and repeated shots. The choice of drug treatment will depend on the data obtained and the patient's well-being.

Rehabilitation of the patient after discharge from the hospital

Depending on the type of surgery, the general well-being of the patient, the presence of complications, discharge home can be made on the third or tenth day after the operation. Before discharge, the doctor must give the operated patient detailed and complete recommendations, the observance of which depends on the restoration of health and all functions of the spinal column in the future.

Rehabilitation after removal of an intervertebral hernia is carried out by any patient with mandatory compliance following conditions:

• For a month and a half, you can not sit, this will avoid the re-formation of a hernia and pinching of the nerve roots.
• It is necessary to avoid sharp inclinations, turns, twisting of the torso, jumps and blows.
• About three months of travel in cars or other vehicles are allowed only in a reclining position. It is advisable to wear a corset during such a movement.
• Do not lift heavy objects. Within a month after the operation, it is no more than two kilograms in both hands, in the future the weight is increased. For the first six months, the maximum weight in one hand does not exceed three kilograms, while the load is distributed evenly.
• It is unacceptable to tense the muscles of one half of the body while relaxing the other. Therefore, it is advisable to carry all kinds of weights in a backpack behind your back, which provides uniform distribution.
• Every hour and a half it is recommended to give rest to the spine, for this they move from a vertical position to a horizontal one.

During the first weeks after the operation, the postoperative scar heals, the disturbed sensitivity of the nerve endings is restored, and the processes of restoration of the functions of the spine take place. Therefore, the task of the patient at this stage is to create the most favorable conditions for his spine. Active recovery of the spine after the operation is started in about a month, rehabilitation measures include:

• Therapeutic exercise.
• Physiotherapy.
• Spa treatment.

Restorative gymnastics in the early stages is carried out only under the supervision of a specialist, various sudden movements can lead to an attack of pain. Rehabilitation after removal of a hernia of the spine, in addition to exercise therapy and physiotherapy, may also include classes on special simulators, therapeutic massage, and reflexology.

Therapeutic exercise in the postoperative period

Physiotherapy exercises are necessary throughout the entire period of recovery of the body after surgery and in later life. Physical exercises increase joint mobility, strengthen the muscular corset, increase blood supply, nutrition of the spinal area, and help to remove toxins accumulated in the skin and muscles. The doctor is obliged to choose exercises and explain to the patient all the principles of gymnastics during the rehabilitation period.

You can start extended exercise about a month after surgery, but warm-up movements for the limbs and joints can be practiced already on the second or third day after discectomy. The simplest exercises after surgery include:

• Circular movements performed by the hands and feet.
• Flexion and extension of the elbow and knee joints.
• Slowly pulling the knees to the stomach. In the early days, do not strongly stretch the spine in an effort to fully pull the knees to chest.

Developed general recommendations and rules for patients undergoing surgery for the removal of an intervertebral hernia. Their observance allows you not to experience discomfort and pain and to provide maximum beneficial effect on the spine.

• During the exercises, sharp turns, inclinations are avoided, all elements are performed slowly and smoothly.
• They begin to perform exercises with one or two approaches, gradually their number is brought up to ten at a time. A set of exercises is performed in the evening and morning hours.
• If there is persistent pain or discomfort, you should consult with your doctor about changing the set of classes.

The exercises below are indicated for postoperative patients, but it must always be remembered that a rehabilitation doctor will be able to draw up a training plan correctly based on the patient's well-being, the presence of contraindications and the anatomical features of the spine of a particular patient.

1. It is necessary to lie on your back, bent knees gradually bring them closer to the chest. At the same time, tension is created in the muscles of the buttocks, then a period of relaxation and a slow return of the legs to their original position.
2. The position is also lying on your back, legs bent, arms spread apart. The pelvis is raised above the floor and held for the first time up to 10 seconds, in the future, the duration of the execution time gradually increases.
3. The next exercise includes a whole range of elements performed from one position. They are conveniently located with their backs on a hard surface, the hands are brought under the head, the legs are bent, the feet are on the floor. Movements are performed with the pelvis up and down, to the right and left side, then tilting the knees to the right - to the left and “bicycle” with the legs. At the end of the exercises, it is necessary to pump the abdominal muscles without lifting the lower back from the floor.
4. From a prone position, push-ups are performed from the floor, swinging the legs to the sides and up. The “cobra” body position is recommended - while inhaling, leaning on the elbows, it is necessary to bend as much as possible and stay in this position for 6 seconds, while exhaling, slowly return to the starting position. "Cobra" is performed up to 10 times.
5. Exercise "stand" helps to strengthen the muscular frame of the back and abdominal wall and stretch the spine. It is performed against the wall of the room, on which the protruding points of the torso, head and legs are supported. Hands rise up and in this position you need to stand up to 5 minutes. As you recover, the time increases, and the exercise is complicated by lifting on tiptoe.

