Rehabilitation after a herniated disc
introduction
Nowadays there are different ways of preventing a herniated disc (med. also: disc prolapse) to treat. As a rule, only about 10% of patients with this clinical picture are operated on at all.
The vast majority are now treated rather conservatively, which has positive effects on returning to everyday life and reintegration into work.
Both are usually possible again much earlier for those affected after conservative therapy, and the number of incapacity for work and early retirement is therefore significantly lower. In order for this to work, however, it is crucial to start the appropriate rehabilitation measures at an early stage.
In rehabilitation, a fundamental distinction is made between conservative rehabilitation and follow-up treatment (AHB) after a disc surgery.
Duration of rehab
The duration of the rehab differs on the one hand depending on the severity of the clinical picture and on the other hand according to the chosen form of therapy.
In total, after a herniated disc, at least three to eight weeks of rehab must be expected in order to be almost symptom-free and to regain the greatest possible range of motion.
Last but not least, suitable rehabilitation measures play a major role in mental health after a herniated disc and the avoidance of painful conditions, which in turn can be associated with fears or even depressive episodes.
A typical rehabilitation program after a herniated disc includes stabilizing and muscle-strengthening exercises as part of physiotherapy, back training and relaxation training. On the other hand, there are also everyday training courses and measures for reintegration into the respective professional situation.
Conservative rehab without prior surgery should generally not take more than six to eight weeks. The aim is to achieve a significant improvement through the training and the newly learned exercises, up to and including the complete absence of symptoms.
This can vary individually in the length of time. If, however, there is still no noticeable improvement after eight weeks, the whole case should be re-evaluated by a doctor and, if necessary, operated on. After this period of time, the chances of being able to successfully treat the herniated disc with conservative therapy alone are usually negligible.
In contrast, there is follow-up treatment (AHB) after a disc surgery. This usually begins a few days immediately after the operation and the patients often go straight from the hospital to the rehabilitation clinic of their choice.
The central contents of the follow-up treatment (AHB) are on the one hand physiotherapy and water aerobics to strengthen the muscles, but also psychological and nutritional advice methods in dealing with the disease play a decisive role.
The duration of such a follow-up treatment (AHB) after an intervertebral disc surgery is usually around 3 weeks. An extension of this period is possible if there is a medical indication for this.
You might also be interested in our next article: Consequences of a herniated disc
Appointment with a specialist for a herniated disc?
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
A herniated disc is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.
Therefore, treating a herniated disc requires a lot of experience.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
Which sports are offered in a rehab?
After a herniated disc, there are various ways of doing sports in rehab.
At the beginning it is advisable to take part in the medically guided rehab sports groups. There, the group does sports games, gymnastics and movement exercises that help to build up the muscles.
In addition, there are many offers in the field of back training in rehab. In addition to strength and endurance training and stretching exercises, this includes above all tips and instructions on how to do back-friendly activities in everyday life.
If you also want to be active yourself, one of the first sports you can start with is swimming. In water, the body is lighter and the spine is less stressed. In addition to guided aqua aerobics groups, simple swimming is very good for your back. Backstroke is preferred.
Breast and dolphin swimming should be avoided if possible, as a lot of pressure is exerted on the entire spine, the intervertebral discs and especially the lumbar spine. In aqua gymnastics, the patient can develop and practice muscle development and movement sequences under easier conditions (because of the buoyancy, the whole body weight does not have to be carried).
In addition to swimming, hiking, Nordic walking or cycling are also recommended in the course of rehabilitation. You don't have to do this on your own. Many sports or district clubs offer such activities in groups and target them specifically to patients in rehab. Fitness studios also have a large number of offers in the field of rehab. Some are specially geared towards rehab and offer structured outpatient rehab treatment in connection with therapy centers.
You might also be interested in:
- Exercise after and after a herniated disc
- Exercises for a herniated disc
- Lumbar Spine Syndrome and Exercise
Submit an application - how can I apply for rehab?
In principle, the patient must be able to rehabilitate in order to be approved for a rehabilitation program. For this, the doctor has to submit an individual assessment of the goals and prognosis of the rehabilitation treatment in the form of a letter to the insurance company in advance.
In rehab, a distinction is made between the goal of restoring the ability to work and the restoration of health.
The first is through the pension insurance company, the latter through the health insurance. If it is an accident at work, the application must be made to the accident insurance institution.
The form of rehabilitation must also be determined, i.e. an outpatient or an inpatient rehabilitation program. In addition, the type of rehabilitation measures must be described, namely whether medical, occupational or even social rehabilitation after the herniated disc is indicated.
If follow-up treatment is to take place, the attending physician must submit an application while the patient is in hospital. This is usually done through the company's social counseling service, preferably with a lot of lead time.
Who is applying for rehab?
Rehabilitation after a herniated disc is requested directly from the treating doctor:
- After an operation, the attending doctor on the orthopedic ward is responsible for this.
