Hey, so I am reaching out to the friendly STW community for any experience or help with a prolapsed disc.

I have experienced sciatica of varying degrees for years now and Pilates, stretching, gear choice and being careful has worked.

But, I did a couple of big rides this year (112 followed by 135 miles, both gravel). I ride a lot (mtb/road/gravel) but generally don’t do more than 60 miles in one hit. The result of the last big ride is a prolapsed disc and horrific sciatica.

Seeing a physio for it but only just started on this road. I am just wondering if anyone has any experience of this, what the recovery time is and how to best avoid this in the future (I assume it’s CORE CORE CORE!?). Not looking for treatment advice as I am confident in my physio, but anything else gratefully received.

Thanks

From initial prolapse through gradually worsening sciatica and escalating prescription painkiller consumption until eventual surgery was 5 months-ish.

After surgery it was about three months until I started very gentle riding again but then I put in some great rides over the following two years, so all is absolutely not lost, but this will probably be a sort of pause and reset of your riding.

Core core core is basically correct, but for me, the problem stemmed less from a weak core and more from over-used low back muscles, because my glutes weren’t working.

Once you’re on the mend it’s more about relearning (via lots of basic exercises) how to utilise your glutes for everything but especially pedalling!

Best of luck!

I can only talk to my experience. I had a very large prolapsed disc that was undiagnosed for 4 years. When it was finally diagnosed, I had the option to have very quick surgery with a top class surgeon.

It did work (took me about 3 months to get back on a bike). However, once you have surgery, it does introduce a weakness that means you have a higher likelihood to prolapse again.

This happened to me after a crash and I’ve been managing the resultant prolapse for over a decade.

Given my time again, I’d maybe not have the surgery. I’ve found a set of core exercises that manage my pain and mobility. I’ll never get back to where I was.

My advice is to try to manage your condition through targeted exercises and avoid surgery if possible.

There is a book called “treat your own back” by Robin McKenzie. It seems to work for some. Might be worth a shot.

Man, that sounds tough.

I am really hoping that I don’t need to go as far as surgery.

At what point was this decided the best route?

At what point was this decided the best route?

I was determined to avoid surgery, had physio, chiropractor, injections, massive pain killers and in the end I just couldn’t deal with the endless grinding pain and said “**** it, do the surgery”. I was off work for 6 weeks, some ups and downs, but (touch wood) have been fine since. The doc’s parting words were “don’t baby it, live your life”.

Wow, really appreciate you both sharing your experiences. It sounds really awful, I feel for you both. Really good to hear the positives in both your cases.

At the moment it appears to be slowly getting marginally better, but sitting down is a no no, as is riding.

Let’s see how things pan out with the physio.

I have ordered the back book.

I had prolapsd disk and managed to recover without surgery. Several weeks off work, loads of NHS physio including a back strengthening class which was pilates-based. For ages walking was the only thing which gave me any relief from pain so I walked night and day. I think I was off the bike for a few months. 2 years on I have to look after my back carefully, daily stretches and core work, but I can ride and carry heavy things. Good luck with your recovery.

Get it checked out with a specialist if you haven’t already. The pain is the prolapse pressuring your spinal cord (I’m sure you know this) and you don’t want that pressure to get worse with the wrong treatment

Me too…

Several months of least invasive treatment led to a ‘percutaneous discectomy’. I didn’t know what that meant – ‘through the skin’ apparently.

Under Ket (I think) on all fours, they insert a thin tube through the skin into the wobbly disk, drill a hole then suck all the jelly out. This collapses the disc and takes the pressure off the nerve. No pain and very pleasantly spaced out…

Almost instant results and very little recovery time, from memory.

Wow, so it’s quite a lot of us.

@timba I am seeing a physio who diagnosed it, so I am hoping they know what they are doing…

What about causes? Is it a riding thing without paying attention to other muscles?

Add me to the list as well. Stenosis and prolapsed disc has me currently medicated up to my eyelids and hobbling round like a 90 year old.

