In America alone, millions of people see the doctor every year for chronic back pain, and a large portion of them are left either temporarily or permanently disabled by the condition. According to a 2009 study on chronic low-back pain:
“Low back pain (LBP) is the second most common cause of disability in US adults and a common reason for lost work days.An estimated 149 million days of work per year are lost because of LBP. More than 80% of the population will experience an episode of LBP at some time during their lives.” (1)
For years, like most of those millions of people, I thought all I could do to prevent my discs pinching the sciatic nerve and sending me off to bed for weeks like an invalid was take pills, physical therapy and just rest it out until the pain subsided of its own accord.
Microdiscectomy
After years of these practices, they landed me on an operating room where the top neurosurgeon in my country performed a microdiscectomy. The operation is a microscopic procedure, where the section of the disc that has been herniated out of position and is pinching the nerve is literally sucked out of existence.
While the nerve will be released as a result, fibrosis and damage to the root of the nerve are an extremely common consequence of such operations. On the other hand, the disc is not being reconstructed, so there is a big chance of relapse, including the possibility of other discs becoming herniated in the long run.
People suffering from herniated discs are faced with different alternatives. Although the Mayo Clinic states on its webpage that back surgery is necessary in only a small percentage of cases, statistics show that back pain is the third most common cause of surgical procedures in the US (1).
Common surgical alternatives for herniated discs include:
- Discectomy. The removal of the herniated portion of a disc. It is done as open surgery and usually involves removal of the back portion of a vertebra to access the ruptured disk.
- Laminectomy Removal of the lamina — the back section of the vertebra over the spinal canal, thus decompressing the nerve.
- Microdiscectomy. Using a microscope to view the affected area, this procedure is a less invasive version of a discectomy, allowing the removal of disc portions with a smaller, less damaging incision.
- Artificial disks. A metallic artificial disk is implanted after removing the injured disks. Relatively new procedure with consequences still under study (2).
In my case, microdiscectomy was prescribed. However, nobody said anything to me about fibrosis, and how there was virtually no treatment for it, and it would only get worse with time. All they said was that I needed an urgent operation. The way my surgeon dealt with my reluctance to go under the knife was by saying that I was in risk of permanent paralysis; the bit of disc that was bulging out of place could get cut, fall and paralyze me from the pelvis down. That sealed the deal for me. Just like millions of people faced with the same dilemma every year all over the world, I thought I didn´t have any way out.
A chance meeting
Right before I got my operation, I was appointed to make a film about an athlete and physical exercise guru who does the decathlon at 75, and I realized that exercise had the power to keep a body healthy and young. The man, whose name was Raul, was a great inspiration for me in many ways.
After surgery, I was still in pain. The surgeon had me scanned once more, and he found out there was a bit of disc left inside me. So, they had to open me again. I believe that this second operation was what seriously damaged the root of my nerve. When the ozone therapy department head who had first sent me over to see the neurosurgeon saw my final scan, he exclaimed, “I wish I hadn´t sent you to get the operation. This is worse than before. You got horrible fibrosis.”
Post-surgery blues
Like every other patient who has been through herniated disc surgery, I had to take Gabapentin pills, which block out the pain in your nerve from reaching your brain; but the pain is still there. Meanwhile, I was swimming and cycling for 20 minutes at low speed in the gym; that was all the exercise doctors would allow me to do.
(Here you can read my poem A Prayer; a sort of No-ode to my surgeon & surgery)
Muscle power
But I had met a man who was doing the pole vault and 75, and had told me that there were muscles I could strengthen to fight the pain, the herniated discs, and the lot. So, one day, I had had enough of pills and lies, and of being unable to improve my body on account of my impossibility to take on a harder workout routine. So, I went to the trainers at my spa, and I told them I wanted to strengthen my back and my abs, without straining my lower back.
After four months of hardcore training carefully designed by experienced trainers, I lost about 14 pounds, built a lot of muscle, and started feeling much better. On the fourth month, I decided to stop taking the pills doctors said I would have to take every day for the rest of my life. I haven´t needed the pills, or seen a doctor for that matter, since that day.
Two months later, I feel stronger, my posture has improved, and I walk around in the gym carrying two 11-pound weights, when I used to have trouble carrying my laptop case. More importantly, I do not seem to be the exception to the rule, since a study showed that patients with low back pain who followed an exercise routine to strengthen all main muscle groups, combined with back care education, experienced a 40% reduction in reported days off work when compared to patients who weren’t working out (3).
What my experience has shown me is that the prevention of herniated discs would be much easier, if people would commit to an exercise routine as soon as they experience the first symptoms of back problems, and especially lower back pain.