Physiotherapy exercises will bring undoubted benefits after surgery and will prevent the recurrence of a hernia after surgery if the patient performs exercises constantly, moderately increasing the load. Throughout life, the patient is recommended to perform three basic complex exercises - push-ups, squats and a bicycle. Allocating 10 minutes in the morning for exercise will allow you to transfer all daytime stress without discomfort and pain.

Therapeutic measures aimed at recovery

The sets of exercises selected by the doctor must be performed for 6 months or more, it is believed that during this time a hernia is formed at the site of hernia removal. callus. After this period, physiotherapy exercises are expanded with exercises on simulators, massage, physiotherapy, mechanotherapy.

Mechanotherapy is the use of various simulators, with the help of which the physical conditions of influence on the limbs and spine are expanded. In patients with various paresis and paralysis of the limbs, a verticalizer can be used to give the body a vertical position - a device designed to prevent complications that develop with a long prone position.

The patient in the verticalizer improves the work of the cardiac, respiratory and urinary systems. Several types of verticalizers are produced, in some of them the patient can train lower limbs, in other back muscles, others are equipped with a device for independent movement.

Massotherapy It is recommended to perform a few weeks after the operation. A professionally performed massage relieves tension, swelling, and prevents muscle atrophy. There are several massage techniques, their choice depends on the general health of the patient and the nature of the surgical intervention.

Usage physical methods exposure - ultrasound, laser, magnetic fields, electrical impulses enhances blood supply, nutrition and metabolism in the spine.

During the rehabilitation period, important importance is given to the diet after the hernia removal operation. Nutrition should be aimed at preventing constipation and gas formation, which can create an excessive load on the operated area. It is recommended to eat often, but in small portions, the daily menu should contain dishes with vegetable fibers and a sufficient amount of liquids - jelly, compotes, rosehip broth.

In the first days after the operation, they mainly eat vegetable and milk soups, liquid cereals, then the food is expanded by omelettes, steam dishes from vegetables, meatballs, meatballs, boiled fish. In the future, it is necessary to minimize products with cocoa, coffee, alcohol. You constantly need to monitor your weight - excess kilograms create an unnecessary load on the spine, which is categorically not recommended after the removal of intervertebral discs.

An intervertebral hernia can cause a lot of suffering to a person, so a successful surgical intervention cannot but rejoice. To maintain the positive effect of the operation and prevent the occurrence of complications and relapses, you can follow the following recommendations.

Rehabilitation after spinal surgery with a hernia lasts at least six months. During this recovery period, it is necessary to follow all the recommendations of the attending physician - restriction of movements, minimal weight lifting, refusal to drive a car and travel by transport.

• Therapeutic gymnastics is effective tool spine recovery. Patients with an intervertebral hernia will have to engage in muscle strengthening throughout their lives.
• Compliance with the diet in the first days after the operation and subsequently to prevent the appearance of extra pounds.
• It is necessary to undergo preventive treatment regularly, consisting of medications, physiotherapy, massage courses, vitamins and reflexology.
• In the first weeks after surgery, it is necessary to wear an orthopedic corset, but not more than six hours a day.
• Jumps, bumps, sudden movements should be avoided.
• Swimming in the pools, skiing and cycling are shown.
• It is necessary to avoid hypothermia and treat respiratory infections in time.

Compliance with all the measures proposed by the doctor to restore the body will allow you to lead a normal life, not limit yourself in doing your usual work and prevent the development of relapses.

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Rehabilitation after removal of a hernia of the spine

Surgical intervention for herniated discs is prescribed quite rarely, and such a conclusion indicates a special degree of severity of the pathology. The success rate of the operation is quite high, but not guaranteed. It is important to understand that in addition to the operation itself, there is also rehabilitation after the removal of an intervertebral hernia, neglecting which will nullify all the efforts of surgeons.

Any rehabilitation after hernia removal intervertebral disc helps a person gradually adapt his body to a lifestyle in which there will be no recurrence of pathology. Remember that the postoperative recovery period is purely individual and you need to be able to analyze your condition, listen to the advice of doctors and take your time.

What is a rehabilitation period?

Main Feature is an individual for each patient duration, which is determined by the type of operation (with rough methods with fusion of the vertebrae - up to a year), the age category of the patient and the size of the intervertebral hernia. In the period that comes after the removal of the intervertebral hernia, it is important to ensure that the patient is looked after by such specialists:

• The doctor who treated the patient before the operation;
• The doctor who performed the operation;
• A doctor who specializes in postoperative rehabilitation.

The main goals that proper recovery after surgery helps to achieve:

• Formation of the correct muscular corset and posture;
• Restructuring lifestyle for a new height of the spinal column (reduction due to disc removal during discectomy);
• Prevention of recurrence of pathology;
• Elimination of pain and return to normal functioning.

