Did you know that here in the US the volume of spinal fusion surgeries is the most increased among Orthopedic “procedures”? Since 1996 the number of spinal surgeries has increased as much as 116%. Spinal fusion surgery is not that simple and it’s not always successful either. Sometimes underlying problems which caused your back pain in the first place are still there; poor posture, sacroiliac joint instability, weak supporting muscles, hip and thoracic spine limited rotational movement and shoulder girdle hypo or hyper mobility. Without proper treatment of underlying problems the spinal fusion alone is not the final answer to get rid of your pain longer term.
It is very true that in many cases the lower back pain is caused by lumbar spine instability (and nerve irritation) which basically means that there is too much unnecessary movement between vertebrae. Spinal instability does not come overnight and it is more complicated than how it looks like. One reason to have lower back spinal instability is when your hip rotation is limited or you have limited rotation on your thoracic spine. Lumbar spine does not have rotation or lateral flexion, but if rotation is not happening naturally from the place where it should (hip, thoracic spine), the body starts to compensate with excess rotational movement from your lumbar spine. Lumbar spine has to change it’s functioning and force vertebras, discs and ligaments to work the way that they are not built for, causing nerve compression and PAIN. And if spinal supporting muscles are also weak they are adding unnecessary movement and pain. Research shows that deep stabilizer back muscles are “shut down” those who got chronic back pain.
What happened after spinal fusion then? Spinal fusion limits your spine movement at the place which caused the pain, and that is a good thing, right? Unfortunately, body starts to compensate again and looks for the next place to do those missing movements and guess what, that is above and below fusion point. Those vertebras are now in danger and maybe develop similar spinal instability and nerve irritation to those vertebras which were fused together. What now – new fusion?
However, there is an other way to deal with this and that is to find a Physical Therapist who will assess your posture, muscle balance and whole body functioning, not just isolate back problems alone. Heat/cold pack, massage and back exercises are not working. Main problem might be elsewhere than in your lumbar spine alone. PT will analyze your movement and concentrate on increasing your spine & joints mobility and normal range of motion (especially rotation) and decrease hyper mobility with proper strengthening exercises (spinal stabilization training). Our body is a kinetic chain and all parts have to work together, so instead of just isolating to treat back pain, you must understand and treat the whole body.
Getting lifelong results and better spinal and proper body function, I warmly recommend to try Pilates private training. Pilates is an incredible treatment for all people with or without spinal fusion. If you don’t find a Physical Therapist who can teach Pilates for you, just look for an experienced Pilates Instructor who has education and experience to working with people with back pain and after spinal fusion. Pilates does probably not include that much stretching that people with back pain might need (hamstrings, piriformis, hip flexors), but it is a good way to strengthen your spinal supporting muscles, improve your range of motion and working your whole body more efficiently and safely. And the best part – with good Pilates instructor you will learn BODY AWARENESS. Body awareness is going to be a big help taking care of your spinal health after spinal fusion and back pain – and that is PRICELESS!!