A decade in for me now. I didn’t go for surgery due to the, very unlikely, associated risks and that fact that it’s just removing the herniated material with no guarantee. As you get older the disc dries and shrinks anyway. Riding a bike keeps mine in check, but I realise I’m lucky. The riding is just keeping other muscles in balance though, rather than altering anything in my spine. Glutes, Psoas, IT band etc all need to be correct. I’m sure your physio is taking a ‘holistic’ view on the issue, checking skeletal alignment and all the muscle groups. Good luck – it does get better!

Ok, so there is a trend here.

Perhaps we could do a GCN and do a STW core exercise thing?(they did a cycling specific core workout video) GCN core exercises

Another Sciatica sufferer here. L5-S1 plus an endplate infraction to the marrow at L4. Some was due to injury, but some due to work. Saw a specialist who said if I didn’t change my role in work I would end up in a wheelchair. Lots of physio but no surgery, so when it happens again, its pain management.
I was advised the risks for surgery so didn’t want to go down that route.
Throughout all this the Doc’s said cycling was fine, but to avoid the off road stuff when it was bad.
There are some very good pain killers out there. But to anyone who has back issues you have my sympathy

Ok, next question is painkillers. Gp has prescribed tramadol, which I was taking spaced out throughout the day with ibuprofen and paracetamol.

Appeared to be helping, but then I was running out of tramadol, so went back to gp. He said it’s not a good long term drug so said I need to reduce it. Now I only use it for bad pain but I the ibuprofen and paracetamol is not working well enough and means I am pretty much lying down most of the time – with little walks and potters around the house every half an hour or so.

Gp didn’t offer an alternative! What have people found that works? Just so I can ask the gp about them…

At least he didn’t try Cocodamol – manufactured by Blue Circle I hear…

Tramadol, Naproxen and Paracetamol here. Naproxen being Ibuprofen like but Kinder to the stomach.

I gradually worked up to a cocktail of tramadol with an anti-nausea drug, Gabapentin, and either diclofenac or a prescription paracetamol/codeine mix, I forget which.

Finished up with a few wee bottles of that reduced strength liquid morphine but I don’t honestly know if it did much.

Three months of that lot and I was ready for the surgery!

My problems stemmed from muscle imbalances/weakness/inactivity (specifically the glutes) which meant I would use low back muscles too much to stabilise core, which meant they got fatigued and would spasm. Too many spasms (e.g. the contraction of the muscles) ultimately did for the disc I think.

Core is good, obviously, but a couple of physii did explain how difficult it was to strengthen low back muscles if they were already fatigued/overworked and prone to spasm. Instead working on the muscles that SHOULD be working (glutes again) whilst learning to relax the low back muscles, was the key.

Is a very fine line to tread. I still can’t do glute bridge moves as I can’t seem to prevent the low back taking over and getting twitchy again 🙄

Aye I forgot about the Gabapentin. I still use it when I occasionally get a muscle spasm. The physio suggested the muscles spasm as a protective measure against the old injury. This usually ends up with me out of action for a couple of days inhaling industrial quants of Gabapentin.

I lost a box of it when I was tapering off after surgery, that was an unpleasant crash after 3 months at max dose 😭

Just recently re-found the ‘lost box’ but binned it before giving in to temptation, didn’t realise it worked short term, thought you needed to build up the dose.

Prescription strength diclofenac is still my go-to if things get twitchy, it really does seem so much better than ibuprofen!

Another question – are people pretty much doing a little bit of hobbling around but mostly having to lie down (only way I can get comfy). I can’t sit for more than a couple of minutes.

Trying the odd short walk – but that makes things worse.

