L4/L5 L5/S1 disc bulge

Yoga Discussion General Yoga
#1

Namaste friends,

I wonder if you could give me some advice.

I am a 28 year old female with a minor disc bulge of both L4/L5 and L5/S1. I have been practising yoga for years, but only began to practise ashtanga daily a year and a half ago, while at the same time carrying around a heavy backpack. I became aware of pain in my back and leg around a year ago and it has persisted - neither improving nor worsening. I have tried chiropractic work and it has not helped. I have continued to practise yoga throughout this time while trying different modifications (which I admit has not been the smartest of choices).

I finally had the courage to have an mri to discover the issue. I wonder if I can still practise with modification- which poses to do, which to avoid. I wonder if I will ever be able to practise regularly again. Many fears and anxieties arise. I also understand that it is a lesson to adjust and be more aware.

Any advice would be greatly appreciated.

#2

Namaste and welcome.

I guess my first question is what did your doctor say? After having an MRI and discovering the disc issue, what did he/she recommend? Is your disc bulge posterior or anterior? If you don’t know, I would suggest you find out as this would help with customizing your practice. And what of your teacher? Have you discussed this with her/him?

You do not have to stop your yoga practice (asana) but will definitely need to modify based on your answers to the above questions. I have moderate/severe herniation at L4-5 and L5-S1 also. They recommended PT which was mostly asana. For me, extensions (due to posterior bulge) are therapeutic. Keeping the piriformis stretched and core strong has helped immensely. Twists are tricky with back issues and if done, should be done precisely. Pelvis and spine move together.

While we await your answers to above questions I would suggest a more gentle practice. Use heat before practice and ice after. And as you do a more gentle practice, really pay attention to how you move and what you are feeling.

Looking forward to your reply.

#3

Thank you so much for your response. Wow, it’s so nice to have some support :slight_smile:

I am based in Uganda in a village, so I have been practising yoga on my own. When I do get to a class, most teachers just tell me to stop when it’s painful, but it’s never to the point where it is really painful when I am practising, it is only when I am sitting. I saw an orthopaedic who basically prescribed me pain killers and gave me a list of poses to do (which I already do).

From the report of the MRI it says that I have a mild disc bulge at L5/S1 putting pressure on the anterior cauda equina. But the doctor said from the photos he can also see a very slight bulge at L4/L5.

Any further advice would be so appreciated!

#4

What exercises does your doctor have you doing?

#5

Hi lotus girl, thanks again!!!

So sorry, I just got clarification and it is actually a posterior bulge (giving an impression on the anterior cauda equina).
They gave me a hand-out of around 16 exercises including pelvic lifts, crunches, hip extensions, twists, push ups, etc.

I mostly have sciatic pain, but on rare occasions I have numbness on my left genitalia (which must be the cauda equina).

#6

As mentioned, be careful with twists. They must be done impeccably. Don’t use your hand to twist yourself further.

For sciatic pain, try pigeon and the reclined modification of pigeon. On back, knees bend,cross R ankle over left thigh. Weave hand through on either wide of L thigh and bring knees in toward chest. Keep shoulder blades firmly on mat. Hold for at least 1 minute. (same goes with pigeon) Repeat other side.

How do you feel (meaning your back) as you forward fold? As you backbend? How flexible are your hips?

I know, lots of questions! But if your bulge is to the back, “generally” backbends are more therapeutic (like for me) and forward folds must be done cautiously, if at all. Check to see if your hips move as you fold forward. When they stop, you should also. And with sciatica, refrain from seated forward bends like Paschimottansasana which can exacerbate your condition.

#7

Welcome Ganeshayogini, in addition to what beneficial thoughts Lotusgirl has already offered you, I wanted to also direct you to many other relevant threads deeper in the forum where similar lumbar and sacrum issues have been addressed by Mukunda Stiles. The posts are often done in a question and answer format, taken from email correspondence shared between himself and his Structural Yoga therapy students, and his own Yoga therapy clients.

Wishing you well in your search,
Nichole

#8

More than 90% of all herniated disc occurrences are movements toward the spinal canal, “posterior” or “backward”. It is incredibly rare, almost unseen, to find one that moves forward or anterior.

There are certain sorts of practices that are ill-advised when such a state exists in the spine. Those are practices have one of four elements; lacking alignment, jumping about, moving at a pace such that awareness is diminished (since the two are inversely related), or where there are “mandatory” postures contraindicated for herniation (like Utthita Hasta Padangusthasana).

What I have found to be best for this situation, in both my own practice with my own issues AND in my teaching of classes and privates over the past ten years, is three-fold.

In [B]asana[/B] that which creates space; traction and gentle twists in traction.
In [B]meditation[/B] looking at your feelings of lack of support and any financial issues that may be nagging (usually over time but not necessarily) AND the use of appropriate colors, light, and breath.
In [B]lifestyle/nutrition[/B] eating only the highest quality of foods (in with organics, avoiding "C.A.T.S.), maintaining the three primary nutritional elements (hydration, oxygenation, and alkalinity) and avoiding that which disrupts or agitates the nervous system.

Since you are remotely located and the chance of you getting contact hours with a skilled therapeutically trained yoga teacher are less likely, please avoid forward bends (paschimotanasana, Janusirsasana) and passive twists. If you have a wall rope system then hanging in AMS, ardha uttanasana, and ardha sirsasana will all be helpful - assuming you’ve found or can find the ability to place your consciousness in the lumbar spine and create the space needed for the discs to go back from whence they came.

#9

Good day everyone,

Wow, all of this information is incredible, thank you all!