Stages of rehabilitation

Any rehabilitation after operations to remove the intervertebral hernia lasts the rest of the patient's life, but the degree of necessary measures is different. The first few weeks after surgery are the most difficult, a person is worried about pain, depression, uncertainty. During this period, it is necessary to surround him with support from loved ones and prescribe a course of painkillers.

From the beginning of 3 weeks to the end of 2 months after the operation, the patient learns to move and perform many other vital functions without harm to the spine.

When a person is a little accustomed to a new lifestyle, a delayed recovery period begins - a healthy lifestyle without excessive load on the back. All this is accompanied by proper nutrition, gymnastic exercises and some folk methods. It is important to take all the doctor's instructions responsibly in order to prevent the recurrence of an intervertebral hernia or other complications.

Early period

The first 14-15 days after the removal of a spinal hernia is an early recovery period, which implies many limitations. The course of drug treatment is also ongoing. The patient is prescribed various drugs that relieve inflammation and pain. One more necessary measure are constant examinations, sometimes even an MRI is done. It is important to ascertain the effectiveness of the operation and its effect on the soft tissues of the back. You will also need to pass a number of other tests at the discretion of the doctor.

Some people do not feel like getting out of bed during this period, but doctors recommend movement. Of course, not immediately, but a few days after the operation to remove the intervertebral hernia.

• See also: Is it possible to do massage with a hernia of the spine?

The first safety measure in case of walking will be a rigid orthopedic corset, which has a lot of useful qualities:

• The required degree of rigidity will not allow you to make sharp turns with the body;
• The corset serves as a support for the spine, which has not been strengthened after the operation;
• By reducing the load with such a device, the patient feels less pain when walking.

Walking 3 days after surgery is useful, but there are some limitations:

• Duration - should not exceed 90 minutes;
• You can’t sit down; when getting up, this position should be avoided;
• Walk only in orthopedic corset putting it on lying down.

Late period

When the patient stops complaining about pain, the so-called “late rehabilitation period” begins, which lasts up to 8 weeks. During this time period, the patient must restore the mobility of the "squeezed" areas of the back, finally get rid of pain and strengthen the muscle corset.

In the late period after the removal of the intervertebral hernia, some physical exercises and physiotherapy procedures. Any exercises after removal of the intervertebral hernia must be performed without sudden movements, all techniques must be discussed with your doctor.

After spinal surgery, it is necessary to start with a very short duration of training. The simplest movements are selected that contribute to the normalization of blood circulation.

The following gymnastic exercises are usually used:

• Light bending of the back (rounding) with knees bent at the legs;
• Movement with straight arms with a flat back;
• Kneading movements with arms bent at the elbows.

Any physical education is performed only if there is no pain. And if there is, either you need to wait, or consult a doctor about other exercises.

Physiotherapy

• Novocaine electrophoresis - serves as an excellent pain reliever;
• Ultrasonic irradiation;
• Impact with magnetic fields;
• Exposure to weak electric current;
• The use of mud solutions to reduce pain and relieve swelling.

Delayed period

The use of exercise therapy after removal of an intervertebral hernia is not limited to late period. The delayed period begins from 3 months of rehabilitation, but even at this time the patient is not yet strong enough and one should be extremely careful when performing one or another exercise. You should not make sudden movements and exercise for too long, smoothness in movements and proper technique are important. Failure to follow these rules can cause pain. In this case, you should stop exercising or reduce their intensity. When pain accompanies any exercise, this is an occasion to visit a rehabilitation doctor.

good choice there will be push-ups from the floor and semi-squats. Such exercises can well strengthen the muscular corset with minimal stress on the spine.

Morning exercises will also become a constant companion in life for people who have undergone such operations. Proper therapeutic exercises are very useful for the back after removal of a vertebral hernia and at any other time, exercises restore impaired blood circulation, relieve spasms.

Exercises on simulators

The rehabilitation doctor also prescribes an individual course of kinesitherapy, which perfectly relieves pain. Any exercise is performed with the help of simulators. The main goal is to smoothly stretch the spine with an increase in the space between the vertebrae. Orthopedic trainers involve fairly long sessions to reduce the risk of pinched nerve endings. Slow stretching of the spine relieves inflammation and pain.

Also, after surgery for a hernia of the spine, a set of stretching exercises is used. It is very effective to use them underwater. For this, various weights and devices are used.

Baths

Everyone knows that the density of water is higher than the density of air. Accordingly, the spine in such an environment will be much less loaded and the person will be able to relax faster. But in order to enhance the relaxing effect and add anti-inflammatory to it, it is necessary to add various substances to the baths. Here are some examples:

• hydrosulfide baths. Able to significantly reduce swelling, improve blood circulation, relieve spasms.
• With the addition of turpentine ointments. Substances actively affect the focus of inflammation and help accelerated wound healing after surgery.
• Baths with medicinal herbs. They serve as an excellent sedative, help get rid of inflammation and relieve stiffness from the muscles.
• Baths with dissolved inert gases. One of these substances is Radon, which has an anti-inflammatory effect.

