Managing Disc Herniation: Tips for Students with Back Pain

Prolonged sitting for 90 minutes and resting in a prone position on the desk?

Hello Doctor: A young female patient experienced prolonged lower back pain in mid-2014 and sought treatment from the rehabilitation department.
Following the doctor's advice, she underwent rehabilitation for three months, but still felt mild pain when getting up from a seated position.
By the end of the month, an MRI confirmed a diagnosis of L4-L5 disc extrusion.
To this day, she has been overly concerned about the potential worsening of her condition, fearing incontinence or lower limb paralysis.
During her university years, she applied for a leave of absence.
After gaining a better understanding of her condition, she no longer lives in constant fear and now wishes to retake her studies.

Over the course of approximately two years since the onset of her symptoms, aside from three instances of radicular pain due to nerve root inflammation, which caused mild numbness in the inner left calf, and occasional lower back pain from prolonged positions, as well as brief muscle twitching in the left thigh, she has not experienced other significant issues such as foot numbness or delayed reflexes.
She understands that the absence of pain or neurological responses does not mean the L5 nerve is no longer being stimulated; rather, the spinal nerve has "adapted."
She would like to ask:
1.
Given that the retake class schedule consists of approximately 90 minutes of sitting followed by a 10-minute break (and knowing that prolonged sitting or standing is not advisable), if she maintains proper sitting posture and performs moderate stretching during the breaks, could her condition worsen after a year of retaking classes?
2.
For her afternoon and evening breaks, she needs to lie on her desk to sleep.
Is this position, which involves lying sideways, a significant load on the intervertebral disc? If so, how can she reduce this load?
3.
Since she lacks time for physical therapy to stretch her back, she relies on leaning on the desk and using her body weight to stretch her back.
Is this method effective?
4.
Currently, she knows that swimming is a suitable exercise, but running and playing sports are not options.
What other exercises are appropriate for patients with her condition (HIVD) that are also convenient to perform?
5.
Does strengthening the core muscle group help alleviate her condition?
I apologize for the lengthy message and sincerely thank you for your patience in reading it.
Thank you!

Christina, 20~29 year old female. Ask Date: 2016/06/18

Dr. Zhang Junwei reply Neurosurgery

It is recommended that you consult a rehabilitation physician for better answers to your questions!

Reply Date: 2016/06/18

More Info

Managing disc herniation, especially for students who spend long hours sitting, requires a comprehensive approach that combines proper posture, regular movement, and appropriate exercises. Here are some insights and strategies to help manage your condition effectively.

1. Sitting for Long Periods
Sitting for extended periods, such as during a 90-minute class, can exacerbate back pain and contribute to further disc issues. While maintaining correct posture is crucial, it is equally important to incorporate regular breaks. Aim to stand up, stretch, and walk around for at least 5-10 minutes every hour. This can help alleviate pressure on the lumbar spine and improve circulation. If you notice that your symptoms worsen after a year of this routine, it may be beneficial to consult a healthcare professional for a tailored management plan.

2. Sleeping Position
Resting your head on your arms while lying on a desk can indeed place significant strain on your spine, particularly if your body is twisted or unsupported. To reduce this load, consider using a supportive pillow or cushion that maintains the natural curve of your neck and spine. If possible, try to sleep in a more neutral position, such as lying on your back or side with proper support, to minimize stress on the lumbar region.

3. Self-Treatment Techniques
Using your body weight to stretch your back by leaning against a table can provide temporary relief, but it is not a substitute for professional physical therapy. While it may help alleviate some tension, it is essential to engage in structured exercises that strengthen the muscles supporting your spine. If time constraints prevent you from attending physical therapy, consider online resources or apps that guide you through safe and effective exercises for your condition.

4. Suitable Exercises
Swimming is an excellent low-impact exercise for individuals with herniated discs, as it allows for movement without putting undue stress on the spine. Other suitable activities include:
- Walking: A gentle way to maintain fitness without excessive strain.

- Cycling: Stationary or outdoor cycling can be beneficial, provided you maintain a proper posture.

- Yoga or Pilates: These practices focus on flexibility, core strength, and proper alignment, which can be very helpful for back pain management. Look for classes specifically designed for individuals with back issues.

5. Core Strengthening
Strengthening your core muscles is vital for managing disc herniation. A strong core supports the spine and can help alleviate pain. Focus on exercises that engage the abdominal and back muscles without putting excessive strain on the lumbar region. Examples include:
- Pelvic tilts
- Bridges
- Modified planks
Always consult with a healthcare provider or physical therapist before starting any new exercise regimen, especially if you have a history of back issues.

Conclusion
Managing disc herniation, particularly for students who are often sedentary, involves a multifaceted approach that includes proper posture, regular movement, and targeted exercises. By being proactive about your spinal health and incorporating these strategies into your daily routine, you can help mitigate pain and improve your overall well-being. If symptoms persist or worsen, it is crucial to seek professional medical advice to ensure that you are following the best course of action for your specific condition.

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