Cycling with L5 / S1 Disc Protrusion

Dizeee

Hi all

I am after some advice please. After months of issues with my back I had an MRI at the start of December which has shown a small central protrusion of L5 / S1 affecting the traversing S1 nerve root. I basically now get nerve irritation / pain / sciatic symptoms now and again, sometimes I take painkillers sometimes I don't. It is manageable but very irritating.

I took a couple of months off the bike last year whilst investigating what was going on, and it had no effect on helping it. It actually got worse and I had a large flair up over xmas. Since new year I am back up to my usual 8 hours a week on the bike, and it seems to have helped.

But nobody is able to advice on whether cycling is a good idea with this condition? Does anybody have any exprerience? I have a bike fit booked on Monday and as yest other than NHS who have been slow and vague I have not sought any other medical attention.

Thanks

Quins

I have disc generation L3,4,5 , went through a very painful period with sciatic nerve affecting thigh and groin area. Consultant told me to take things easy, I followed his advice and it got worse. Went back to a bit of jogging and cycling, being active certainly helped me to feel positive. I was told that the degeneration and bulging would settle down as the degeneration goes through phases. No,problems on the bike or with running ( I'm not running at the moment). Occasional flare ups with particular activity , usually lifting feed bags on small holding, tipping heavy wheelbarrows, grass baskets.

Cycling was recommended by consultant, low impact. Get yourself comfortable in set up, do some core exercises as well. Getting gluteus to fire helps, apparently. My position has changed slightly over last couple of years, taking spacer out and raised saddle a couple of mm, not an aggressive riding position. Some hard efforts or hilly routes can give a bit of gip a day or two later, can feel pain in groin or low ab, MRI rules out hernia, could be weakness in abdominal wall or referred pain from back. Waiting for next appointment.

Good luck , let us know how you get on.

keef66

I had slipped L4-5 disc nearly 20 years ago. No imaging done; the GP just stuck morphine in my @rse cheek and left me in bed with a pile of codeine based painkillers. Very slow, painful recovery. At night my back muscles would go into spasms which gave me excruciating pain. My wife used to leap out bed at the first sign of an attack because it would make me thrash about so violently. Couple of months later the GP poked it and pronounced it fit for work.

Still gives me pain, sometimes quite bad. Seems to be aggravated by prolonged standing or sometimes sitting. And I have to be very careful with anything that involves bending forwards.

Any kind of activity seems to help. Walking, swimming, cycling. If it starts to act up I just hop on the bike and go do some hill repeats. Stretching afterwards is also beneficial.

Dizeee

Cheers

I have so far had 2 weeks daily physio and a few GP appointments. Nobody has said not to cycle. I cycle fairly hard and fast, but never has discomfort on the bike. I stretch and plank religiously now and have been since end of Nov. It has all helped but I still get twinges. Apparently these bulges heal themselves, yet I really cannot see an end to this constant tip toeing around and trying not to aggravate my back.

I will continue cycling, I also find it mentally wearing having this issue as I am constantly thinking about what I do and what it means in terms of my back. Wish I knew what caused it or how it has happened. At 33 I don't feel I should be going through all this.

Stupid-death

18 months ago I had a herniated L5/S1 disc that decided to eject some of the contents of the disc onto S1 nerve. Was crippled in pain with tramadol only taking the edge off, and had a numb foot. Was advised to keep as mobile as possible. Missed seeing the tour coming through Yorkshire cause of it. I got back on the bike 4 weeks later and gently built back up. I still get the odd shooting pain in my back when I twist or lean over now and again but the numb foot is back to normal. My advice is take it easy and listen to your body, if you're getting pain while cycling stop, otherwise cracking on, life is too short.

sandyballs

About 5 years ago had prolapse of L4-L5 and L5-S1, after sciatica that was excruciating for about a year an incident left me on the floor in agony unable to do anything. Surgery was the only option and they performed a discectomy on both. I have always found being active the best way, and I have had no real problems since. If there is a flare up I only rest for about 48-72 hrs then get back to doing something. I rarely use painkillers preferring heat pad treatment since I like to feel what is going on. I am very active again now competing in cycle racing, skiing and being a squaddie work throws a lot my way. I would recommend that you limit the amount of seat to bar drop though.

Forgot to ask where are you having your bike fit? I went to Adrian Timmis after my surgery and he was great. If you have not heard of him Google or bike radar search he is very well known regarded.