Sanatorium treatment

After a few months, when the time for active rehabilitation passes and the body gets a little stronger, you can think about a trip to a sanatorium. Everyone knows that in such institutions the body is perfectly restored.

If you try to be treated at home, the effect will be, but not so strong. You will need considerable perseverance to regularly perform all the exercises and attend the procedures.

In the case of a sanatorium, it is easier to restore your health, because there are many doctors - rehabilitators who will prescribe the necessary procedures and monitor your condition. Such institutions provide many specially equipped rooms where various wellness procedures are carried out. The patient is selected a number of procedures that depend on his condition:

• Various kinds of therapeutic baths;
• Mud compresses;
• Sunbathing;
• Paraffin therapy;
• Acupuncture.

We must not forget about the enormous benefits of the sea climate, which greatly speeds up recovery. Another plus of the sanatorium is proper nutrition. Doctors know what substances the patient needs for recovery - with high content fiber. It is in sanatoriums that the diet is easiest to observe.

Contraindications for rehabilitation

Surgical intervention in the structure of the spine is a dangerous thing that can have many unpleasant consequences. Even if everything went well, your spine will no longer be the same and it is important to remember this in order to avoid relapses of the pathology. There are many rules that must be observed in order not to nullify all the efforts of surgeons.

• Also Read: How Is Neck Surgery Performed?

Here are the basic principles of successful rehabilitation on early stage:

• Sitting is prohibited.
• Leaning or making sharp turns is also prohibited.
• Exercises with a load on the back (small) are carried out only in a special corset. But you can’t wear a corset for a long time, a maximum of several hours a day.
• Bad habits are unacceptable, especially in the early period of rehabilitation.
• The maximum allowable items that can be lifted in such a situation should weigh no more than three kilograms.
• Massage of any kind is prohibited.

• See also: Rehabilitation after spinal surgery.

The late rehabilitation period also has a number of limitations:

• Sitting is also not allowed. The first attempts can be made only after the permission of the rehabilitation doctor and not earlier than 6 weeks after the operation. Moving in public transport is not allowed, any travel can only be done lying down or reclining.
• You need to change your posture frequently to keep your spine moving.
• You can do some physical exercises with a moderate load on the muscles of the back. But there is always a warm-up first.
• Sharp movements are prohibited.
• A corset is also used, but it is always necessary to consult a doctor to know how long to wear.
• It is impossible to lift weights, the maximum allowable weight is up to 8 kilograms.

It is necessary to adjust your lifestyle, as the spine is now more vulnerable. Prolonged sitting is not recommended even a year after the operation, it is important to take breaks, it is advisable to spend this time lying down.

Excessive loads on the spine are unacceptable, and several years after the removal of the hernia, complications may arise. Do not overcool, especially in the place where the operation was performed.

Proper nutrition and a healthy lifestyle will sooner or later help you forget about your past illness and enjoy life without pain again.

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pozvonochnik.guru

Rehabilitation after surgery to remove an intervertebral hernia

Surgical intervention is extreme method treatment of this pathology. The operation is performed only with the ineffectiveness of conservative therapy, since it is associated with the threat of dangerous complications.

Rehabilitation is carried out under the supervision of specialists

Competent rehabilitation after removal of the intervertebral hernia minimizes the likelihood of negative health consequences and prevents the recurrence of the disease.

Goals of the rehabilitation period

Recovery should begin immediately after the operation and last 3-12 months. But even after the end of this period, one should not stop, because a person needs to engage in supportive procedures for the rest of his life. Microdiscectomy is performed to relieve the patient of pain, treat and prevent complications of the pathology. The rehabilitation period is aimed at solving such problems:

• relief of pain;
• prevention of the development of the disease;
• restoration of the ability to serve themselves;
• strengthening muscle tissue;
• restoration of the work of the disturbed part of the spine;
• prevention of recurrence of the disease;
• increasing the ability to perform more strenuous physical activity.

The success of rehabilitation directly depends on the timely started rehabilitation. surgical treatment. If, after a successful operation to remove the intervertebral hernia, recovery is not immediately started, its results will be reduced to zero.

Recovery steps

Conventionally, the rehabilitation period is divided into several stages, each of which has a certain duration:

1. The first stage begins from the end of the operation and consists in the relief of pain and the elimination of neurological problems.
2. The second stage is the adaptation of the patient to everyday life.
3. The third stage involves the implementation of measures that are required to normalize the mobility of the spine and prevent recurrence of hernias. During this period, it is very important to do exercises aimed at strengthening muscle tissue.

Particular attention should be paid to the early recovery period. It must be started immediately after the intervention and continued for about 2 weeks. At this time, the postoperative suture heals, sensitivity is restored, pain decreases. In the early rehabilitation period, the back still hurts, so the use of non-steroidal anti-inflammatory and painkillers is required. Depressed patients are prescribed sedatives. It is not recommended to lie in bed for a long time after the operation. Literally after 1-2 days, you can make simple movements, but you should definitely use a corset.

