Will Lower Back Pain Improve After Tummy Tuck?

Question

I'm getting a full tummy tuck for my "paper thin" fascia, belly button hernia will get fixed, plus skin removal.  Although my physical therapist is willing to contest the insurance company to get it covered, (I'm not going to bother; very skeptical it'll get approved) she thinks my back pain will not seriously improve. Every doctor agrees, however, that I have NO core left because of my stomach muscles.  My plastic surgeon says I'm one of the most severe cases she has seen.  I have no history of back pain before all this and am naturally thin.  Does anyone have a similar story where the back pain seriously improved because my lower back finally has a "core" again?  I want to be hopeful but not disappointed if NOTHING changes from the back pain aspect of my problems.

Otto Joseph Placik, MD · Answer

An preliminary report published in 1990 suggested that Wide Abdominal Rectus Plication (aka the WARP abdominoplasty technique) produced some back pain relief in 24/25 patients treated.
However, this has not been substantiated and should not be the primary reason you seek abdominoplasty .
If i can explain. Your spine depends on a delicate balance between your stomach muscles and back muscles. When your stomach muscles are weak you may have an abnormal posture which creates excessive back discomfort.
Think about how it feels on your back when you have been sitting "Indian-style" for a while.
This is the reason orthopedic surgeons and spine surgeons will often prescribe a course of physical therapy to strengthen your abodminal muscles. It is also why Pilates and Yoga core strengthening exercises can improve minor back pain. I perform Pilates after a long week of surgery and I find dramatic relief from back strain.
The muscle rearrangement that occurs with abdominoplasty  can enable you to use these stomach muscles in a more normal fashion and improve back pain but it should not be the sole reason you seek surgery.
In fact, in the early postoperative period, you may experience a greater degree of back pain you feel due to excessive bending forward from your tendency ot releive the pull felt by tightening the skin. 
I hope this helps!
Check out this video!

J. Timothy Katzen, MD, FACS · Answer

Hello Mom_of_Two, thank you for your question regarding lower back pain improvement after a tummy tuck.

It's encouraging to hear that you're scheduled for a full tummy tuck, which will address your fascia, belly button hernia, and excess skin removal. Given your description of having "paper-thin" fascia and a significant lack of core muscle strength, it's understandable that you're experiencing lower back pain. When the core muscles are weakened or separated, as is often the case after multiple pregnancies or significant weight changes, the body loses a key support structure for the spine, leading to compensatory strain and pain in the lower back.

A tummy tuck, particularly one that includes muscle repair, can significantly improve the function and strength of your core. By bringing the separated rectus muscles back together, the surgery essentially reconstructs your abdominal wall, providing better support for your spine and improving overall posture. Many patients report a notable reduction in back pain following a tummy tuck, as the surgery helps restore the balance and alignment of the body's core muscles.

However, it's important to have realistic expectations. While many patients experience relief from back pain post-tummy tuck, individual results can vary. The degree of improvement in back pain can depend on several factors, including the severity of the muscle separation, the extent of the surgery, and your body's healing process. Additionally, while the surgery can restore your core structure, ongoing physical therapy and core-strengthening exercises will be crucial in maintaining and enhancing the results.

Your physical therapist's skepticism is not uncommon, as medical professionals often advise caution and set realistic expectations. It's important to understand that while the surgery can provide structural improvements, it may not completely eliminate back pain, especially if other factors are contributing to it.

In conclusion, based on your severe case and the nature of your surgery, there is a good chance that your lower back pain will improve as your core strength is restored. However, continue to work closely with your physical therapist and follow any post-operative guidelines from your plastic surgeon to maximize your recovery and results.

Good luck with your surgery, and I hope this helps to provide some clarity and optimism regarding your lower back pain.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Jeffrey Zwiren, MD · Answer

The   abdominal wall forms a cinch around the lower abdomen giving some support to the lower back.  Clinically I see many patients who report that their back pain is improved following an abdominoplasty.

Michael Diaz, MD · Answer

The tummy tuck will centralize the stretched and displaced muscles. By bringing your muscles together, the "corset" of muscles around your core is tightened and can alleviate some of your back pain. I have had some patients who report back pain relief after a tummy tuck, but most say there is no difference.

Will Lower Back Pain Improve After Tummy Tuck?

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Answer: Improving back pain after Tummy Tuck

Answer: Improving back pain after Tummy Tuck

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Will Lower Back Pain Improve After Tummy Tuck?

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Answer: Improving back pain after Tummy Tuck

Answer: Improving back pain after Tummy Tuck

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Everything you need to know about Tummy Tuck

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