Prevention, prevention
Once a disc is already herniated to the point that mine was, it is possible that you won´t be able to get away without surgery. But, even then, working these muscles will improve your posture and keep your vertebrae apart, so that your nerve won´t be pinched again, which is the main source of pain and movement inhibition in these cases.
There are countless studies all over the world trying to prove that lower back surgery works. There are also countless studies which demonstrate with the same eloquence that back surgery does more damage than good. Randomized controlled tests regarding the effects of exercise on lower back pain have largely been dedicated to mild stretching, motor control exercises (4), and the like; the results of which have typically not been very conclusive. It seems to me that it is time for researchers to devote more studies to the positive effects of hardcore physical exercise and muscle training, since this may be, after all, the only treatment for herniated discs that is 100% free of adverse effects.
WHERE TO START?
Here are some links with some exercise ideas and tips that might be useful. People keep emailing me for exercise tips after reading this post, hence this list. Hope it´s useful. Notwithstanding, my BEST ADVICE is find a sports medicine specialist or fitness expert with a profound knowledge of anatomy and spine problems. This can´t be just a regular fitness trainer, they need to have experience and serious University degrees. Only this type of person can guide you in your recovery, but it IS possible. Wishing you all good health for many years to come.
A playlist of exercises 2017
NOTE: The exercises in the playlist are not what people were recommending in Uruguay in 2010 when I first wrote this article. But they are the ones I find work best and make the most sense considering the anatomy of spine and discs.
Wisegeeks Exercises for herniated discs
Herniated disc exercises from NYTIMES Health
References:
1. Freburger JK, Holmes GM, Agans RP, Jackman AM, Darter JD, Wallace AS, Castel LD, Kalsbeek WD, Carey TS. The rising prevalence of chronic low back pain. Arch Intern Med. 2009 Feb 9;169(3):251-8.PMID: 19204216
2. Boos N, Aebi M, eds. Spinal Disorders: Fundamentals of Diagnosis and Treatment. New York, Berlin: Springer, 2008.
3. Klaber-Moffett J, Torgerson D, Bell-Syer S, Jackson D, Llewelyn-Phillips H, Farrin A, et al. Randomised controlled trial of exercise for low back pain: clinical outcomes, costs and preferences. 1999; 319:279-83.
4. Costa LO, Maher CG, Latimer J, Hodges PW, Herbert RD, Refshauge KM, McAuley JH, Jennings MD. Motor control exercise for chronic low back pain: a randomized placebo-controlled trial. Physical Therapy. 2009 Dec; 89(12):1275-86.PMID: 19892856
Hello Veronica, It seems we have more than “muse stories” in common.
In my twenties I was a truck driver and injured many parts of my body multiple times, including my lower back. Ten to fifteen years later all those injuries began to mature and to really hurt.
Sometime during the following ten years I came to the same conclusion that you did. I began a self-prescribed routine of daily exercises, not to “build myself up,” but to maintain a pain-free life. I do a special series of exercises for strengthening all the muscles in my lower torso, just to preserve my lower back.
I am now over 60 and pain-free. More importantly, I’ve never needed any kind of surgery.
Hopefully all the people who read your message will learn a lesson and learn to avoid surgery themselves.
Good for you, Jan. Yeah, it´s a pity people don´t realize and education does not emphasize the fact that exercise is the best way to ward-off every disease. Cheers,
V
hi veronica, i have currently been diagnosed to have PID L3/L4. you mentioned a special exercised to reduced the pain. i hope you can help me by giving some guidance about the exercise. by the way, i’m 25 years old female with overweight (obese actually) problem. thanks for your time and good luck.
I want to know some exercise if you give some exercise its really very helpful for me…Thanks
Great Post!
Hi Veronica, I would really love some help.. please tell me what exercises or routine to do. I’ve had herniated disc with nerve compression for several years. Numbness in part of both feet, and pain/weakness daily. I am terrified to have surgery from all the horror stories I’ve heard. One ER Dr told me to do exercise and lose weight to avoid surgery because the strongly suggested against surgery. I have a 1yr old very active baby and I am desperate to get my life back so I can be normal with her, this has me so depressed at times. Please please help. Any advice would be much appreciated. Thank you in advance, please help
Hi , i am so glad i stumbled on this. I was afraid I wouldnt be able to go diving and outdoors anymore. Thanks for the post!
Hi – I’m just looking around the web for solutions to herniated disc. I would love to see what your exercise regimen is, Veronica. I, too, believe that strengthening my body is the way to repairing the problem and making sure it doesn’t recur, but I don’t know which exercises are the most beneficial/safest. My physio has me doing Cobra poses and TA strengthening, but I want to learn a whole program. Yours sounds great. Any info would be so much appreciated!