Such devices must be worn for several months when performing exercise therapy and physical work. With the help of rigid bandages, it is possible to prevent displacement of the vertebrae and discs of various parts of the spine, and accelerate the healing of sutures.

lechuspinu.ru

Features of rehabilitation after surgery to remove an intervertebral hernia

The stage of treatment does not end with the operation, since the person still needs rehabilitation after the operation to remove the intervertebral hernia. The time interval that it occupies is 3-12 months.

Need for rehabilitation

As a rule, rehabilitation after removal of a spinal hernia is based on the selection of exercises for each patient separately and the determination of the types of procedures at different stages of recovery. During this period, the doctor is obliged to conduct a comprehensive monitoring of the patient. Recovery occurs with the correct and precise observance of all prescriptions given by the surgeon, rehabilitation specialist and neurologist. And, of course, prevention of the appearance of new hernias is mandatory.

The first feelings after the elimination of the intervertebral hernia are the relief of the condition and the disappearance of pain associated with the withdrawal of swelling and the elimination of compression of the intervertebral discs. However, this effect is short-term, and if you do not listen to the doctor and start to lead a correct lifestyle, then complications will appear. It is not for nothing that rehabilitation after removal of an intervertebral hernia is also called a period of restorative treatment - it is curative (increases working capacity) and prophylactic (prevents the formation of new hernias) in nature.

If the previous surgical intervention was aimed at eliminating the cause of back pain, then the goal of rehabilitation can be considered:

• to achieve a stable condition of the patient;
• tidy up the muscles of the back;
• remove restrictions on self-service;
• get rid of pain and restore neurological functions;
• eliminate restrictions in physical work;
• restore the functions of the musculoskeletal system, make the spine mobile and restore the biomechanical functions of the vertebrae.

recovery program

First of all, the program of rehabilitation measures is determined by the type of operation performed. For example, with a traditional discectomy, the fusion of two adjacent vertebrae takes place within 6 months (rehabilitation lasts about the same time). Minimally invasive methods significantly reduce the recovery period and rarely lead to complications (method of endoscopic discectomy, microdiscectomy, puncture vaporization with a laser). The physiological characteristics of the patient play an important role. For example, age and the presence of other diseases. The program also depends on the severity of the course and the duration of the progression of the disease before surgery.

Effective recovery can be achieved by observing the following points:

• drug treatment;
• exercise therapy (complex of physiotherapy exercises);
• physiotherapy procedures;
• Spa treatment;
• kinesitherapy and hydrotherapy.

Recovery conditionally takes place in 3 periods. At an early stage, within 2 weeks, activities allow you to prevent and eliminate pain, get psychological help. In the late phase, which lasts 2-8 weeks, the patient tries to adapt to self-care in everyday life. In the delayed period (2 months after surgery and then throughout life), the program is aimed at restoring the biomechanics of the back, preventing relapses.

What is forbidden to do?

In the early recovery period, you can not sit, wear heavy objects from 3 kg and above, do physical exercises without a bandage or corset, drive a car, bus in a sitting position, wear a corset for more than 3 hours, move sharply (tilts back, forward and sideways) , smoke or drink alcohol, undergo a massage course, play sports (football, ice skating).

In the late rehabilitation period, you can not jump from a height, lift more than 5 kg, supercool your back, sit for a long time and wear a corset, do physical work without warming up your muscles. Regardless of which stage the patient goes through, it is recommended from time to time during the day to give the spine a rest (lie down on the bed for 25 minutes). You also need to control your weight, do not expose the body to stress.

Rehabilitation after surgery for a hernia of the spine is based on a light restrictive mode with a consistent increase in the load on the body to its usual state.

Therefore, the doctor's control over the patient and the development of an individual recovery program are so necessary.

Therapeutic procedures and kinesitherapy

Kinesiotherapy is a complex of special dosed movements, selected individually for a person. As a rule, orthopedic simulators are used in recovery, allowing the spine, joints and muscles to slowly take on the load by stretching. As a result, the hernia “vacuumizes”, excess pressure in the nerve roots disappears.

Over time, with a smooth, dosed effect on the muscles, a so-called corset around the spine is formed. It turns out that the blocked immobile vertebrae are compensated by the mobility of adjacent joints. This is how stretching occurs naturally, which leads to the restoration of power to the discs and the correct location of the vertebrae relative to each other.

The most common physiotherapy procedures:

• electrophoresis - used to penetrate drugs through the skin;
• phonophoresis - drugs are administered with the help of ultrasound, the procedure is similar to non-contact massage, it helps to relieve swelling;
• ultrasound - makes the rehabilitation process fast and stimulates cell growth;
• magnetotherapy - activates the metabolic process by exposure to a low-frequency magnetic field;
• mud treatment;
• interstitial electrical stimulation - regenerates pinched nerves, relieves pain and improves tissue nutrition;
• EHF-therapy - tidies up muscle tone, has an anti-inflammatory effect.