I am very flexible but my core and my legs are unstable, obviously why this issue has come about. I began to practise with a tight belt around my sacrum for stability, this certainly brought awareness to my poses and I realised how much I had been crunching in order to bend forward. With the belt in place, I was so much more limited and I certainly felt the pain. Without the belt, I am able to fold forward and backward quite easily with a slight radiating pain down my left leg and tightness in my hamstrings.

Thoughts on the use of a belt for support??

I definitely notice the use in the poses you suggest Inner Athlete, but even find that in order to create traction and space I need to bend my legs in AMS as my hamstrings are very tight. Does anyone have any suggestions about strength building? Is running something advisable during this time?

As for meditation, it is interesting you bring up the feelings of lack of support, I have definitely felt ungrounded, it is something I have been working through and know that the physical injury is as much emotional.

Inner Athlete, i’m afraid i’m not so sure about the mix of hydration, oxygenation and alkalinity. I have a very healthy vegetarian diet with a lot of fresh fruits and veggies, whole grains, nuts and oils and at least 4 L of water a day.

Thank you everyone for your support and guidance :slight_smile:

#10

IA, can you please share what poses you do for spine traction? cause all of the traction poses seem to be similar to FF

#11

@nichole

Unfortunately the link you provided comes up empty. I think that people need to do the search themselves. Searching the Mukunda Stiles forum for disc bulge turned up a few results. You might try some different searches.

@ganeshayogini

I’m not a yoga teacher like some of these other fine folks but I do have some personal experience with back problems. First of all, I would say that if you are experiencing pain that has not improved, your problem isn’t all that minor. Second I would say that you’ve been lucky so far that your problem hasn’t gotten worse. It can get worse depending on what you do so you need to be mindful all the time until your condition improves, and it is possible for you to take actions that will help your condition to improve.

I have found a book called Treat Your Own Back from the McKenzie Institute to be the best source of information on what to do and what not to do. It’s available online. You’ve already been advised to avoid forward bends, especially seated forward bends and I urge you to heed that advice. Also I don’t think running is such a good idea right now. As Inner Athlete said, jumping about or creating a lot of impact on your joints could be harmful. If you have access to an elliptical machine or other type of machine where you can get the benefit of running without the impact, that would probably be OK. Swimming is great for strength and endurance with no impact on the joints.

#12

[QUOTE=CityMonk;71249]IA, can you please share what poses you do for spine traction? cause all of the traction poses seem to be similar to FF[/QUOTE]

What please is “FF”?

#13

@Asuri,

Treat Your Own Back by Robin McKenzie is quite good I agree! From what my Physiatrist said, there is strict protocol with the McKenzie method (extension) and is not a good fit for everyone. Another really good book is, Back RX by Vijay Vad, M.D. A mix of yoga and pilates.

@ganeshayogi,
Check with your M.D., if you are interested in the above to see if you fit the protocol.

@Gordon,
I am familiar with Traction Twists, but only on back with knees wide and allowing them to fall to one side. But it is the subtle movements that make it wonderfully therapeutic. Moving tailbone toward heels, abdominals engaged then moving to opposite side of twist. I find it a wonderful compliment to my own practice for my back issues. What other traction twists would be beneficial and appropriate?

#14

I was hoping CityMonk might reply to my question on “ff” but I’ll forge ahead assuming it means forward fold.

There are several ways to create traction in asana. And I believe that is the question. So that’s the one I’ll answer.

Some traction can be created using the mind in the body. For example parsva virasana (a spinal twist in Hero’s pose). Most students do this pose as a passive twist. That is the twist itself is ONLY a rotation. However when the sitting bones are rooted and the sides of the waist are recoiled (or lifted) then the twist is not passive it is active and it is not ONLY twisting it is also lengthening.

However…when I’m talking about traction in a therapeutic context I am almost always referencing the use of props; yoga belts or more likely the wall rope system.

Here are some examples of that use [B]BUT I am not advocating doing ANY of these things without proper instruction.[/B]

One
Two
Three
Four

#15

IA

if ganeshayogini learns to bring her sacrum/tailbone in and up while at the same time having the semi circles at the tops of her hips move down, and keeping the chest lifted, can she fold forward in dandasana?

I would also think to advise her to introduce herself to her sit bones if she was going to try this. To do this she would sit on a hard, even floor in dandasana with the flesh pulled away from her butt.
#16

Also, I believe the Svaroopa style of yoga has a heavy focus on sciatica.

#17

@Rd

I’m uncertain I jive with your lingo. But if I do then I would respond in two parts; a) this sounds perhaps like instruction for appropriate forward bending and b) no I would not advocate doing even the most appropriately executed forward bends when the student has bulging discs in the lumbar spine.

#18

Just watched http://www.spine-health.com/video/lumbar-herniated-disc-video to get a better idea of this problem. Ouch and wow I can see why that would be a bad idea.

#19

The recommendation in ‘Treat Your Own Back’ is that a person should be pain free for a month before attempting forward bends. That is for people with herniated discs, which is a little more serious than a bulging disc, but I think if you have the same type of pain from a bulging disc then the advice probably still applies. To restore full health eventually you need to get back to forward bends, but if you’re experiencing pain then no, don’t do it until you are sufficiently healed.

I think a yoga teacher assumes quite a bit of risk if he/she makes a determination that it’s OK for a someone to resume doing forward bends. Better to err on the side of caution.

#20

[QUOTE=InnerAthlete;71465]What please is “FF”?[/QUOTE]

sorry…FF=forward fold