Blew out number 4 about 15 years ago. I also had sever ba k pain and constant slipping disk 25 years back. If I knew now and had the option I would have had surgery 25 years ago.
Work on pain. So if you have lost the use of your left leg and crying in pain so bad you had to call an ambulance then take the surgery option. It won’t get better.
Really common in manual workers which I have been for all my working life.
Age. They don’t lime operating over 40 years old for some reason.
Weight. If you are carrying any lumber then lose it.
Physio. The best advise I ever had was hang from your hands. It separates the disk and works instantly.
You can also hang from a table from your hips. Very similar to traction.
Repair after surgery. I walked out the following day after being fused.
Was back at work in a week.
Suffered lower back numbness for 6 months then one day it disappeared.
Good as new now but just always be aware it’s had surgery.

I had sciatica from cycling with poor posture, just too stretched out.

Could barely walk, had to crawl upstairs. Fixed with some very simple exercises from a book. I can’t recall the title but I have mentioned it before. PM me if you can’t find it.

Also now ride slightly shorter, higher stack bikes.

@oldnpastit was it “treat your own back”?

This was recommended earlier in this thread, so have ordered a copy.

If not, always happy to consider other recommendations.

I need to consider the position on my bikes, especially road/gravel as I have become a fan of longish and low – but perhaps my body hasn’t!

I had this about 5 maybe 6 years ago, first hurt my back before Christmas and then just after I bent down to tie my shoe laces and I just couldn’t move. I didn’t have surgery, dr said it was a prolasped disc, walking was the only relief I had, small walks which took forever leading to quicker bigger walks. I paid for private physio and back then was £65 a session which was half an hour a week, felt like it helped as the walk there was originally an hour and when I was recovering got it down to 20 mins.

Oddly I had a back spasm issue last week first time in years, but I put that down to overworked and doing things I really shouldn’t. You can live with it but be sensible and don’t rush the recovery, I stayed off the bike for 4 months and built back to the bike slowly.

You could try and find a physio that uses this https://spiralstabilization.co.uk/
My local practice use it https://fountainsquarephysio.co.uk/

It’s interesting that a number of you have found walking to help. I can’t say I find walking helps at all. I go for short walks as instructed by my physio, but it does hurt after a short while.

I take on board what people are saying about not rushing recovery. I can cope without riding for a while as long as I can get out and walk.

I am about 3-4 weeks in, so sounds like I have a way to go, but you are all giving me a lot of hope!

I was supposed to do the calder divide last weekend! Will keep that as a long term goal.

This is fascinating. I’ve been practically immobilised for about 5 weeks with the same thing. The physio called mine a « bulging disc », but it’s definitely the disc pressing on the nerve.

Someone else mentioned walking. Our dog has never been happier. I’ve been walking the dog some nights at 2am, 4 am and 6am. The dr prescribed stronger cocodamol, naproxin and methocarbamol. Even with all of those, sleep was elusive.

Ive bought myself a standing desk. Even after 5 weeks, sitting can quite quickly become painful.

I plan to sign up for Pilates. I’m gently starting to mountain bike again, but only on the flat. Shining seems to help too.

That sounds brutal @johnhe, sleep is sometimes an issue, but not to that extent.

Standing desk would be great, before I was signed off work I was alternating between lying down with a laptop on my chest and standing at a high table but couldn’t do this for long at all.

Sounds like we need to create a support group!

Spent nearly a decade managing an L5 problem, slowly riding less and less until it totally failed 2 years ago. 6 months of physio and then gentle riding until I was well enough to ride more.

8 weeks ago shooting oaun between shoulder blades, last Wednesday 3 hours surgery (acdf) on c6/7 and well behind square one!

Good luck, I think it’s pot luck if lower back surgery sorts you out permanently

I actually had a pain between my shoulder blades a month before things got bad, it only lasted a couple of days.

Hope that’s not related…

was it “treat your own back”?

This was recommended earlier in this thread, so have ordered a copy.

If not, always happy to consider other recommendations.

I need to consider the position on my bikes, especially road/gravel as I have become a fan of longish and low – but perhaps my body hasn’t!

That’s the one.

Also might be worth looking at piriformis exercises.

Long and low means that you can kind of slump down and then end up using your legs to mash up your own spine, if you don’t have the core strength to resist it (I certainly don’t).