How does exercise and medication help?

After the operation, the patient may complain that his back hurts. This is due to inflammation of the spinal nerve, which has been compressed by a hernia for a long time. Another cause of pain can be trauma to the ligaments and tissues from the operation. The doctor prescribes drugs that can suppress inflammation and relieve pain.

The type of medication, dose and frequency of administration is determined by the attending physician, taking into account the nature of the pain, the presence of other diseases and contraindications. Paracetamol, NSAIDs, strong and weak opioids may be prescribed.

The types of exercises for physiotherapy exercises are determined by the doctor. Sample exercises:

1. Lie face down on the floor. Put your palms under your chest, spread your legs. Further, leaning on the toes and palms, it is necessary to raise the torso and arch the back up. The head should be lowered, the pelvis should be higher than the head, the legs and arms should be straight. After that, it is necessary to lower the pelvis to the floor, and leave the legs and arms in the same position.
2. We accept the initial position, as in the first exercise. Further, when the pelvis is raised and the back is arched, you need to turn the pelvis to the left, dropping sideways as low as possible, the left leg remains motionless. We do the same to the right. Arms and legs are straight. You need to do the exercise slowly.
3. It is necessary to sit on the floor and spread your arms, transferring the load to them, bend your legs slightly. Now you need to raise the pelvis so that the load is on the arms and legs. It is recommended to do this exercise intensively, first 7 times, gradually increasing to 20 times.
4. Lie on the floor face up, arms out to the sides, legs straight. Then bend your knees and pull them to your chest, clasp your hands. After that, we try to push off from the hips and knees, but at the same time we continue to hold our legs with our hands. Hold this position for 5 seconds. Repeat 3-4 times.

Spa treatment and hydrotherapy

Often, underwater traction is included in the rehabilitation program. In another way, it is called traction therapy. The purpose of its implementation is to stretch the elastic tissues and joints of the spine under the person's own weight.

Often used such hydroprocedures:

• herbal baths - help relieve tension and pain;
• turpentine baths - have an anti-inflammatory effect, are able to dissolve postoperative scars and remove adhesions at the seams, activate the rehabilitation process, improve blood circulation;
• radon baths - have a beneficial effect on blood circulation, relieve pain and inflammation, improve neuromuscular conduction;
• sulfide or hydrogen sulfide baths - improve muscle contraction, blood circulation and accelerate metabolic processes.

Spa treatment is carried out at a late stage of rehabilitation, since the patient after the operation needs to avoid adaptation to a new place and climate change. In special sanatoriums, therapeutic mud, massage, gymnastics, various baths (sulfur, turpentine, radon), paraffin treatment, proper nutrition, physiotherapy, acupuncture, etc. can be offered.

Collapse

Removal of the uterus with appendages is perhaps one of the most serious and heavy operations in gynecology. It can carry quite a lot of complications, and in addition, be characterized by a long and difficult recovery period, during which various restrictions apply to many areas of life. But it is precisely the careful adherence to the doctor's recommendations at this stage that can significantly speed up the recovery from the disease, recovery after the procedure and improve the quality of life. About how the postoperative period goes after the removal of the uterus, what features it has and what recommendations should be followed at this stage of treatment, is described in this material.

Duration

How long does the rehabilitation of the patient after such an intervention actually last? To some extent, this is influenced by its method and volume. For example, if the uterus with appendages was removed, then the recovery period can be up to two months, and if only the organ cavity itself, then up to six weeks or one and a half months.

It is customary to distinguish between early and late rehabilitation period. Early is understood as the first three days after the operation, and the first 24 hours have the maximum value. Late means the rest of the period - up to one and a half to two months.

Quick Recovery

How to quickly recover after removal of the uterus? Express methods of recovery after this intervention does not exist. This intervention is quite serious and voluminous, accompanied by hormonal changes in the reproductive system. And also, they have their own effects and symptoms of the disease, due to which it was necessary to amputate the organ. Therefore, the recovery period after removal is normally long and is accompanied, to the greatest extent in the first weeks, by a deterioration in well-being.

Taking into account individual features body, recovery after removal of the uterus can go a little faster or a little slower, but there will still not be a significant difference. And even if the state of health improved after 2-3 weeks, this does not mean that the implementation of the doctor's recommendations should be stopped.

Within 24 hours after the laparotomy was carried out, it is necessary to observe bed rest. It takes a lot of time just to get out of anesthesia. You should not sit down and get up even to the toilet. Although by the end of the first day, gently, with the help of hands, it is already permissible to roll over on its side. Only liquid food is allowed.

First 72 hours

Over time, it is necessary to increase physical activity. At this stage, the patient should already half-sit in bed, get up to use the toilet, roll over on her side. There should still be liquid and semi-liquid food, by the third day starting to include easily digestible ordinary food. It is important to control the work of the intestines so that there is no constipation and gas formation.

