Continuing Weight Training with Sciatica and Herniated Disc

Bigger Stronger Leaner Injuries and Rehab
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I am just curious if there are people who had sciatica or lumbar herniated disc that continues to do weight training??Is your pain affecting you a lot,what’s your recovery and treatment method for your sciatica/herniated disc symptoms??Why did you continue to lift if there is pain??

I have stopped working out for 3 days but might get back to weight training,need to hear some advice or stories of fellow people with herniated disc/sciatica

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I have had sciatica flare-ups three times on my right leg, have had multiple lower lumbar disc bulges, and am currently dealing with an acute flare-up of left-sided lower back pain. I never stopped training, but adjusted my training lots to be able to cope.

My pain would definitely affect me, and limited what training options I had. To get around that, I modified my exercise selection, sets and reps, and tempo to continue to train within a comfortable pain range (2-4/10).

For example:

  • Squats become hack squats with a slow tempo
  • Deadlifts become leg press with my feet high on the sled
  • RDLs become hip thrusts
  • Barbell lunges become single-leg leg press
  • Use lots of leg extensions and leg curls to pre-fatigue the lower body
  • Bench press with feet on the bench
  • Using chest-supported rowing variations
  • Swapping military press for machine or landmine shoulder press

Low back pain has a really really good prognosis:

  • Most people will be symptom-free in 3 months, even in the presence of sciatica
  • Disc bulges, if present, have been shown to heal within 6 months
  • Exercise actually leads to thicker, stronger discs, which has been showing in weightlifters, rowers and runners
  • Disc bulges, if present, don’t necessarily cause pain. As people get older, the rate of symptom-free disc bulges increases to over 50-60%. We can think of disc bulges a lot like skin marks - they can occasionally bad, but are often just a normal consequence of aging
  • Pain itself isn’t a perfect marker of tissue damage. It is more an indicator that your brain is feeling threatened by the position and load it is under. When people are more stressed out, and have been in pain for a long time, the threshold of stimulation it takes for the brain to feel threatened reduces, and people feel more painful with less and less load or movement. In a way, pain (especially back pain) is like a smoke alarm: it often comes on at the slightest stimulus (burnt toast) but is impossible to ignore.
  • As a result, low back pain symptoms are often more strongly associated with how active and how confident an individual is. This leads me to how I managed my back pain, and why:

I remained active, and trained up to a pain threshold I was comfortable with - about a 3-4/10. At this level of pain, I know that I am not damaging any structures in my back, and am reducing my brains threat-level with exercise. Furthermore, tolerable physical activity actually has a pain-relieving effect that lasts up to a few hours. Remaining active also prevents me from detraining all the other systems and areas of my body.

For example, here is what my current workout plan looks like (acute low back pain flare-up), 3 days per week

  1. Light kettlebell mobility/flows: 8-12kg for 5-10 minutes
  2. Light clean/snatch derivative: 20-30kg for 15-30 total reps
  3. Squat or lunge/split squat variation: 3 x 5-15
  4. Hinge variationt: 3 sets of 10-15
  5. Upper body push: 2-3 x 10-15
  6. Upper body pull: 2-3 x 10-15
  7. Higher-rep core, hips or upper-body finisher: 1-2 sets

I do some kind of light cardio on the off-days. If I’m really sore, that means walking or (better still) wading in a pool. If I’m feeling a bit better, I’ll do a very light jog, bike ride or stairmill

So, above all:

  1. Don’t panic! Pain is like a smoke alarm, and doesn’t reflect tissue damage
  2. Keep your pain levels within a comfortable limit, up to 4/10 is okay, provided you don’t feel worse the day after the workout
  3. Substitute things that are intolerably sore for things that are tolerably sore or pain-free. I suggest using machines, slow tempos or single-limb versions of exercises
  4. Use light aerobic exercise like walking to keep your aerobic and mental health high. This can also help reduce your pain levels

Lastly, I know you’re working with a chiropractor. So far all the advice he’s given you seems to be good. It is very important you discuss your concerns with your clinician, and follow their advice to the best of your ability

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No advice, because @j4gga2 has you covered, but my quick experience.

