Back injuries such as slipped discs have been on the rise over the past year. You might think that once the pain dies down, you can get back into the gym to make up for all the time lost lying in agony on the sofa – but recovery isn’t always that straightforward, as writer Fiona Ward has been finding out.
2020 was the year that I became more committed to a fitness routine than ever, but my goals had nothing to do with mastering the press-up challenge or doing a couch to 5k. Before last year, I dabbled in everything from running to HIIT and weight lifting. Now, movement is something I rely on to be pain-free.
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I wasn’t alone. A 2020 survey by the Institute for Employment Studies found a significant increase in the number of people experiencing musculoskeletal complaints while working from home – 55% of which were back problems. Sitting at our desks for long periods of time and moving less than usual are thought to be the main culprits.
It was May 2020 when I began to feel terrible shooting pains down the back of my right leg – leaving me a sobbing mess as I rifled through my medicine cabinet to try and find something to take the edge off and frantically calling my GP for help.
She confirmed that I was suffering from sciatica, a condition caused by irritation of the sciatic nerve that’s often associated with disc problems. My knowledge of back health was so poor back then, I hadn’t realised that I’d been showing the classic warning signs (hip pain, mild back spasms and discomfort after sitting for too long) for months.
Since then, I’ve been diagnosed with two slipped discs in my lower spine, as shown on an MRI. Scan results aren’t necessarily confirmation of an issue; lots of people can experience the same symptoms without anything ever showing up on an MRI. Likewise, it’s known that slipped discs are very common and sometimes show no symptoms at all.
What is a slipped disc?
Specialist musculoskeletal physiotherapist Uzo Ehiogu explains: “When we talk about a slipped disc, we’re saying that a disc is bulging – or there’s inflammation around the disc – and that causes an irritation or a compression of the nerve root.
“Your discs are made from protein and in the middle of them, there’s a gel-like substance. That’s the bit that tends to push outwards. If that substance pushes outwards, it starts to cause an inflammatory response which then annoys the nerve – causing the symptoms.”
In total, I’ve had three so-called “acute” episodes of pain. Flare-ups do happen and I’m learning how to deal with them. Thankfully, the sciatica hasn’t returned, though the intense back spasms that came in its place were no more welcome. Each time they appear, my body tightens up as a protective mechanism so once the pain is gone, I’ve focused on recovering by loosening out my muscles and strengthening them again. I’ve learned so much about my body during the process.
Physiotherapy is key
It was after that initial episode of sciatic pain that I began to take my exercise routine more seriously, looking at the parts of my body that were weak, stiff or overcompensating. I began a focused physio routine and plenty of clinical pilates, focusing on strengthening my lower abdominals and glutes, and stabilising my pelvis. Now, I notice my pain returning if I don’t stick to regular classes.
Admittedly, it’s been a journey of ups and downs. I’m someone who lives with anxiety – fear and stress have been big aggravators for me. One thing’s for sure: a slipped disc doesn’t mean you can’t get back to fitness – in fact, it might just be the best thing you can do. I’ve tried two types of chiropractors, acupuncturists and osteopaths – and all have their merits. In terms of building a fitness routine that eases my pain, boosts my happiness and helps me feel strong again, however, it’s physiotherapy that has been a life-changer for me.
Uzo advises: “The best type of physiotherapy examination and evaluation is based on what the patient wants. A physio should be reverse engineering where the patient wants to be – whether that’s getting back to a certain form of exercise, back to work or whatever else. We need to look at the movements you’ll be doing in your daily life and (work out) what’s stopping you from doing them – be that flexibility issues, strength, pain or range of motion.”
Movement can be medicine
Back pain might make you want to take a sofa day but in most cases, getting up on your feet can really help. While I tend to take it easy when I’m experiencing an acute flare-up, even having a short walk around the house can help.
“The broad message is that when you have low back pain, trying to remain as active as you possibly can is never going to be a bad thing,” says Uzo, “unless your pain is so bad that you really absolutely cannot do it. When you choose your mode of exercise, it will probably depend on your symptoms, particularly while you’re in an acute flare-up.”
Finding triggers is important
Like many who have bulging disc symptoms, there are certain movements that I know are sensitive for me, such as putting my back into flexion (imagine a forward-fold in yoga). While I avoid these if I’m in a flare-up or feel particularly twinge-y, I have tried not to take any movements out of my routine completely.
“While things are acute and everything’s a bit raw, you’re going to want to avoid those sorts of things,” Uzo tells me. “When things start to ease up – and you’ll know it’s getting better because you’ll feel like you can do a little bit more – it’s at that point that we need to start to reintroduce these activities. A good physio will be able to advise you on how to progress your return to sport or activity.”
Focus on core and glute strength
Virtual pilates classes saw a boom during lockdown for many reasons. For me, it was what got me feeling strong and capable again after months of waking up feeling stiff and sore in a body that didn’t feel like mine.
I train with my physio in classes and one-to-one sessions, and in my case, we mainly focus on glute strength, hip stability and deep abdominal control in order to help stabilise and strengthen my back. My key exercises include clamshells, tabletop core work, opposite arm and leg reaches and glute bridges.
Mobility is as important as strength
Through my clinical pilates sessions, I’ve learned that mobility is just as important as strength, and warming up for my workouts with a tailored routine has been so important for preventing further flare-ups.
I have, however, learned the hard way by doing my own stretches at home and pushing myself too far. At the risk of sounding like a broken record, it’s best to go to a recommended physio for some sound advice on technique.
Mental health can hamper recovery
Unfortunately, my own poor mental health has had a detrimental effect on my rate of recovery. Anxiety and worry have further fuelled my pain and perhaps even held me back in getting better.
Uzo confirms: “Fear can impact recovery massively. Anything that reduces someone’s confidence in themselves and their body’s ability to do things is bad. I think wording is important. I try not to use the phrase ‘slipped disc’ because for a lot of people, it would cause anxiety – and that can really negatively affect someone’s pain trajectory and ability trajectory.”
For me, the learning process of gaining strength through pilates has allowed me to become more aware of my body, and with time, I’m learning to let go of fear as well as learning my limits. That doesn’t mean that those limits won’t change as I improve, however – so I’m practicing patience and looking forward to a time when my forward-fold comes with ease once again.
Sore back? Head over to the Strong Women Training Club to find our collection of Stretch-in-10 guides. You’ll learn how to do the most effective stretches, designed to release tension, elongate muscles and build strength.