These days, treatment is already being carried out after removal of the uterus - antibiotics are taken. a wide range steps to avoid infection.

You need to pay attention to your general condition - heat after the procedure at this stage may be a sign of an inflammatory process.

One and a half to two months

About a week after the abdominal operation was performed, antibiotic treatment ends. Often, at this stage, hormone treatment may be prescribed to facilitate entry into menopause (when the ovaries are removed). At the same stage, consultations of a psychologist are appointed, if they are needed.

The patient can eat normal food, but it is important that it is healthy and natural, and does not cause constipation and gas formation. Bed rest is moderate for the first two weeks. Then it can be canceled, but physical exertion should be avoided.

Rehabilitation after removal of the uterus excludes saunas, baths, any overheating. You can not swim in natural reservoirs, you can maintain hygiene with the help of a shower.

What should be done at this stage? It also depends on the type of intervention. Depending on it, the patient may be given additional instructions for rehabilitation.

Subtotal hysterectomy

Perhaps the simplest removal of the uterus, the postoperative period in which is short. With such an intervention, only the body of the organ is removed, the neck and appendages remain unaffected. The duration of the rehabilitation period is about one and a half months, the scar is small, hormonal treatment is not required.

Total hysterectomy

The uterus and cervix are removed, without appendages. The duration of the recovery period is about the same, you can return to sexual activity no earlier than two months later. Hormonal treatment also not required.

Hysterosalpingo-oophorectomy

Not only the body of the organ is removed, but also the appendages - the ovaries and the fallopian tubes. Extirpation of the uterus with appendages is a rather difficult operation, involving a long, up to two months, rehabilitation period. The scheme of the procedure in the photo in the material.

Radical hysterectomy

The entire organ is removed. Rehabilitation has the same features as with total hysterectomy.

intimate life

During the entire recovery time after removal of the uterus, it is advisable to abandon intimate life. Although in many ways this can be determined only on the basis of the method by which the intervention was carried out. For example, when only the uterine cavity is removed and the vagina and cervix are completely preserved, doctors are allowed to resume sexual activity after a month and a half. If the cervix and the upper third of the vagina were removed, then the period of abstinence may be longer, since the suture after the intervention may be injured.

Thus, during the first five weeks, sex is prohibited. After this period, it is worth consulting with a specialist on this issue. This is true for any period that has passed since the abdominal surgery to remove the uterus - before resuming sexual activity, consult your doctor.

Sport

When can I exercise after hysterectomy? This question can only be answered taking into account the type and intensity of loads. On the early stages recovery after the procedure of any physical activity should be minimal. After the first week of rehabilitation, therapeutic exercises can be added to prevent the formation of adhesions, etc. After a full rehabilitation period, you can again do gymnastics and aerobics in moderation and without excessive loads and strength exercises.

You can also start doing fitness no earlier than 2 months after the intervention, and only with the permission of the attending physician. As for professional sports, bodybuilding, the time to start such exercises should be discussed with the doctor separately, since important role plays the nature of the load, the nature of the intervention, the speed and features of healing.

Example of daily routine

Rehabilitation after surgery is faster with the correct daily routine. You need to sleep more - in the first 7 days after the procedure, you need to sleep as much as you want. Then it is recommended to sleep for at least 8 hours, but you can’t sleep for more than 10 hours either, since at this stage it’s no longer worth lying too much. Physical activity is needed to avoid stagnation of blood and the formation of adhesions. That is, bed rest should still be observed, but not excessively - taking into account sleep, it is worth spending 13-15 hours a day in bed, the rest of the time it is better to sit, walk, do simple, non-stressful household chores.

Starting from the second week walks are shown. First, short - 15-20 minutes. Over time, their duration can be increased to one hour in good weather. Every day for 10-15 minutes you need to do therapeutic exercises.

Diet Example

As already mentioned, the first three days it is better to eat fairly light food - natural vegetable broths and mashed potatoes. Then you can gradually introduce food of the usual consistency, and by the end of 5-6 days the patient should switch to a diet of the general table. Although the food must meet the requirements healthy eating, it is necessary to avoid fried, fatty, canned, smoked, and in addition, sweet, preservatives and dyes. For example, the diet might be:

1. Breakfast - oatmeal porridge, egg, black tea;
2. Late breakfast - fruit, cottage cheese;
3. Lunch - vegetable or chicken / meat broth soup, lean beef with rice, rosehip broth;
4. Snack - vegetable / fruit salad or yogurt;
5. Dinner - white fish with fresh or stewed vegetables, tea.

In general, after the operation to remove the uterus, it is necessary to adhere to the rules of a healthy diet, eat fractionally, do not overeat. The calorie content of the diet should remain the same.

