UKH

I've been sat out with a herniated L5/S1 disc for the last few months and now it looks like I'll be getting a microdiscectomy in the next few weeks. After that I'm looking at a 6 month period until I'm fully recovered and able to fully get back to normal.

The main thing I've been told that I'll have to avoid is heavy lifting, but I guess that certain movements might simulate that. Does anyone know how much load various activities are likely to place on the lumbar spine? I'm really unfit now so I'd like to be able to start running again asap and I'd obviously like to be able to climb again as well. A bit of scottish winter would be nice too.

I'm going to take anything I find out on here with a pinch of salt and compare and contrast with what I'm being told by medical professionals, so don't worry that I'm just going to go out and mess myself up! The last 9 months has been awful and I'm not in a hurry to repeat it.

Back in 1978 I fractured my L3 or L4 lumbar in a fall from the Ben. Treatment then was lying flat on my back for five weeks in Belford hospital at Fort William. My advice is to take things slowly. It took me more than a year to recover. If it starts to hurt stop doing whatever you are doing. Do all the physio exercises you are given.

I had/have an extrusion (burst bulge, possibly same as a herniated disc?) on my L4/5 disc…..I was basically a write off for the best part of a year, I managed to physio/yoga myself back to fitness but it took 2 years from the initial injury to start feeling almost normal. I was offered a discectomy but waiting list was around a yr, which in the end was maybe a blessing as it gave me time to heal myself. I’m now coming up for 4 years since my back went. 

I’ve kept up my yoga/stretching and I’m now more flexible than I ever was, I can skip days but I’ve a good routine and tend to do at least 5minutes every day but 15-20mins at least a couple days a week. 
 

Running I found to be one of the worst exercises for my back (I’ve only recently started enjoying it again). I think the impact and the tightening of calf’s/hamstrings then pulling into the lower back made it not worth it until recently. I found cycling initially was easier on my back but still had to make sure and stretch lots after rides. 

I’ve never been into weights and now I would be super wary of any heavy lifting. I much prefer body weight exercises. Climbing wise it’s again only really the past year that I’ve started feeling like I can push again and try hard (for me).
 

I was 33 when i got injured btw. Anyway I feel your pain! It was a very long year with a lot of stress, hope your op and rehab goes well, my main thoughts would be physio and yoga (but make sure to get help/tuition to be doing things correctly) and whatever you do go easy/slow for probably a lot longer than you want to 👍

Scottish Winter might not be the best idea as it's quite hard to click the undo button if you feel a twinge! You're looking at either further damaging yourself on the retreat or getting choppered off. 

I found that lots of stretching (especially backs of hamstrings) and nerve-flossing was useful when I had a disc injury.  

Thanks. I was going really well on the physio and pilates every day and seemed to be making a recovery until a couple of months ago when I overdid it a bit and the symptoms came back with a vengeance. Since then I've been very very cautious about any exercise and activity. After a second MRI it seems like the herniated bit hasn't changed shape at all so I guess that the recurrent symptoms are due to the nerve getting inflamed again rather than any change in the bulge itself. I'll probably be able to get surgery in about 8 weeks or so.

Now the symptoms seem to be subsiding again I'm tempted to push things a little bit - basically I think if I can inflame it again with a return to mild exercise then surgery is certainly the right route. On the other hand, if in 6 weeks time I'm doing lots of things and I feel OK then I can cancel the surgery.

I've never been particularly flexible and I've never done much in the way of yoga or regular stretching. This has been a massive wake up call!

Yeah, I think this winter might be a bit of a pipedream. Its just really frustrating to be missing a season, particularly after the last few years. I think I might pin all my mountain hopes on a big trip the alps early next summer instead as a consolation.

What's nerve flossing? Moving it about etc?

Argh. It's shit isn't it. 

I've got L4/5 instability with arthritic facet joints, bilateral stenosis of foramen and 2 Synovial cysts. Both L5 nerves are getting squashed. My big pains kicked off 4m ago. Had 3 horrible bouts of 7 days each interspersed with easing off of symptoms.

I'm needing maybe just conservative treatment but if not settling, fusion of L4/5 with metal work etc.

Probably like you, I was just fine one day, then this metaphorical bus of back issues ran me over.

I think everyone has different experiences with spinal back nerve root pain issues so everyone has a different story, different advise etc.

I used to run but have sacked that off for good. It really hammers my back more than anything. I've found I can road cycle for hours and it helps my back, gets rid of pain. I can keep my lower back stable ish and cycling is low concussive compared to running. Swimming so far also seems ok. 

I've continued to climb but not pushing it. I've found climbing makes me worse if push it. With me flexion of lower back squashes these nerves and even with carefulness I can't seem to stop this when climbing.

I've been doing lots of 7/3 repeaters on a hang board that keeps me fit and also doesn't stress my back. Also been getting my core as fit as possible but having to avoid certain movements.

I think bulging discs usually settle resolve with time. I suspect if u have surgery things will do good with time. I think, finding exercise your back is ok with and keeping really fit is very important. It may get you out of surgery, or if have surgery, give quicker recovery.

For me, I'm 50 50 to sack of climbing and take up mountain biking for thrills. As I am, climbing flares me up. After a fusion I think I'd be better but also scared a fall would pull metal implants out etc.

My wife is a GP and keeps telling me to be patient which is bloody hard. But, it's possible you may just flare up occasionally and be pretty good rest of time.

I feel your pain sir.