I did/ do. It was bad enough that I struggled walking at times (I thought I’d torn a hamstring at first) and it always hurt. I did end up with a couple surgeries that helped tremendously.

It did impact me and I legitimately can’t do some things I used to do, but there’s way too many variables to say that’s because of some sciatica. I did need the aforementioned surgeries (2-level laminectomies/ discectomies) and I would do those again; I did not have a fusion. In terms of treatment strategies, I’ve done chiro, PT, rehab, etc. and everything had its place. Now it’s a little more of a pound of prevention: I try not to dig myself a hole. I don’t let form breakdown on complex lifts at all, I don’t use form or exercises that don’t feel right to me (that doesn’t have to be debilitating: I high bar squat instead of low bar, for instance), I’m very careful how I structure my week so I don’t have multiple days of heavy spinal loading, and I shut exercises down if I feel a tweak. Basically I just have a “tomorrow’s session” mentality and I’m fine. My default is to do something dumb, though; I think that context is important.

Because I wanted to. There’s really no other answer. When I first got hurt I didn’t want it to be the case (I had a physical job at the time and it impacted that) so I tried to just keep doing the same stuff. After the surgeries, I just wanted to deadlift 500 lbs. I actually saw that as a milestone people on this site used. Now I’m pretty sure everyone that’s been lifting as long as me is deadlifting 700, but that wasn’t the point. That was a goal that took long enough it required me both to train hard but also smart because if I got hurt again I couldn’t hit it.

Honestly, you don’t have to lift. Do it if you want to, but if it’s causing you angst or fear it’s probably not beneficial. It stressed me out more not to, so I did it. You do need, for your own sake, to exercise in some manner that includes both resistance and aerobic work. You can accomplish this with walking and calisthenics, though. Why not walk and do push-ups, planks and pull-ups for awhile? Try to take care of your injury and just let the lifting bug bite you on its own? Even as you start to get the urge, just had low-risk, high-awesomeness stuff like curls and side raises. This is a half-century game, if we’re lucky; backing off for a month or 12 to heal body and mind is a good investment.

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Chef’s kiss

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Ive suffered with severe back pain for near 2 decades, ive 3 herniated dics and had coccydynia (got the latter sorted this year with surgery). I was prescribed slow realise morphine and gabapentin for 12 years. Thankfully i no longer need them unless ive a flair up. I should note, my back troubles were the result of working long hours in back breaking jobs.

For me, the best thing was exactly what well meaning people advised me against…i now regularly raw deadlift heavy (relative term i know) with both the regular bars and hex bars, preform heavy loaded carries, block pulls, prowler pushes etc. Ive switched from standing OHPs to steep incline DB or BB pressing, thats helped matters a lot too.
My back pain levels has improved greatly since dropping squats and leg presses, my legs have not suffered for it neither. When i did preform them it was in HIT style, slow cadence, smooth turnarounds etc. Tread carefully and eliminate what causes issues is my advice.

Best of luck

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@Mobc1990 thoughts?

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Is it bravery or stupidity to continue to lift as it is one of the hobby I love besides gaming.It is a hobby that make me able to be more focus on work,but now I think it makes me less focus as the pain is coming on.

What hurts me is the duration of the sciatica,would rather the pain be more painful but lesser in duration​:hushed::hushed:

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What’s your goal? If you had no pain, no injuries and all the time in the world, what would you want your body to look like and do?

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My goal was to improve and be able to enjoy lifting session.I like breaking PR,I like getting a little bit stronger and lifting more as weeks go by.I enjoy that,and I remember the goal I had for years,was to train consistently each week,but now the goal to be consistently had be lost lol

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If you’re not finding any joy from lifting, or lifting is causing you more mental stress than benefit, I would revert to @TrainForPain 's advice

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I love the focus and relaxing feeling after an intense workout,and it does feel like a tick to the daily to do list.
I have continued my routine for a week now,but to be honest I am masking my pain with Yoko Yoko applied to my back,stretching and also nicotine gum if my pain last more then a few hours

All the things I do is legal

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And how is chiropractic going?