Thanks!
Thank you. Totally stumbled on this as well. I am one micro down, re-herniated and was feeling kind blue. Excercise it is. To the bionic women!
You mention university degrees. What would you type into a search engine to find the right kind of exercise trainer.
I have a back injury from excessive working-out and I have to tell you that your post here made me change my mind about doing surgery.You gave me hope that i could do this and get better.
Thank you.
Hi there. For all the remarks about being healthy to.avoid it I would like to know why I got a herniated disc l4-l5 then? That’s simply a myth. My dad and uncle both had the same bulging herniated disc. Uncle.had surgery and stays active and dad can’t afford surgery and has his bad.bad days. I was very active.. I ran 5ks, 8ks, 10ks, and half marathon just this past year. Light weights, JM 6 week.6 pack cardio, everything. I consider it a.myth… Meanwhile, this past March I was walking.up the steps with a bag of groceries abd.bam, back.locked up, then.turned to sciatic nerve, then numbness and ankle pain. This can happen to anyone. Got MRI showed an inflamed herniated disc. Couldn’t walk from room.to room. Resting, walking, ice, nothing helped. Did 3 injections and it helped.it.70%. Just had surgery a week ago, a microdiscectomy, and I am feeling great already. Surgery is rough the first few days, but I feel like I can live my life.again. Back pain is.very depressing. Not everyone can get away without.surgery and I think that this can happen to anyone whether fit or not.
Interesting story. There are many factors, psychological, etc, as you mention, there may also be a genetic predisposition, but being fit and avoiding putting too much stress on your spine is the only way I know to prevent these problems, other than trying to live a relaxed, happy life. My microdiscectomy is also working out fine so far, but I do help it with exercise, as often as I can, and I only feel pain when I stay away from the gym for too long. Thanks for writing! V
Hi,
This is extremely helpful and encouraging. I’m 29,a delivery truck driver for a wine and liquor distributor of 9 years and 10-12-12 BOOM!! At a Walmart pulling off a 56 case pallet of wine with a manual hand jack and it caught on the dock plate. After the pop, I continued working that day with discomfort. The following Saturday morning I couldn’t get out of bed. Ultimately, I had an MRI, 3 epidural steroid injections, and over the course of broke ass year being off work a Dr finally told me that my L-5 was severely herniated and he actually showed me the MRI. I decided to have surgery and approximately 45 days after surgery I had 9 sessions of Physical therapy which was excellent. A week later I went back to work and on very easy duty the pain began to come back which right now feels okay only because my job has taken me back off because they are making me reapply (bullshit) However, the new pain is sometimes worse than before surgery! It feels right in the crack of my butt like bones grinding and rubbing together. Plus more numbness in toes than ever before. I had some extra hydrocodon left over from after surgery but I finished them up over the last two weeks. I have an appointment on 10-28-13 Monday with my surgeon/ Dr. I hope that I don’t receive bad news. Iwas the sstate champion powerlifter and an MMA fighter. And now I’m miserable and can’t workout.
But there is power in the name of Jesus Christ! I hope to be a testimony after all this crazy nonsense
This is an encouraging post 🙂 I’m 24, herniated a disc when 23, despite any noteable trigger. After being at doctors, chiropractors and physiotherapists in Germany and the uk over the last year, the one solid piece of advice from all is to move as much as possible.
I wanted to say to MP, my situation is similar to yours- I actually was the healthiest I’d been in a long time when I hurt my back. I put it down to not stretching properly after the increased exercise I was doing. It actually turned out one leg was 5mm longer, making my lower back area unstable. So you never know what may have caused it. The best thing is to keep your core muscles strong, and make sure you are stretching properly. Veronica is totally right – exercise can only help. That and a good bed/mattress!
Keep positive guys, feeling bad about it will only make it worse. I just tell myself there are tons of conditions out there that are much worse, and a least I can try and make mine better myself.
🙂
You know,
that´s funny, my exercise guru once mentioned one of my legs was shorter than the other.
I guess they should test kids for that,
to help prevent herniated discs…
Glad you are doing OK.
I have been lazy for a while, but one full work-out at the gym and a bit of stretching
in the pool, and it becomes clear that skipping the gym is the worst of ideas, and you have to work out every day, there is no way around it. Keep it up! Best, V
I had been suffered from back pain when over 30minutes’driving.
I was diagnosed as slipped disc with 4-5lumbars.
I developed simple backrest with shoulder press.
I named it as ‘Waist Crutch’ and launched crowd funding on the ‘Indiegogo crowd funding’.
Please check and advise me.
Thanks for your attention