- If there is no hospital stay before rehab (especially in the case of conservative treatments), the resident orthopedic surgeon can apply for rehab.
When applying for rehab, it is important to find the cost bearer for the therapy.
Depending on whether the person concerned is employed or has already retired, the statutory health insurance or the pension insurance is responsible for assuming the costs.
Often the insurance companies shift the responsibility on to one another, so that the rehab application must first be reckoned with.
Against this, the attending physician has to file an objection.
After several attempts, it usually works with a rehab permit.
Type of rehab - depending on the previous therapy for the herniated disc!
The rehab usually differs in the previous treatment method. If a herniated disc has been treated by an operation, at least three weeks of follow-up treatment is sometimes carried out in an inpatient setting.
Too intensive rehab after an operation for a herniated disc can lead to another herniated disc. Therefore, rehabilitation measures are carried out less and less after an operation of the herniated disc.
If, on the other hand, the herniated disc was treated conservatively without surgery, outpatient, inpatient or semi-inpatient rehabilitation usually takes place. The form and duration of the rehabilitation then depends on the severity of the clinical picture, the individual requirements of the patient and the aim of the rehabilitation measures.
Please also read our topics:
- Treatment options for a herniated disc
- Operation of a herniated disc
Illustration of a herniated disc
Disc prolapse -
Nucleus pulposus prolapse
A - herniated disc from the left
B - herniated disc from above
C - Healthy disc
a - neck and chest area
b - lumbar region
- Fiber ring -
Annulus fibrosus - Gelatinous core -
Nucleus pulposus
1st + 2nd intervertebral disc
(Intervertebral disc) -
Discus inter vertebralis - Spinal nerve -
Spinal nerve - Spinal cord -
Medula spinalis - Vertebral bodies -
Corpus vertebrae - Spinous process -
Spinous process
You can find an overview of all Dr-Gumpert images at: medical illustrations
How does rehab after an operation differ from rehab after a conservatively treated herniated disc?
After an operation for a herniated disc, the rehab begins with light relaxation exercises.
In addition, consideration must be given to the operated area after an operation.
The wound in particular can still cause problems at the beginning of rehab and must be treated in addition to the back.
On the other hand, it is assumed that after an operation there are no longer any restrictions due to the herniated disc:
Therefore, in the later phases of rehab, you can focus very strongly on flexibility and strength.
While conservative treatment must always pay attention to which exercises are possible despite the herniated disc.
Overall, the exercises that are performed in rehab after an operation and in conservative treatment are very similar.
Rehabilitation after a slipped disc - outpatient or inpatient?
Most rehab clinics offer various concepts in inpatient, semi-inpatient and outpatient form for both conventional conservative rehab and follow-up treatment.
For outpatient rehab, patients go to special rehabilitation centers during the day, where they complete a fixed rehabilitation program. During this time, however, they live at home and must therefore be able to ensure daily travel to the rehabilitation center. This treatment concept usually involves a personal contribution of 10 euros a day.
A more intensive treatment program can be guaranteed as part of inpatient rehab. This is particularly important, for example, when the focus is on reintegration into work or a return to a structured and independent everyday life. The patients then live in a rehabilitation clinic for the duration of the rehabilitation program. Here, too, a personal contribution of 10 euros per day is usually charged and the maximum duration of such a stay is a total of 28 days.
Follow-up treatment (AHB) is indicated if the herniated disc has been operated on or if the symptoms are particularly severe. For this, the attending doctor in the hospital must submit an application to the respective social insurance agency. Follow-up treatment must then be started no later than 14 days after discharge from the hospital. It then usually lasts 3 weeks. Depending on which insurance pays for the follow-up treatment, the patient can choose the rehabilitation clinic independently. If the costs in the chosen facility are higher than those in the contractual facilities, the patient must pay the difference.
Rehabilitation with a child - what should be considered?
Fathers and mothers have the opportunity to take their child with them during rehab. This is possible if the parent and the child both need rehab or if the separation from the child during rehab would not be reasonable.
You can take your child with you up to the age of 12. In exceptional cases up to the age of 14.Rehabilitation with children takes place in rehabilitation centers that are specially designed to meet the needs of parents and children. The duration of a rehab with a child is limited to a maximum of 3 weeks and can only be extended in exceptional cases. The centers for rehab with children belong to the maternal convalescence organizations and similar institutions that offer appropriate measures for fathers and children.
Parents have the opportunity to have a say in the choice of the location of the rehab if suggestions have been received from the health insurance company. It is important to know that there are different requirements for the age of the child, depending on where the rehab is to be carried out. It should be noted here that the child must be released from school during this time. In addition, parents are entitled to financial support for domestic help if the child is not in rehab. And for the period of rehab, parents have a right to continued payment of their wages. For rehab that affects father and child, there are specialized centers that are precisely tailored to their needs and requirements. Fathers and mothers can find out more from the Müttergenesungswerk, health insurance and pension insurance.
