A herniated disk can be the result of lifting, pulling, bending or twisting movements that push the center of the disk against its outer ring. The resulting bulging of the disk can put pressure on spinal nerves, causing pain in the lower back and often in the buttock and legs as well. Treatments vary from bed rest to exercise and even surgery. Before engaging in any exercise program, particularly if you suffer from back pain, seek approval from your physician.
Exercise With Back Pain
All movement, not just exercise, is painful with a herniated disk. Some doctors recommend two to seven days of bed rest, while others suggest that longer than two days may lead to back spasms. After a day or two of rest, limited activity as tolerable is generally recommended. Return to your normal routine slowly and avoid heavy lifting or twisting. Exercise 10 to 30 minutes a day, one to three time a week, as long as the pain is not severe.
Back Strength Building
Abdominal, back and leg strength provide support and help reduce the risk of back injury. But exercises that target these areas can lead to greater pain if you do too much too soon. Abdominal contractions strengthen the ab muscles without flexing the spine. Lie on your back, knees bent and spine in neutral. Place you hands on your belly just below your ribs and feel your abs contract as you squeeze them towards the floor. Hold the contraction for five seconds and then release, repeating 10 times. Another back stabilizing exercise is quadruped. While on all fours, squeeze your abdominal muscles as you extend one arm in front and the opposite leg behind you. Your extended arm and leg should be parallel to the floor and your back flat in a neutral position. Keep your head and neck in line with your spine. Hold for several breaths and then switch sides.
Back Stretches
Stretching the erector spinae muscles, glutes and hip flexors provides support to the back and increases flexibility and range of motion. Perform the single-knee-to-chest exercise by lying on your back with one leg extended along the floor. If you feel back pain or can't keep your back in neutral, you can bend the extended leg. Place your hands behind the thigh of the opposite leg and gently pull the knee toward the chest. Hold for 20 seconds and repeat on the other side, doing five repetitions each. Advance to the piriformis stretch by lying on your back with one leg crossed over the opposite knee. Reaching through your legs, hold the back of the thigh of the foot that is on the ground and pull it toward your chest.
Aerobic Exercise
Aerobic exercise should only be performed if the pain is not severe and with a doctor's approval. Back surgeons recommend walking since it doesn't involve much impact and uses little spinal flexion or extension. Start by walking a few minutes several times a day. Avoid leaning forward or back, which can put strain on the back. Keep the pace slow and comfortable. Slow down or stop if the pain increases. Set a goal to increase your walking time to 20 to 30 minutes during a single walk.
References
- American Academy of Orthopaedic Surgeons; Low Back Pain; May 2009
- "American Academy of Family Physicians"; Clinical Evaluation and Treatment Options for Herniated Lumbar Disc; S. Craig Humphreys, M.D., and Jason C. Eck, M.S.l; February 1999
- American Academy of Orthopaedic Surgeons; Low Back Pain Exercise Guide; July 2007
- Beth Israel Deaconess Medical Center; Exercise After a Back Injury; Kathy Shilue, PT; 2010