Effects

The consequences after removal of the uterus in the recovery period are possible if the rules for its passage are violated, as well as with some features of the body. For example, complications such as:

1. Depression, nervous breakdowns, other complications of an emotional and psychological nature;
2. Bleeding due to poor healing of sutures or stress on them;
3. Suture endometriosis - a condition in which the endometrium begins to form on the peritoneum (it is extremely rare);
4. Infection of the blood or peritoneum, neighboring organs in the hodge operation manifests itself just during this period;
5. Prolonged and persistent pain syndrome that develops when the nerve trunks are damaged;
6. Inflammatory process, temperature after removal of the uterus is its sign;
7. Accession of viruses and infections, fungi, as a result of reduced local immunity;
8. Some deterioration in the quality of sexual life, which usually disappears after hormone therapy;
9. Decreased libido, which is also regulated by hormones;
10. Possible problems with the intestines, constipation;
11. Symptoms of early menopause when removing not only the cavity, but also the ovaries.

Moreover, after abdominal surgery, which was performed under general anesthesia complications are always possible after anesthesia. But they appear already in the first 24 hours after the procedure.

Conclusion

Regardless of the method of surgical intervention to remove an organ, a well-conducted recovery period is no less important than careful preparation for the intervention and its high-quality conduct. It is now that healing is taking place, and it depends on it whether the patient will be worried about the consequences of this intervention in the future. For example, if the postoperative period after removal of the uterus is carried out correctly, then adhesions are not formed, which can later cause pain, the scar will be more or less aesthetically smoothed out, etc.

1 month after surgery:

Most of the time during this period you spend in the position of "standing" and "lying", and it is preferable to walk rather than stand. Wearing a corset during this period is mandatory. You can not sit, for 2-3 weeks of the first month after the operation, you can sit down for a minimum time, 15-20 minutes, only during meals. It is important not only how much, but also how to sit. In a sitting position, it is necessary to maintain the shape of the spine with forward deflection in the lumbar region. For sitting, it is better to use a chair with a small seat and pronounced support under the lower back (computer chair), the height of the chair is such that the knees are lower than the hip joints. We sit on a chair and rest our hands on our knees or on the arms of the chair. When sitting, we shift the buttocks as far back as possible, so that the back of the office chair rests against the lower back (the difference between the office chair and the director's chair is the presence of a gap between the back and the seat, often even the metal back holder is bent in this place) with insufficient support under the lower back, put a pillow. We maintain this position, with the most straightened back and the deflection of the lumbar forward, for the entire period of sitting. When standing up, do not bend the spine, but move to the edge of the chair and stand with your legs up, and not forward, preferably with your hands resting on your knees or in the arms of the chair. We increase the time in the “sitting” position gradually, adding 5-10 minutes every day. The task is to reach 45-60 minutes of "sedentary" load by the end of the month, which will allow you, having gone to work, to establish a physiologically correct mode - we sit for 45-60 minutes and walk for 5-10 minutes.
Exclude forward bends from your movements, especially for the first 2-3 weeks, by the end of the month, light bows are allowed, like a famous artist, not like a serf begging for freedom. Basically, the need to lean forward occurs when putting on shoes. Destroy lace-up shoes in your wardrobe and get a shoe horn with the longest handle. If necessary, take a half step forward and squat with a straight back.
Remember to properly get out of bed, only now you can simplify this process. To get out of bed, you must first make a few simple warm-up movements with your arms and legs for a stretch, then turn on your side, bend your legs at the knee joints so that the shins and feet hang from the bed and, pushing off with the elbow of one hand and the other hand, sit down. And already from a sitting position, get up, trying to keep your back as even as possible, without making sudden movements.
The main physical activity of this period is physiotherapy exercises and walking. We start with 0.5-1 kilometers a day, the duration of walks must be increased slowly. At the beginning of the walk, you may feel tension when walking, but gradually on the first 100-200 meters, this feeling recedes and a feeling of confidence and relaxation comes. Under other conditions, do not rush to increase the time and distance of walks. By the end of the first month after the operation, walking 2-3 kilometers a day is good, especially if you haven’t done such walks even with a healthy spine. Remember that when you again feel discomfort and slight pain in your lower back, this is a sign that you have gone enough and you need to lie down or sit down, which obliges you not to go far from home and plan your way there and back in advance.

The recovery period may be accompanied by a temporary return of pain. If you experience back pain, first of all take a horizontal position and reduce the load for the next few days. It is necessary to take analgesics (Katadalon, Baralgin, etc.), anti-inflammatory drugs (Diclofenac, Nise, Movalis, etc.), muscle relaxants (Sirdalud, Mydocalm, etc.). About what drugs to take in case of recurrence of the pain syndrome, agree in advance with your doctor. If the pain does not decrease within two to three days, if there is numbness in the legs and perineum, weakness in the legs, difficulty urinating, body temperature rises, redness of the skin in the area of ​​the postoperative scar appears, you should immediately consult a doctor.