Rehabilitation

What happens as I recover?

With severe spinal cord injuries the rehabilitation effort is the main arm of treatment as there is no expectation of nerve recovery. The goal of rehabilitation is to enable the patient to live a productive and fulfilling life with the disability. When the nerve loss is minor or absent, the goal of rehabilitation is to recover strength and function of the muscles of the lower back. This can be a long process.

In the first place, the muscles are likely to have been damaged by the same forces which caused the fracture. In the second place there may have been surgery with the back muscles cut so that the spine can be exposed. There is often a period of rest and decreased activity during which the muscles become weak through disuse. Bracing can be continued for three months or more after an unstable back fracture even if it has been stabilized by surgery. Finally, there may be some pain in the area as the tissues are healing. This inhibits normal muscle activity.

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 but you may go on improving for up to two years after a serious thoracic 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 a normal working condition in one step. It is often necessary to build up tolerance of working conditions slowly and this is a problem. Employers expect workers to do the work, not treat work as therapy. Work hardening programs have evolved to fill this gap, With supervision by a therapist working conditions are simulated and you gradually do harder and harder tasks for longer and longer periods until you are able to tolerate normal working activities and hours.