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Can rehabilitation therapy help after surgery for a slipped disc?

Photo of a patient doing back exercises with the help of a physical therapist

Rehabilitation programs that are started four to six weeks after surgery for a slipped disc can speed up the recovery process. Whether rehabilitation programs that start immediately after surgery have any advantages or disadvantages remains unclear.

A slipped disc in the lower part of the spine is a common cause of back pain. It can also lead to sciatica (pain that shoots down the leg). Most people recover from those kinds of symptoms within about six weeks. Until then, you can usually cope by relieving the pain and staying as active as possible.

Surgery is an option if the slipped disc becomes an emergency or severe pain continues over a long time despite treatment. Operations on the spine are among the most commonly performed surgical procedures in Germany.

A large number of rehabilitation programs are available for people who have had surgery. Some doctors recommend starting physical therapy for rehabilitation immediately after surgery. Others recommend waiting at first. Opinion is also divided on how intensive rehabilitation programs should be.

Research on rehabilitation

A group of researchers from the , an international network of researchers, looked for studies that compared the advantages and disadvantages of rehabilitation programs after slipped disc surgery. The most reliable kinds of studies are called randomized controlled trials. The researchers found 22 such studies. They involved a total of 2,500 participants who had undergone surgery on a disc in the lower region of the spine (lumbar disc surgery).

In most of the studies, the rehabilitation program started four to six weeks after surgery. The types of exercise varied considerably from study to study. They included endurance training, patient education, stretching, and weight training for the back and abdomen. The activities were done one to three times a week, and lasted 30 to 90 minutes at a time. Most rehabilitation programs ran for up to 12 weeks. Most studies looked at whether rehabilitation treatment can relieve pain and improve mobility.

Rehabilitation can speed up recovery somewhat

Overall, the studies suggest that rehabilitation can relieve pain and improve mobility for a few weeks. There is less good-quality research on whether rehabilitation has longer-term effects.

The researchers also found one good study which looked at whether rehabilitation can help people return to work sooner. The program they looked at had been offered by a statutory health insurance company in Belgium. During the rehabilitation treatment participants saw a doctor once a month and were given advice, guidance and – if needed – were referred to a physical therapist. The study found that:

  • Without rehabilitation, 82 out of 100 participants were able to return to work after one year.
  • With rehabilitation, 90 out of 100 participants had returned to work after the same amount of time.

The study provided no that rehabilitation increased the risk of injury or needing surgery again.

There is some to suggest that rehabilitation treatment is more likely to relieve pain if it is started within the first four weeks after surgery than if it is started later or not at all – without increasing the risk of side effects. There has been hardly any research into the possible advantages or disadvantages of starting rehabilitation treatment immediately after surgery. This makes it difficult to say anything about them for now.

Czabanka M, Thome C, Ringel F et al. [Operative treatment of degenerative diseases of the lumbar spine]. Nervenarzt 2018; 89(6): 639-647.

Oosterhuis T, Costa LO, Maher CG et al. Rehabilitation after lumbar disc surgery. Cochrane Database Syst Rev 2014; (3): CD003007.

Statistisches Bundesamt (Destatis). Die 20 häufigsten Operationen insgesamt (OPS 5): Vollstationär behandelte Patientinnen und Patienten in Krankenhäusern 2020. 2021.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Can rehabilitation therapy help after surgery for a slipped disc?

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Updated on July 19, 2023

Next planned update: 2026

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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