practice logo

Lumbar Spine Protocol


This section applies to all patients. 

  • 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 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.

The following may not apply to all patients. Your provider will complete this section, depending on your needs.

☐ 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, may walk 5 minutes longer the next day.

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

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

Weeks 2-4:

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

  • -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 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 saddle. Exertion 7-9/10 during intervals

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