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  1. #1
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    Bulging Discs in Lower Back

    About a year ago my girlfriend got into a car accident that resulted in pain caused by bulging discs in her lower back back. The Lumbar, likely L4 or L5, for you Orthopedists. This was before I knew her and we haven't been dating for very long so I don't yet have a good idea of the pain but I mentioned that I would love it if she wanted to get into cycling and I would even buy her a bike.

    She was a gymnist before the surgery and an avid runner but can no longer participate in either due to the pain and her figure has suffered for it. Her words to me were,

    "I would love to get into some exercise that doesn't hurt my back."

    So, finally, my question is, Is cycling a good choice for someone with bulging discs? Running and gymnastics cause the spine to compress which causes the pain and, while you are somewhat stretched out and experience lower back pain when you ride, I wouldn't think that there would be much pain associated with compression of the spine.

    And lest you think I'm some kind of monster, I think she is a beautiful girl and I don't wish her to change a bit. But I do think that she is a little self conscious about her getting further and further out of shape and I'm just looking for ways to help.

  2. #2
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    I have a couple back injuries, including bulging discs. The injuries and their nagging was the reason I got into biking in the first place. Can't be for everyone, but for me, it was the absolute right thing to do. At this point, if I spend some time off the bike, it begins to feel bad again.

    I also recently began working out twice a week at a gym and part of the training is a reverse situp (don't know what it's called) on a specific type of bench. I noted that after the first time I used it, the remaining nuissance sensations from my back was gone.

    Full suspension is my friend as well.

    PS-it's not the case with me, but be on the lookout for painkiller usage.

  3. #3
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    Staying active has helped me too. It's not the back that hurts, it's the pain from the muscle spasms protecting the back. Stretch, build your core and use a foam roller on your back and legs. Be sure she gets her bike fitted. Technique will be different too, using more legs and little back when pedaling.

  4. #4
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    Try cycling and yoga......

    After many years of riding and running and not much else I came up with sciatic and back pain 5 or 6 years ago. The doc told me I had bulges on all my lumbar discs and sort of hinted maybe I should dial back my activities. I hated to give in to old age (I'm 49 now) so instead of slowing down I went out harder.....but smarter. I got started in Yoga and worked really hard on core strength and flexiblity. Cycling is a really limited motion and as you ride you strengthen your muscles and tendons in the limited range of motion. The Yoga is great for combating that. Yoga creates an overall balance and now I am in much better overall shape than I was in my 20s and 30s. I ride fixed (road) and SS (mtb) almost excusively and do a fair bit long endurance riding. I'm also doing a lot of running lately and planning to run my first 50mi. trail run next year. None of this hurts my back, it has slowly gotten better over the last 5 years (slowly....you have to be patient). I agree with the comment that you have to stay active. It's insidious, you feel bad so you do less so you gain weight so you feel worse and worse. I think you can heal yourself from many chronic conditions but it takes commitment and work.

  5. #5
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    Well I had a bulging disk in the neck that finally went splat!!!!!! and 25% sponylolithesis of the lumbar back. You gitrl freind probably has spondy as a lot of gymnasts actually get 75% spondy. Their lower backs are almost V-shaped not curve shaped (you see that in a lot of young gymnasts).

    What has helped me the most is doing reverse situps on the excercise ball 30/day 1 minute to strenghten the muscles around the back. Once disks bulge, they could be more likely to go splat!! in the fuure.

    ***********************
    I suggest a course of professional PT using the excercise ball to strengthen the back area and hamstring stretches. Buldging disks can un-bulge sometimes.
    ************************

    Let me ask does she have neuropathy (nerve pain radiating into the legs, cramping etc). I'de be surprised if she didnt.
    Last edited by Chris0381; 11-07-2007 at 10:27 AM.

