NHS physio - herniated disc

[Rachaelrachael]

I wonder if anyone who's suffered with a bulging/herniated disc can offer any advice?
I've been suffering with my back on and off for 10 years. During this time I've had periods where I cant get out of bed due to the severe pain but it usually resolves itself after a few weeks. The last time my back went was a year and half ago, and it still hasn't fully healed.
Over the last 10 years I've seen a couple of private physios who told me not to do any movements that require bending forward as this puts pressure on the disc.
Anyway, fast forward to now and I've finally been referred to an NHS physio. The problem is, this physio is really pushing me to do an exercise that is basically standing then bending forward to try and reach my toes. It causes me pain and I'm so worried as this is exactly the motion that causes my back to go. Every private physio I've seen and everything I've read online says to avoid this movement. When I raise this with the physio he basically implies that the pain is in my head and its a mental block stopping me from moving more as I'm scared of the pain.

So the question is, if you've had this injury, is this an exercise that you've been asked to do? I really don't want to be that person who thinks they know better than a professional, but I just don't trust him.

Sorry for the essay and thanks for any advice you can send my way!

Yes, did they give you a standard print out with that and a couple of other exercises too? I thought the same as you, that you shouldn’t bend over like that (especially if it causes you pain?) but when I asked my chiropractor, he said it was an outdated notion that bending forward should be avoided with herniated discs 🤷🏻‍♀️ It’s so hard to know what to do as there is so much conflicting information out there and you obviously don’t want to make yourself any worse…

@Sickandtiredofbeingsick I was sent an email with a list of exercises to do and most of them are fine, but whenever I go to physio they make me repeat the bending over exercise and try to touch my toes.
You're right, it is so hard to know who's right! When one person says absolutely don't even bend over to put your socks on and then another is saying that's a load of rubbish!
Did the exercises work for you?

Bending down to touch your toes with straight legs, if you don't have the hamstring length or the flexibility to do it without rounding your lower back would be a large load on the lumber vertebra. loaded lumbar flexion is generally contraindicated with disc issues. You need to learn to hip hinge rather than round the lumbar spine. look at the alignment of both your pelvis and rib cage. Actually your whole body alignment! Google "hip hinge Katy bowman" for a good explanation. Pilates is also good for addressing pelvic and rib cage alignment although a lot of crunch type exercises would be loaded lumbar flexion too so not all of the Pilates rep would work.

Several years ago, I was referred to a group session for people with back issues after an injury. I'm a frequent flyer in physio, so I'm well used to their being annoyingly right.

Out of all the participants, only one other person did the exercises - the rest resisted, refused and did not do their homework. And out of the class, only two people had significant improvement within a couple of weeks - me and the bloke who did as we were told.

If you're scared (understandable) it is possible to work up to it at home by having a chair in front of you or to your side as support/reassurance as you gently and slowly travel down. Don't force it, don't round over, take your time and think about where your pelvis is in relation to the movement - but it is an important movement to do in order to regain strength and mobility.

But then on the other side of it, if I had done that exercise I would have caused massive damage
I went to a private physio who eventually sent me for an MRI and refused to touch me until I had it. Herniated disc which wasn't going to resolve with physio

I see massive improvements with a herniated disc if I work on lengthening ny hamstrings. I suppose the exercise could be done wrong as a pp said by rounding your back so just do it carefully and correctly

My NHS physiotherapist told me my pain was all in my head and to get more active... A couple of weeks later I was having emergency spinal surgery for cauda equina! So glad I didn't listen to her or I might have ended up paralysed or incontinent!

I was the same as you but I have been so lucky to have mine resolved with surgery in 2018. No pain since but I was a mess before.
Since my surgery I have been strengthening my core and back performing dead lifts with resistance bands.

I had a herniated disc on L5/S1 a few years ago. NHS were absolutely rubbish with me and it wasn't until I went private that I got an MRI and diagnosed. I then went to private physio for months.

My physio got me to do the exercise you describe - but not necessarily touching my toes, just going as far as was a comfortable stretch. I remember it was taught to me as slowly bending over, moving one vertebrae at a time. The idea behind the movement was stretching out your spinal cord to relieve the pressure that the ruptured disc was having on it. As PP has mentioned, stretching and lengthening your hamstrings are a big part of the recovery - strength in your hams and glutes is critical for looking after your back - they are all very much linked!

Based on my experience, I would be comfortable doing the exercise - but only to a comfortable level and not to push through the pain - pain is there for a self preservation reason to a certain extent, so don't ignore it. You will hopefully find over time that you will be able to take the stretch further until you feel that pain.

Well it turned out that I didn’t have herniated discs as such, just that two of them had ‘lost height’ from normal aging and wear and tear. Only reason I was referred to physio in the first place was because of tingling in my lower legs and feet (which is why I was given the exercises to do) but the MRI I had done during the summer ruled out any nerve issues in connection with my back as it came back ‘normal for someone my age’ 🤷🏻‍♀️So physio said I didn’t need to see her anymore so stopped the exercises 🙄 I still see the chiropractor for a tune up every so often as I do get lower back pain on and off (I get it in lots of places, think I’m peri menopausal 😫) and this does help get rid of it. Have you thought about consulting a different physio or a chiropractor/osteopath for their advice? It really is such a minefield, with all the conflicting information out there 😫

I have chronic back problems. I can bend forward ok as long as it's not repetitive (like picking socks off the floor of DCs rooms) but I cannot arch my back as that will put my back out for 6+ months. I stopped going to physio as I couldn't find a single one who would bother checking my scans, listen to the type of surgery I had, or do anything but give me the standard back problem list of exercises. I find walking has been the best thing for me. That and not picking too much washing off the floor!

@Hohohoholidays what if there is nerve compression