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Spine Institute
Glendale Adventist Medical Center
1500 E. Chevy Chase Drive, Suite 401B
Glendale, CA 91206
Ph: (818) 863-4444






Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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Positive Encouragement, Usual Care, or Both after Disc Surgery?

Posted on: 11/30/1999
Recovering from disc surgery can be difficult for some patients. Doctors don't know why some patients get better quickly while others don't. Doctors and therapists are looking for ways to help make rehabilitation quicker and more effective after disc surgery. Recent studies have focused on the mental part of rehab. The theory is that it may not be enough to fix the physical problems. Doctors and therapists need to help patients lose their fear of pain and of doing certain movements.

The theory is good, and some research looks promising. These authors in the Netherlands tested such a program for patients who had surgery for a herniated lumbar disc. The patients were still in pain six weeks after surgery. The rehab program was called behavioral graded activity (BGA). The BGA program involved exercise training. The training was designed to teach patients that it was fine to move. Exercises were designed for each patient. The exercises got slowly harder over time. Therapists and doctors gave lots of encouragement to patients.

The BGA patients were compared to a group of similar patients who got the usual care. The authors compared pain, function, fear, and opinions between the two groups. They found no major differences. The authors note that usual care may not have differed as much from BGA therapy as was expected. Many doctors and therapists giving usual care encouraged their patients to move without fear. And BGA therapists often turned to traditional care. Still, the authors found no reason to recommend BGA therapy to patients having problems after disc surgery.

References:
R. W. J. G. Ostelo, et al. Effectiveness of Behavioral Graded Activity after First-Time Lumbar Disc Surgery: Short-Term Results of a Randomized Controlled Trial. In European Spine Journal. December 2003. Vol. 12. No. 6. Pp. 637-644.

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