Exercise programme following cervical spine decompression surgery

The aim

This leaflet is designed to provide information about cervical spine surgery.

The information will help you to understand typical recovery time frames after your surgery. The leaflet also includes several exercises to aid your rehabilitation and to help you become more active.

The spine

The spine is split into three curvatures or sections. The cervical curve is the upper part of your spine, your neck. The thoracic curve is the middle section of your back and the lumbar curve is the lower portion of your back.

You have had surgery to the cervical section of your back. The operation might have been to help with pain, with altered sensations or movement, or it may have been due to a combination of these factors.

The cervical spine

The cervical section of the spine begins at the base of the skull and supports the neck. The spine is made up of vertebrae that have intervertebral discs which lie between each vertebral level. Spinal nerves exit the spinal column in nerve roots, pass between the vertebrae, and supply the rest of the body enabling sensation and movement.

Surgery

Cervical decompression surgery is a procedure that is performed to remove any structures compressing the nerves in the neck. This is done to relieve neck pain, leg weakness or other neurological symptoms that you might have as a consequence.

After surgery

Normal side effects from the general anaesthetic include drowsiness, dry mouth and a sore throat. Sensitivity at the wound site and discomfort in the general neck area are normal and should reduce with time and mobility. Some patients find that previous symptoms such as pain or weakness, have been alleviated, but the degree of relief varies from person to person.

Becoming active

Unless your surgeon advises otherwise, you should avoid heavy lifting for six weeks. It is best to adopt a common sense approach and gradually increase your exercise regime. There are multiple benefits to becoming active as soon as possible, including improvements to your range of motion, strength and blood circulation. Activity will also reduce the risk of gaining a chest infection. Try to avoid long periods where your back is inactive.

Gradually build up your activity level and increase your walking distance daily if you can tolerate it. If you have a sudden increase in pain during or after a particular activity, stop and rest before building up to the activity again over the next couple of days.

If you are experiencing more pain, think back to the activities you did in the previous days.

That may help you identify the cause and suggest how pacing the activity next time may help.

Exercises

The following exercises can be completed in a sitting or standing position, just ensure you are maintaining a tall spine and avoid slouching.

There are other simple exercises you can do which are part of everyday activities, such as sitting down, standing up and step-ups. Do these slowly and with control. Keep your spine lengthened at all times while you are doing them. Walking is a very good exercise and helps you to keep fit, it also improves your circulation and general strength. Start by walking a short distance and then gradually build up your speed and distance.

When should I start the exercises?

• You will be expected to be sitting out of bed and walking on the ward the day after your surgery, unless advised differently by your doctor.
• Start with gentle neck and shoulder exercises. Ensure you are feeling the stretch. Avoid rapid or jerking movements.
• Take regular pain relief.

Why should I do these exercises?

• To restore movement to your spine and to minimise the potential discomfort of scar tissue
• To help to reduce the swelling faster by improving blood circulation
• To reduce pain
• To restore functional mobility more quickly

How long should I exercise for?

• Continue with your exercises for four to six weeks.
• Gradually increase the amount of activity you do each day until you feel you have reached your normal levels of energy.
• Ensure that you maintain adequate posture and take regular pain relief

Sleeping

Try not to sleep with too many pillows (no more than two). It is important to keep your neck in alignment. You might want to take pain relief before going to bed to ensure a good quality sleep.

Swallowing

In some cases, depending on the site of the surgery, you can experience some swallowing difficulties due to swelling. This eventually should settle down and should only last a few days. Please let your nurse or doctor know so they can advise you or refer you to your speech and language therapist.

Driving

Returning to driving is likely to vary depending on your recovery, but could be from two to six weeks, unless you are advised otherwise.

In order to drive, you must:

1. be able to sit comfortably in the car
2. be able to turn your head as required in order to check the blind spot
3. be able to carry out an emergency stop safely

When will I be able to return to work?

This will depend to some extent on your age, duration of pre-operative symptoms, level of fitness, other medical conditions and the nature of your work. Generally, most fit patients make an uncomplicated recovery and go back to work in two to four weeks. If your work involves heavy manual labour you may need to speak to your doctor, as you may need six to eight weeks prior to returning to full duties. Discuss your needs with your employer to ensure your workplace can be suitably adapted, helping you to return to work safely.

Goals

In order to get back to full fitness, goal setting is really important.

Please write down three goals, one short-term, one mid-term and one long-term. Make them realistic so that they help you to focus on your rehabilitation.

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2.

3.

Can you think of any barriers which may prevent you from achieving any of these goals?

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2.

3.