I used to row, and it’s the same problem – you end up “bum shoving”.

Ok, think I will get a bike fit for my road and gravel bike. I would assume an mtb is less of an issue due to moving your position around a lot and it being less about the pedalling. I tend to ride reasonably gnarly stuff on the mtb and longer/Xc stuff on gravel which is a more static position.

Does running lower gears help?

Sitting is a problem because the prolapsed/herniated disc is being squashed at the front by the vertebrae and protrudes further at the back = more pain.
Problems are more common in the lower back and neck because these areas of the spine aren’t supported by your ribcage, which tends to keep the vertebrae better aligned.
Try lying on your front, but it’s important to restore core strength and posture as well using specialist-recommended exercise

Thanks, that makes sense. Lying on my front does help at times actually.

The exercise that I have been told to do is lying on my front and doing a press up but keeping my pelvis on the ground (whilst relaxing my glutes).

That helps.

That is a relatively good exercise. Try propping on your elbows and then lifting one lower leg from the ground keeping you pelvis and thigh flat on the ground. Nod your head at the same time. Then do the same with the other leg. Do it slowly 30 times a leg. Don’t push further than you can comfortably raise your lower leg and not lift your pelvis.

Sobering reading and I wish you all speedy and full recoveries.
I’m just about recovered from a simple pulled/injured muscle in my lower left back which then spasmed. Did not like. Couldn’t roll over, couldn’t sit up, no chance of standing as the pain was unbearable just trying to sit up in bed to eat, bathroom visits we’re a 15-20 minute ordeal and it’s all of 5 yards away. Thankfully there was only 3 days of agony before it started to ease up, a week later and I was able to walk about reasonably pain free, two weeks later and it’s pretty much gone. The only time I’ve felt pain that bad was a kidney stone and that ended when the paramedics morphined me as they couldn’t get me strapped in 😀

I was prescribed diazepam, diclofenac, omeprazole (to counteract the side effects of the diclofenac) and zapain (30/500mg codeine/paracetamol) also a laxative that I can’t remember the name of.

I was also referred to our local surgeries muscle and bone specialist. So far she has been nothing short of brilliant, ex nhs physiotherapist, a long chat on the phone with her prior to the face to face. Stripped down to my trollies in the surgery and asked to squat/ touch toes and various other movements. Muscle imbalance, left lower side weaker than right, weak glutes (apparently sees this a lot in cyclists) along with a damaged right foot (I dislocated the ball and broke some metatarsals back in March) means I’m subconsciously compensating for the lack of rom in big toe when exercising, specifically squats. Lots of exercises and stretching techniques to target the glutes.

Thanks for the exercise @Fat-boy-fat.

It’s the length of time that’s bugging me. Had a bad couple of days, just getting flare ups from nowhere.

Ears have started ringing too, apparently a side effect of ibuprofen (!) I do suffer from vestibular issues from time to time anyway.

Physio tomorrow! Going to have to hit the strong painkillers just to get there. Fun.

It’s all about patience. A fine balance between rest and maintaining some mobility. Don’t rush yourself. It will get better, just be gentle with yourself. Just popping up on your helps while lying flat on your front should help. Again, don’t push too high when propping.

I’ve found having a theragun helps me. I had a bit of a sports physio habit where I was getting a massage every week and then also bi weekly “proper” physio. That wasn’t possible during COVID, so I had to find something else. The theragun means I can really pummel muscle imbalance and tightness in my ITB, psoas, hamstrings, etc.

This doesn’t help with the disc itself, but it does relax the muscles surrounding my back, which has the knock on effect of lessening in pain from the back.

That would be something for your future at the moment though. Concentrate on resting and keeping some mild mobility. Too much too soon will mean things take longer.

One more thing, for those that have been in this position (or in this position). I had a bad spell today and got really, really low. I had taken some tramadol a couple of hours earlier, does this sometimes do this?

How do folk cope mentally with the pain? I think I need to address that too.

Hopefully having acupuncture tomorrow