Rehabilitation

What happens as I recover?

When a severe spinal cord injury results in permanent loss of nerve function, the goal of rehabilitation is to enable the patient to live a productive and fulfilling life with the disability. More commonly, nerve loss is minor or absent and the goal of rehabilitation is to recover strength and function of the muscles of the lower back. This can be a long process.

Muscles are likely to have been damaged by the same forces which caused the fracture. The surgery necessary to fix the fracture may have damaged the back muscles. Pain in the area as the tissues are healing inhibits normal muscle activity. There is often a period of rest and decreased activity during which the muscles become weak through disuse. Bracing required while the spine heals further weakens the muscles through disuse.

Physical therapy is often very helpful in reducing the pain and allowing you safely to exercise and strengthen the back muscles to all the fastest possible recovery. You can expect to gain strength quickly in the first three to six months. You may go on improving for up to two years after a serious lumbar spine fracture.

Return to work after a broken back is a contentious issue. If the injury is stable, there has been no neurological damage and healing has been uneventful there is no inherent reason why you should not recover fully and return to heavy work and sports activity. In practice it is difficult to make the transition from weak, sore and stiff to normal working condition in one step. It is often necessary to build up tolerance of working conditions slowly.

This can be a problem. Employers expect workers to do the work and do not usually consider work as "therapy". Work hardening programs have evolved to fill this gap. Work hardening programs are supervised by a physical therapist. Your working conditions are "simulated" in the clinic. You gradually do harder and harder tasks for longer and longer periods until you are able to tolerate normal working activities and hours. When you are ready to resume your occupation, you are released to return to work.