  6. #6
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    Depends on the injury, where the disc is bulging and whether or not the position you are put in cycling aggrivates that particular area. I am lucky that with my discs that the riding position, both road and MTB, I use actually makes my back feel better. Here is a website that may help you as far as knowing what the heck a particular injury means. I always find the more info you know the better
    http://www.spine-health.com/

  7. #7
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    From a medical point of view most back pain does not originate from bulging or herniated discs. The vast majority of back pain arises from the muscles and ligaments. A study published in the Journal of Radiology, demonstrated that 70% of adults without a history of back injury or back pain, have one or more bulging or herniated discs on an MRI, most commonly at L4-L5. MRIs cannot tell a doctor where the pain is it is only a picture of the anatomy.

    Moreover, a bulging disc only produces significant pain when it compresses the spinal cord or a spinal nerve. Furthermore, the compression must be on the same side of the body as the back pain.

    Without any further information, I would recommend acupuncture and yoga or Pilates to attempt to rehabilitate the back before considering any further surgery. Any activity that aggravates her back pain should be avoided, as it is her body's alarm system telling her she is causing further injury to the back. If cycling dooes not cause back pain, then I would give it the green light.

    Hope this helps..

  8. #8
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    Well, the treatment they are getting ready to administer is an epidural shot that may completely alleviate the backpain.

    What complicates the issue is that there is a lawsuit pending from the accident which I am completely in the dark about so I don't know how that is affecting her approach.

    Yoga and Pilates is a good idea though and I think my gym offers both of those so maybe we can get into that over the winter.

    Thanks for your input.

  9. #9
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    Strangely enough, I have found Dr. Sarno's books worth reading. Seriously, it helped. I bought the book a long time ago. Took me about a year to actually read it. I guess I had to wait till I was ready.

    http://www.healingbackpain.com/

  10. #10
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    I think John Sarno's books are excellent. I don't want to get into the controversy surrounding epidural steroid injections. Double blind medical studies, show it is no better than a placebo injection for chronic back pain. You can make a better medical arguement if the back injury is less than 30 days old.

    Be optomistic and hope it will give her some temporary relief. After the steroids wear off you can begin acupuncture. Check out Sarno's book Healing Back Pain.

  11. #11
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    I suffered a herniated or prolapsed disc (L5-S1) 2 1/2 years ago as aresult of doing squats. The pain was bearable at first but 3 months later worsened to the point that the physiotherapist was too frightened to continue working on my unstable back. I sought the advice of a neurosurgeon who's only words were " when would you like to have the operation?"
    I was back at work 9 days after the procedure and almost 100% 12 months later. I still cycle and do weights and in fact if I stop, I start to seize up and my muscles tighten.
    Surgery is not for every one but if alternate forms of therapy are not successful, must be considered. The risk as quoted was about a 1% chance of paraplegia!!!
    I was in so much pain that it was worth it.
    My advice is to seek a neurosurgeons advice; please don't go to an orthopeadic surgeon, they specialise in long bones an big joints.Most neuros are cautious and will only conduct sugery as a last result. Here in Oz we have some brilliantly trained neuros, so I'm sure that you guys must have similar.
    "Carpe diem, quam minimun credula postero"- Seize the day, trust as little as possible in tomorrow.(Horace)

  12. #12
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    P.S. The more recent the injury, the more amenable it is to correction. Old injuries, especially chronic ones leave a degree of compensation in the patients muscular sketal system and this becomes difficult to compensate.
    "Carpe diem, quam minimun credula postero"- Seize the day, trust as little as possible in tomorrow.(Horace)

  13. #13
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    An aside. There will be artificial discs hopefully available in the US soon (under FDA trials now I believe), they have been used with great success in Europe for the last 15 years. They are a titanium/polyurethane disc that will act in place of a damaged or absent disc. Sure beats having vertebrae fuse together.

    Your girlfriend. Geez, gymnastics.
    Like others have said if it doesn't hurt that is the green light. Get a bike fit that places her in the neutral spine position and she should be gold. If it causes pain then you'll have to rethink it.

  14. #14
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    Quote Originally Posted by MisterC
    I do think that she is a little self conscious about her getting further and further out of shape and I'm just looking for ways to help.