964cup

I've had an L5/S1 protrusion since last June; agonising over the summer. I'm finding that cycling is the only thing that helps; I have pins & needles in my left foot from time to time, but if I miss a day's riding it turns to pain and numbness. I ride a fairly substantial (11cm) saddle to bar drop, which I think helps to open out my spine at the affected disc. I'm also working on posture when standing and sitting, as consciously straightening my lower back to reduce laudosis seems to help, and have bought an inversion table - jury's out on that. I have a follow-up with the consultant next week; he was also of the "it'll resolve itself" school, but I'm not so convinced.

sandyballs

Uk is very much of the conservative approach using physio and pain relief, I wouldn't call it luck but if I had not have had my final incident that left me in agony unable to move or feel my feet I would not have had surgery. The relief was instant after waking up and now I don't have any issues less for when I am lazy and do not think about posture and position. Hope your recovery goes well.

de_sisti

[url=http://www.bikeradar.com/forums/viewtopic.php?p=19780193#p19780193]Dizeee[/url] wrote:

...small central protrusion of L5 / S1 affecting the traversing S1 nerve root.

My pain was overcome by doing regular stretches of glutes and hamstrings.

Proff

Try and get hold of the book "Treat your own back" by Robin McKenzie. You can generally find it on eBay. Follow his advice and you won't go far wrong. Sorted me out after my prolapsed disc. Also took advice from a physio. When I finally got to see a neurosurgeon who reviewed my MRI, he was amazed how well I had recovered from just stretching and exercise.

kingrollo

[url=http://www.bikeradar.com/forums/viewtopic.php?p=19781499#p19781499]Proff[/url] wrote:

Try and get hold of the book "Treat your own back" by Robin McKenzie. You can generally find it on eBay. Follow his advice and you won't go far wrong. Sorted me out after my prolapsed disc. Also took advice from a physio. When I finally got to see a neurosurgeon who reviewed my MRI, he was amazed how well I had recovered from just stretching and exercise.

Loads of back and backside problems over the years.

Decent bike position, and stretches are they key - the Mckenzie book gives some good daily exercises - But Yoga once a week works wonders (well it has for me !)

Dizeee

[url=http://www.bikeradar.com/forums/viewtopic.php?p=19781091#p19781091]964Cup[/url] wrote:

I've had an L5/S1 protrusion since last June; agonising over the summer. I'm finding that cycling is the only thing that helps; I have pins & needles in my left foot from time to time, but if I miss a day's riding it turns to pain and numbness. I ride a fairly substantial (11cm) saddle to bar drop, which I think helps to open out my spine at the affected disc. I'm also working on posture when standing and sitting, as consciously straightening my lower back to reduce laudosis seems to help, and have bought an inversion table - jury's out on that. I have a follow-up with the consultant next week; he was also of the "it'll resolve itself" school, but I'm not so convinced.

This is pretty much exactly where I am at, although I have had several flair ups that have come out of nowhere over the last few months. Most of them came when I was completely off the bike, now I am back on things have improved, but i'm still not perfect.

I used to have a sore lower back and muscular tightness/soreness. Since I have been stretching and improving my posture this has gone but lately I have been getting low level nerve pain, both sides or either side that comes and goes depending on what position I adopt. I don't know whether that means my issue is improving or worsening, but I would like to think the former. There just seems to be no answers from anywhere.

zak3737

I had this same issue in May '14, not sure 'which disc' was theissue, but 'Prolapsed Disc' was the Physio's diagnosis, and like others have found, its bloody debilitating.
I had no idea how it happened, I wasnt cycling at that time, but was playing Golf, but weather I did it like that I arent sure.
I went to a Physio locally for perhaps 8/10 weeks, and if I am honest, although he did the 'usual' Physio stuff with Electro treatment etc, it didnt have any major impact other than what I felt a normal recovery period would have done..... but it scuppered my golf for most of the summer.

It still twinged a lot for months, and then one day, the Pro at my Golf Club told me to go and see someone he went to, a local Ayurverdic )??) Masseur, a Thai Woman. (yes I know........)

So I did, & before I even got onto the table, she already diagnosed the likely cause and issue, - and so it proved.
I spend a lot of time at my desk, using a puter, and basically we develop a lop sided posture, which had caused my sacrum to become mis-aligned, and put pressure on the spine and ultimately disc, - with resultant issue.
I still go to her every 4/6 weeks now, and she manipulates me and tries to keep things in line and supple, and so far so good, I wont give it up at all now. £40 well spent every time.
Play Golf fine now, and touch wood, never had an issue on bike, - as perhaps because the spine is nicely stretched out when riding ?

Forget a normal Physio, find an Ayurverdic Masseur, or similar.

Dizeee

Seeing an osteopath this week so fingers crossed.

Just seen a bike fitter, said overall my position was good, in fact he changed very little other than increased reach and raised my saddle slightly. He did notice on saddle mapping though a slight twist/leaning forward on my right side, although very small.

964cup

So this all went a bit Pete Tong. Apparently, although I do have a disc protrusion, I also have stress fractures to the pars on both sides of L5 and L4, with resulting spondylolysis (forward movement of the affected vertebrae). So a cortisone injection first, then if that doesn't work, surgery to remove the pars and fit titanium bracing. While I'm all in favour of Ti (can mine be 6Al/4V please, to save weight?) this doesn't sound like fun, so at risk of being Jobsian I'm off to try core strength exercises, stretching, yoga, pilates and inversion before I let anyone come at me with a scalpel. I'm getting a second opinion on the cortisone, since the root cause is restricted posterior intervertebral space, not disc inflammation.