Yes, I think certain bits of climbing are like weight lifting.....say powerful laybacking must put heavy forces through your back. I suspect selecting certain routes is needed for me....slabs etc. My problem is, I climb for the awkward, struggle laybacks etc and fall of abit. Reining it in sort of takes away why I do it abit.

Good luck. I winter climb too. We should pair up maybe. 

I had a disc injury a decade or so ago and my sciatic nerve was causing me a bit of discomfort. It's basically fixed at both ends and runs the length of your body, so by lifting then lowering your head/foot, you 'floss' the nerve. Imagine how gross old men floss their undercarriage with a towel in changing rooms- it's like that but the towel is your sciatic nerve. There will be some videos on youtube I'm sure.

Yes it's utterly crap. Some days I feel like going around shaking everyone who looks fit and healthy and telling them they need to look after their backs and work on stability, flexibility and core strength.

The symptoms I've had have been so variable that the bi-monthly NHS physio appointments haven't been very helpful - two weeks after seeing him I'd be presenting completely differently.

All of a sudden a few days ago my symptoms eased considerably, ironically just as I got offered surgery. Now I think I'm going to stress test it - I'm not going to intentionally inflame it but I'm going to up my activity levels and go out and do all the things I want to do. If that makes things worse then I'll know that surgery is the right option, if not then I'll cancel the appointment.

Pairing up for winter sounds like a good idea so long as we can recruit some poor sap to carry all the kit in for us.

It sounds very similar to my own experience. I got a lot worse before I got better, literally couldn't walk 20m without being in agony with nerve pain and it took 12 months with a couple of large backward steps to actually get to the point where I had some confidence in my back. Go slow and steady (don't go out and push it as you're feeling a bit better, that's exactly what I did each time I set myself back months) and be absolutely disciplined with your exercise routine (i.e every day without fail).

Not what you want to hear but wipe out ideas of usual climbing/running/biking etc for the next ~6 months.  Whether you go for the Op or not that will be at least the rough time scale to physio yourself back to health. Stick with the physio/yoga/pilates as it really will make the difference if you're disciplined. I found NHS physio to be pretty poor but was lucky to be able to get help through my work with private physio which really helped and set me on to my (long) road to recovery.

Ps. I second winter climbing not being a good idea, my second big relapse happened when I tripped slightly on a rough path and instantly felt my back twang and the nerve get tweaked down my leg. Walking let alone climbing in crampons would to me be a recipe for disaster.

Apologies and good luck, hope you're back climbing soon(ish).

Sean
 

Yes, I found I'd be in a better phase when I saw the medics too. I think they're used to this. I found NHS physio not helpful. They emailed 3 exercises that I'd figured out myself already. 

If your going to test it, I'd defo go gradual and steady. Wean down any pain meds n see if ok. If ok, maybe lots of steady walking swimming or cycling. I suspect running will flare you.

I find I can cycle pretty good. Sitting in a car for abit really messes me up. I seem fine at lots of thinks but some specific movements stuff me.

Just my thoughts tho.

I think there comes a tipping point where being conservative is affecting you more than surg. And it's probably different for each person.

Hope it goes well. Hang in there.

I've been in your boat too. About 20 years ago I herniated L4 and L5 in a blurry weekend. I was told that I would need to have Cortisone injections or an operation, both of which I declined politely Eventually was prescribed some arthritis drugs(Celebrex I think) and helped enormously, with the herniation eventually receding(apparently a high percentage do unaided over time). I discovered an osteopath who helped me with muscle balance and improving flexibility. Over months the pain dulled to an ache then nothing. 

The advice I was given at the time was to watch out for lifting anything heavy and in particular to the side or in front of me. Vigorous sex I was also told to avoid. To learn to stretch properly and to keep my core strong. That still holds true today as I can overdo it and get a very focussed ache for a few days/week. 

Carrying a heavy load on my back with out a sufficient hip belt triggers my back(think there is limited room for compression now) as does landing heavily on a bouldering pad but otherwise I've done everything I'd have expected to do - mountain marathons, snowboarding, climbing, winter climbing, shifting piano's, pushing small people on bikes for hours, cycling etc etc.

I'm hugely cynical about the medical professions desire to intervene with invasive treatment hence why I took the path that I did. It's worked out for me but we are all different. You have to make our own calls but I would ask you to read what folk are saying here about time, exercise, stretching etc and really consider if you want to go ahead with something that is possibly irreversible. I'd say all in it was 12-18months for me to get back to "normal". 

Thanks for the input. I definitely don't feel like I'm being pushed towards surgery - the consultant has been really good about laying out the options and giving me some choices. Its been 9 months now with no intervention besides various painkillers and the MRI shows no change at all in the size of the herniation, which is why surgery is now an option. I've found the NHS in general to be much more in favour of conservative treatment over any sort of intervention, which seems to boil down to pain management and waiting for the herniation to be reabsorbed by my body.

I've been told by two doctors now that, statistically speaking, outcomes after 24 months are the same whether you opt for surgery or conservative treatment. It's reassuring to know that whichever way I go the outcome will likely be the same by the end of next year, but my quality of life over the next 18 months depends on the choice I make now. Unfortunately there's a financial aspect to it - I'm self-employed and I've had practically no income this calendar year. I need to get back to a situation where I'm able to earn some money, which means being able to walk up hills and climb ladders and perform rescues at height. If surgery gets me there quicker then I'll take it.