    Seems to me all you read here is correct: riding, yoga, Pilates, surgery, epidurals.

    I have multiple herniated discs, sciatica and scoliosis. A diagnosis of spondylothesis 40 years ago kept me out of the jungle. I was happy then, hurt like hell now.

    Yoga: Total winner; lifelong ortho health (having trouble finding the time). Yoga is not primarily aerobic or strengthening. It will mostly not aid conditioning/weight. Riding: One of the most back-friendly of activities--if you spin, not hammer, and if your bike is correctly fitted for an upright posture. Will aid conditioning. Pilates: Never tried it, but it it specficaly designed to minimize back strain. Conditioning although not so much aerobic. Surgery--I'd say go for it except you say multiple discs. (My option there is laminectomy--fusion.) One correction from above--a bulging disc can also impact the largest nerve in your body--the sciaitic. If sciatica gets too bad, she'll be desperate for surgery. Obviously no conditioning benefit except down the line, one hopes. Epidurals--never had one, wish I had.

    But here's very likely your/her best bet for conditioning: Jumping rope. Before you dismiss it, understand that jumping is done in an upright posture, with legs and feet taking up the shock. No heel strike as in running--little transmitted strain. Is done indoors in all seasons on a predictable surface (wear cross trainers) Arm movement is fantastic for cardio health. Play music--like dancing almost. Terrifically fun after just a couple of weeks.

    This year is my 30 year anniversary of jumping every other day for a half hour, usualy to reggae. I call it rastacizing--put on de jah music, mon, den you smoke de rope, den you jump de rope. *laugh* Whatever. If I can do this, she can. I am 58 ****ing years old now (guy), have not gained a pound in 30 years.

    Beyond conditioning and unavoidable weight loss, the psychological benefit of endorphins that jumping produces more of than anything else I know besides xc skiing (also not bad for the back) is amazing. And I have remarkable advanced beauty tips if you or she cares for them. *laugh*

    Really--best wishes--what a shame about her acident, especially for an athlete. Please consider jumping rope. It just might be a life-altering lifelong fun pastime for her as it has been for me.

    I hope I have said enough to make you interested. A rope (get it from the Canadian Jump Rope Association) costs five bucks. A happy, healthy her--priceless.

    I'm telling you it's a blast. It's a religion. I'd quit riding sooner.

    http://www.jumprope.ca/

  15. #15
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    Yeah, I'd rather not go with the fusion even if it is only one level but it's not up to me.

    So, what are some good choices for bikes given the circumstance? Honestly, and I know this isn't road bike review, I was thinking about starting her off on a road bike or an urban SS so we can go pedal around D.C. and the local parks. Sort of get her used to the idea of riding and see how she deals with the pain. Generally, road bikes seem to have more sizes available where mountain bikes are just S,M,L etc. and the handle bars offer more hand positions.

    Putting her on local trails on a hardtail just seems like a bad idea and, bottom line, I just don't think she is interested in that aspect of riding.

  16. #16
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    When I was having back problems from a motor vehicle accident and had two herniated discs, anything that caused me to bounce reproduced the back pain. So, jogging and trampolines made the pain worse.

    You might start with a full suspension MTB that puts her in a comfortable position. A comfortable saddle and a stem that does not stretch her out too much, seems a logical place to start. As she progresses and learns her limits she can modify the bike and make it lighter or more aggresive. Of course, there are comfort and cruiser bikes for pedaling around town. I think a serious road bike would be uncomfortable in the beginning.

  17. #17
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    More misinformation

    I just wanted to clear up a bit more of this misinformation.

    Quote Originally Posted by Don Duende
    From a medical point of view most back pain does not originate from bulging or herniated discs. The vast majority of back pain arises from the muscles and ligaments.