Dizeee

Is that stress fractures to bone/vertebrae? Sounds intense.

I have as of yesterday ditched cycling, gone long term sick from work and decided to start recovery again but more foccussed. My symptoms have worsened, and my sciatic / nerve pain become very bad over the last 2 weeks although as usual I have not had any back pain or issues - just nerve pain and sciatica. 3 months s enough though so I need to give it a proper chance to improve.

Yesterday I went to see my physio who pressed down repeatedly and forcefully on my lumber discs. At no point at all did I feel any pain or discomfort. I woke up this morning and have been in agony, with what feels like bruising or muscular doms to the area's she was pushing down on. Is this normal? The back and spine is really tender and it has restricted my ability to move massively. I only hope this is a short term symptom of what the physio has done, and is a good sign!

thepiman3

Just thought I'd revive this post to see how all those sufferers of lumber disc problems are faring a couple of years on. I had a L5/S1 disc prolapse/dessication in late 2007, with sciatica etc. It took a few month to calm down before I could start cycling again. The cycling and swimming (but NOT breaststoke), together with osteopathy and stretching helped a lot to control the pain, but then i had a really bad injury to the same disc in 2010 (essentially I'd been working really late hours at the office and then in a moment of desperation I did one of the MacKenzie exercises wrong (standing back bend) so I'd say if you do use that back, make sure you follow his indications precisely.
Another MRI showed that i had again injured the same disc. There was a mild protrusion on the S1 sciatic nerve. I did a lot of pilates and physio in 2010 to try to resolve this but i found that cycling made it worse, which was odd because previously it had been like drug therapy for my back - something to do with cardivoascular exercise boosting oxygen supply to the nerves which are otherwise deprived of oxygen because of the increased inflammation/extruded disc material. I had a caudal epidural which helped, but only for a few weeks.
With a lot of help from my physio who educated me about chronic pain and the importance of pacing my activities, i was able to re-educate my central nervous system to get it accustomed to cycling again (something called neuroplasticity of the brain for those who are interested in nerve injuries that persist beyond 6 months). This took months but eventually I was able to get back up to cycling 20 minutes with no flare ups. The idea is you do what you can do pain free 4 times in 5/6 days, and then increase by 10% and repeat 4 times in 5/6 days. Pain that lasts for up to four hours after each session is fine, but pain that lasts longer than that means you've overdone it. I was getting excited that I was finally going to get up to 25 minutes which is enough for me to commute to work and justified a bike purchase!
Annoyingly however I had another flare up last week caused from picking something up in an awkward angle. I will ease off the cycling now until this latest episode subsides (which I have now accepted could take 6-8 weeks) and then I will recommence with my cycling, probably starting at 15 minutes and repeating the 10% and repeat 4 times in 5/6 days method. Frustrating, but I've learnt that this works so fingers crossed it will work again.

Curious to hear some inspiring stories about anyone who might have had similar issues to me and managed to get back into doing (relatively) long cycling. My aim is to commute every day (about 25 minutes in the morning, 30 in the evening) plus do the odd longer journey on weekend, maybe even London to Brighton one day...

drlodge

I had a prolapsed disc L4/L5 a few years ago. I found initial physio sessions helped but then made things worse since they were doing movements and giving me stretching exercises that moved the spine when it should have been kept straight.

Then went to a Chiropractor and that helped a lot. He said that cycling would not be good for the back but I've had no issues and if anything the cycling helps with core strength and makes things better.

My over arching advice is to find a good *chiropractor*. Physios generally do not know what they are dealing with.

kingrollo

drlodge wrote:

I had a prolapsed disc L4/L5 a few years ago. I found initial physio sessions helped but then made things worse since they were doing movements and giving me stretching exercises that moved the spine when it should have been kept straight.

Then went to a Chiropractor and that helped a lot. He said that cycling would not be good for the back but I've had no issues and if anything the cycling helps with core strength and makes things better.

My over arching advice is to find a good *chiropractor*. Physios generally do not know what they are dealing with.

Physio is very hit and miss. a good stretching regime, and time will help most issue.

Don't forget though that physio is a relatively cheap option. I particularly remember one session when the physio was trying to discharge me - and he asked me many different ways if it was any better at all - I got really irritated and replied

"It doesn't matter how many times you reword the question - I still have a problem here"

So my advice would be to be very assertive - set a target goal (mine was to cycle 25 miles pain free) - and don't budge from that. Be aware that most stretching exercises will give an improvement early on - but IME the improvement doesn't continue . Physio's know this and try to fob you off that your cured.

Eventually I got see a sports injury consultant. Together with a physio and some very targeted exercises I recovered.