Intervertebral disc surgery - get moving again instead of taking it easy
What physiotherapy and occupational therapy can do before and after surgery
For many sufferers, disc surgery is the final step after a long ordeal of back pain, radiating discomfort or numbness. However, surgery alone rarely provides a complete solution - because the real journey begins afterwards: back to movement, back to self-efficacy.
Physiotherapy and occupational therapy play a central role in this - both before the operation for stabilization and education, as well as postoperatively to rebuild function, resilience and confidence in one's own body.
When is disc surgery advisable?
Most herniated discs can be treated conservatively. Surgery is usually only recommended for
- persistent or increasing paralysis
- Severe radiating pain that does not respond to any therapy
- permanent neurological deficits (e.g. numbness, muscle weakness)
- Compression of the spinal cord or cauda equina syndrome (emergency!)
Typical interventions:
- Microsurgical discectomy (removal of the prolapsed material)
- Sequestrectomy (removal of the intervertebral disc sequestra)
- Rarer: fusion (spondylodesis) or disc prosthesis
Before the operation - educate, strengthen, prepare
If you understand what is happening in your back, you can prepare better for the operation and the time afterwards. Good pre-operative support helps to release postures, activate muscles and reduce psychological stress.
Physiotherapeutic measures before the operation:
- Gentle activation of the core muscles
- Encourage movement despite pain (without provocation)
- Practicing gait, standing up and lying down techniques
- Breathing and relaxation techniques for vegetative calming
Occupational therapy measures before the operation:
- Everyday aids and movement strategies (e.g. back-friendly standing up, sitting, bending down)
- Advice on workplace adaptation, aids and protection management
- Education about pain mechanisms, behavioral patterns and body perception
After the operation - regaining movement, building up control
After disc surgery, it is important to return to movement as early as possible and in a targeted manner - without fear, without restraint, but with professional support. The focus is on stability, coordination and functional resilience.
Physiotherapy after disc surgery:
- Early mobilization exercises (depending on medical clearance)
- Stabilization of the deep core muscles (core, pelvic floor)
- Gait training, posture development and movement transitions (e.g. from lying to standing)
- Mobility of adjacent structures (hip, thoracic spine, SI joint)
- Medical yoga for body awareness and vegetative regulation
Occupational therapy after disc surgery:
- Training in everyday movements and transfer techniques
- Adjustment of stress at home, work and leisure
- Pacing and energy management for pain or exhaustion
- Building up skills and returning to everyday life
- Advice on sustainable behavioral change and relapse prevention
Biopsychosocial approach - the back heals not only structurally
At Hockenholz, we don't see disc surgery as a "repair", but as the starting point for a profound change. This is because many patients bring chronic pain mechanisms, anxiety, avoidance of movement and inner tension with them to rehab.
That's why we integrate them into our therapy:
- Pain education and reframing - movement is safe
- Vegetative regulation through breathing, mindfulness and movement
- Resource-oriented goal work - what do I want to be able to do again?
- Strengthening self-efficacy and body confidence
- Interdisciplinary collaboration with doctors, rehabilitation teams and psychologists
Conclusion: surgery creates space - movement brings change
Intervertebral disc surgery can relieve pressure - literally and figuratively. But the crucial step is to get back to an active life. With a targeted therapy plan, functional movement, therapeutic education and everyday support, this step can be taken - step by step.
Physiotherapy and occupational therapy are not a rehabilitation formality - but a central building block on the way to greater stability, self-confidence and freedom of movement.
Are you a therapist and want to deepen your knowledge of post-operative back therapy?
👉 Then find out more about our practical training courses on pain physiology, functional therapy and medical yoga:
www.hockenholz.com/weiterbildungen
Are you affected yourself?
We provide you with professional support - before and after the operation - in our practice in Berlin or via online counseling. For a safe, sustainable return to your everyday life.