    Yes, more people have LBP without a discal origin than those that have discal injuries by a large margin. What the writer was talking about was specifically a discal issue in his Girlfriend's Lumbar spine. Pain can definately arise from sprained ligaments and strained/imbalanced muscles, along with segmental dysfunctions/instabilities, end plate fractures...
    The majority of LBP is not casued by muscles. If you check your neuroanatomy, muscles basically do what the nerves tell them to do. Typically the muscle is where the pain is felt, but not the CAUSE of the pain. Most pain can again be traced to chemical inflammation, joint rerceptors (mechanical dysfunctions), ligament sprains, end plate fractures, or other neuro tissue irritation.
    A muscle can be hypertonus and sore, but why does it get that way? It just doesn't happen on its own! The muscles only do what the rest of the body tell it to do (facilitated segments and other neruo issues)



    A study published in the Journal of Radiology, demonstrated that 70% of adults without a history of back injury or back pain, have one or more bulging or herniated discs on an MRI, most commonly at L4-L5. MRIs cannot tell a doctor where the pain is it is only a picture of the anatomy.

    Moreover, a bulging disc only produces significant pain when it compresses the spinal cord or a spinal nerve. Furthermore, the compression must be on the same side of the body as the back pain.

    A herniated disc will cause pain when there is a chemical response to the material as well.
    Nerve roots are now thought to also be irritated when the nerve has to pass around/over the bulge in the disc which essentially uses up the nerve's elasticity and will then cause a stretch to the nerve and the inflammation process that goes with it.

    It is not uncommon at all to have a discal injury on one side of the body and have a mechanical (or even another discal issue) on the other side of the body either. If you are looking at the discal/neuro pain, then I would agree that it is lilkey on the ipsilateral side. It is very common to have radicular sx's on one side and have mechanical sx's on the contralateral side of the body. These mechanical dysfunctions/instabilities are often the cause of the symptoms and discal issues anyway. This is one of the reasons that not all persons with herniated discs have sx's.


    Without any further information, I would recommend acupuncture and yoga or Pilates to attempt to rehabilitate the back before considering any further surgery. Any activity that aggravates her back pain should be avoided, as it is her body's alarm system telling her she is causing further injury to the back. If cycling dooes not cause back pain, then I would give it the green light.

    I would caution you on the yoga. More often than not, a person with a discal injury also has instabilities in the spine at or around that segment that is affected. Often, without proper inner core support and coordination, yoga can make matters worse by stretching an already hypermobile area. I do believe in a good, safe stretching program that is more controlled if the pt is indicated for it.

    Hope this helps..
    BoiseBoy

  18. #18
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    I have had problem with chronic back pain and after many years and much thought I had to retire my hardtail and move up to a full suspension bike. This has done wonders for me since I have always like to ride hard. I no longer have any pain or discomfort after my rides.
    I never could entertain the thought of not riding so its probably my fault that I still have back pain.call it love

  19. #19
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    Quote Originally Posted by Jerk_Chicken
    I have a couple back injuries, including bulging discs. The injuries and their nagging was the reason I got into biking in the first place. Can't be for everyone, but for me, it was the absolute right thing to do. At this point, if I spend some time off the bike, it begins to feel bad again.

    I also recently began working out twice a week at a gym and part of the training is a reverse situp (don't know what it's called) on a specific type of bench. I noted that after the first time I used it, the remaining nuissance sensations from my back was gone.

    Full suspension is my friend as well.

    PS-it's not the case with me, but be on the lookout for painkiller usage.
    My family has a history of back issues and when mine was feeling a little sore I saw my buddy who is a chiropractor and he too showed me those reverse situps (using a medecine ball) so I have been doing them (not as often as I should) as more to prevent injury but they are supposed to be good for back strength which helps relieve the weight of you body on your disc (as far as I understood it). So I second that excersice (of course if your back is injured ask your doc first).

  20. #20
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    I've been experiencing some sciatic nerve pain recently and that could be from bulging lower discs..They have been showing this piece of equipment on TV lately...It really seems like it would do the trick to help build up the lower back muscles...Nothing at my local gym even clomes close to duplicating this movement...I'm really thinking about ordering one...

    http://www.mycorevolution.com/

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