Early Aggressive Exercise for Postoperative Rehabilitation After Discectomy

[Randomized Controlled Trials]

Danielsen, Jan M. Physiotherapist, Johnsen, Roar MD; Kibsgaard, Svend K. MD; Hellevik, Eivind PT

Spine 2000;25:1015-1020

Vigorous medical exercise therapy, started 4 weeks after surgery for lumbar disc herniation, reduced disability and pain after surgery. Because no differences in clinical end pints were observed, there is hardly any danger associated with early and vigorous training after operation for disc herniation.

The outcome of surgical treatment among patients with lumbar disc hernia depends on the postoperative regimens offered.1 Intensive, standardized medical exercise training that ignores fear of provoking pain and begins 4 weeks subsequent to surgery2 seemed to reduce postoperative disability at least in the first 6 months.

Key Points:

  • Patients who underwent surgery for lumbar disc herniation were included in a randomized blinded clinical trial comparing postoperative vigorous medical exercise therapy with an ordinary care program.
  • The training group achieved reduced disability and pain after surgery compared with the control group, but no differences in clinical end points were observed.


1. Howe J, Frymoyer JW. The effects of questionnaire design on the determination of end results in lumbar spinal surgery. Spine 1985;10:804-5.

2. Gustavsen R. Training therapy. New York: Georg Thieme Verlag;1985;chap 1:33.