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I am going again next Monday,was very busy with work so cancelled my appointment last week

I am now doing my workout at night instead of first thing in the morning,but I still have a sore/weakness in my back/leg symptoms.Today it started at 10am until now,I am lying at the restroom now on work

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It really depends. If you have numbness and tingling you need to see a doctor. Over time you can develop nerve damage.

I have found, however, training has improved my back pain 90% of the time. I do have to avoid going for a 1RM or training above ~90%.

I would also avoid a chiropractor. They study pseudoscience.

Also, you might be doing a specific lift that aggrivates your back. Spend time finding out what that is and look for a replacement.

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FWIW, good chiros and good physios will do the same thing, because they draw on the same evidence pool

There’s only a significant difference in care if either or both of the clinicians are subpar

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I feel the the barrier of entry for screwing up as a chiro is much lower than being a screw-up doctor. The fact of the matter is the training for being an MD is more intense and youre likely to get weeded out quickly if you dont have the work ethic or smarts.

Granted, I think some of the training is stupid, like making people work 80 hours a week - I dont see how that makes anyone a better doctor.

With my neck and back it is a risk I wouldnt take.

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For context, I’m a physio so this statement will be biased

I would honestly disagree

Medical doctors other than orthos have virtually zero training on diagnosing and managing musculoskeletal issues. All medical doctors, including orthos, will have a preference for imaging and surgery in many cases.

Clinical guidelines for neck and back pain will recommend non-surgical management, minimal imaging and a strong emphasis on the holistic understanding of the client. This is the quality of care provided by good physios and chiros.

In contrast, individuals who immediately present to medical centres for musculoskeletal pain usually end up with higher cost of care, greater likelihood of surgery, and equal to lower satisfaction in 5 years

If you have a musculoskeletal issue, go consult the people trained to manage musucloskeletal issues.

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Good to know, thanks. I might look into a physio for my neck.

Ive heard horror stories of people getting their spines and neck royally screwed up seeing a chiropractor. I saw one 15 years ago who “adjusted” my neck - Im never doing that again.

I did see an orthopedic doctor several years ago, where he found I had a torn hip labral. They told me to stop squatting and deadlifting. I didnt do that, but I did take a break and found the issue resolved itself.

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For sure, there are bad clinicians in all fields. I think chiros get a really bad rap in the media due to the (very rare) instances of vertebral artery dissection (i.e. stroke) following a neck manipulation/adjustment. This is mostly an availability bias though, as:

  • Vertebral artery dissection is extremely rare following neck manipulation (like, 1 in the millions)
  • There are many many instances of people being unnecessarily referred to surgeries by physios or doctors, and experiencing adverse affects such as surgical complications, infections or non-response

Not to mention that physios are also trained and do perform manipulations as well

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Hello guys/friend I thought I should give an update of my recent situation.My back has been healed now and it’s been the fifth day of working out without pain and lifting relatively heavy.I don’t know what will happen one month from now,but these are the changes I made,and my back is feeling well for a week and 5 workout session before this post.

1.Wear a lifting belt for all strength training.Since I strength train for an hour a day,so it is okay for me personally to just wear a belt as a preventive measure.When I am doing cardio,stretching I don’t use belt
2.Workout after 6pm.The pain started when I workout early in the morning 7am,and I think it’s because I am lifting heavy 10min right after I wake up.So if I workout at night,I am less stressful and my back will be more stable instead of lifting first thing in the morning
3.Reduce stress,not chugging down water.I was targeting of getting 1.2ML of water a day,so whenever I drink water I chug down 400ml on one go.So now,to reduce stress and stomach bloating because of chugging down 400ml of water under 30sec??I just drink whenever I feel thirsty.I have lost some weight and more importantly my stomach is less bloated and there is no back pain.

I will probably give an update in the near future because when I got into trouble,this forum has gave me some mental/emotional support,so it is only reasonable for me to update and maybe people who are like me likes to workout and had back pain can read and maybe sough different advice given in this post,Thanks.

EDIT:I will still try to update even if I feel pain,because I know there is still a possibility that I might feel pain as it’s only been a week of not feeling any pain/symptom…

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