Activity Restrictions for spine patients

[kstarm]

I am curious what if any restrictions you give patients with the following and if so for how long:

acute/sub acute non-surgical disc herniation with mild to moderate radicular symptoms.

Mild symptoms or asymptomatic severe central spinal stenosis: Lumbar or cervical.

Thanks

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[SSdoc33]

I am curious what if any restrictions you give patients with the following and if so for how long:

acute/sub acute non-surgical disc herniation with mild to moderate radicular symptoms.

Mild symptoms or asymptomatic severe central spinal stenosis: Lumbar or cervical.

Thanks

there is no algorithm to follow here

 

[kstarm]

there is no algorithm to follow here

That is why I am asking the question. What do you tell patients when the ask about activity restrictions?

 

[SSdoc33]

That is why I am asking the question. What do you tell patients when the ask about activity restrictions?

That’s what I mean. Depends on the patient, herniation, stenosis, pre-injury activity level,etc.

In general I err on fewer/less restrictions

 

[Baron Samedi]

Don't get in any car accidents

 

[Ducttape]

walk, 10000 steps per day.
nonflexion based exercises.
water walking.
yoga
tai chi.

live life. stay active. keep moving.

 

[MD87]

Be as active as you can be within your pain tolerance. Listen to your body - if you feel any pain, particularly radiating pain, this an activity you should avoid. You will know better than I what activities are good for you.
Very few absolute restrictions, but I tell people with disc issues that unless dead lifts and heavy squats are the only things that bring them joy, they should avoid them.

 

[au bon pain]

I am curious what if any restrictions you give patients with the following and if so for how long:

acute/sub acute non-surgical disc herniation with mild to moderate radicular symptoms.

Mild symptoms or asymptomatic severe central spinal stenosis: Lumbar or cervical.

Thanks

If they have a legit herniation and/ or severe canal stenosis, I review lifting mechanics/give precautions and tell them to avoid chiropractors and golf.

If their spouse is with them I also tell them to replace lifting heavy things with mowing the lawn and doing all the dishes.

 

[Agast]

and then they ask you about sex and you have to awkwardly think about the least mechanically stressful position

(Big spoon little spoon imho)

 

[SSdoc33]

and then they ask you about sex and you have to awkwardly think about the least mechanically stressful position

(Big spoon little spoon imho)

no CHANCE that will work with most of our patients. you have to have a somewhat flat belly on the dude (nope), a non-gigantic butt on the woman (hard pass there) and the guy has to be built like john holmes.

 

[bedrock]

no CHANCE that will work with most of our patients. you have to have a somewhat flat belly on the dude (nope), a non-gigantic butt on the woman (hard pass there) and the guy has to be built like john holmes.

😂😂

 

[Laryngospasm]

Aqua therapy/aerobics
Yoga
recumbent bike
Walking especially at an incline preferably on treadmill to reduce risk of injury
No lifting over 30lbs.
No flexion based exercises
Static exercises for core
Stupid things at your own risk of severe injury.. side by side racing/jumping/ horseback craziness/ lake jumping/ water skiing/ snow skiing etc

 

[knoxdoc]

Two things I tell them: 1) No heavy lifting. 2) Let pain be your guide.

 

[SpineandWine]

With herniations, I usually say no major repetitive bending or twisting motions, 15 pounds

Agree with being active, stretching and doing disease specific activity
- flexion biased for spondylosis
- extension for herniations
- Indian style for SI

 

[Ferrismonk]

I don't give restrictions, in part because I WANT them to be active. I guarantee that if I gave any formal restrictions, 90% of my patients would reach into their back pocket and ask for me to write that down so they can get work restrictions/disability/etc.