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      Post Procedure Lumbar Spine Protocol


      • No NSAIDS such as Advil, Motrin, ibuprofen, Naprosyn, and Aleve x 2 weeks

      • Pain: Tylenol for mild pain and if needed use mild narcotic provided

      • Driving restrictions: No driving until able to safely move foot from gas to brake if right hip,
        and/or safely use a clutch if left hip.

      • Work restrictions: Depends on duration of weight bearing restrictions

      • Exercise restrictions: 2 weeks relative rest followed by 4 weeks progressive PT. No running, jumping, or deep squats until 8 weeks.

      • Use Lumbar support brace for __________ days constant, _____ days PRN with increased activity.

      • Use crutches (partial weight bearing) until able to walk normally without limp

      • Limit rotational movement of body/low and extension arching of the back for 4 days

      • Avoid overhead work or lifting/weight bearing overhead for 1 week

      • Avoid rotation motion with weight with for 1 week

      • Use SI belt for 3-4 days continuously and then for 4-6 weeks with ambulation

      • f/u for PT in 5-7 days

      Activities: In general, with strength and activities, keep pain level below 4/10.

      ​First 2 Weeks:​

      • Strengthening/Motion: Isometrics always good. Non weight bearing and passive range of motion is good too. Try to get full range of motion by 2 weeks.
      • Walking: No hiking. May walk on flat ground initially for 10-15 minutes. If this goes well, you may walk 5 minutes longer the next day.

      • Cycling: May gently ride a stationary bike for 15 minutes after week 1. Exertion level 1-3/10

      • Swimming: May use a pull buoy after week 1. No kicking.

      ​Weeks 2-4:

      • Strengthening/Motion: Start gentle low load closed chain concentric/eccentric.

      • Walking: May begin gentle hiking (no more than 30 minutes), watch hip angles.

      • Cycling: May ride 30 minutes. No getting out of the saddle till after week 3. Exertion 4-6/10

      • Swimming: May begin gentle kicking mixed with a pull buoy. No more than 1⁄2 -1 mile.

      Weeks 4-6:

      • Strengthening/Motion: Progress to moderate load, progressive strengthening.

      • Walking: May progress to longer hikes up to 60 minutes, still no big step-ups.

      • Cycling: May ride 60 minutes. May get out of the saddle. Exertion 7-9/10 during intervals

      • Swimming: May swim up to 1-2 miles now. Still encourage breaks with buoy.

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