Laura is a Toronto actor in her mid-seventies. Her work is diverse and demanding; sometimes she is on stage for two hours a night. When she is booked for parts in a film, she must be ready to jump into a scene at a moment’s notice. Because of the requirements of her profession, she has to stay fit and does so with long walks, Nia (aerobic movement set to music) and Pilates classes.
Laura had been doing Pilates with me for at least fifteen years. Occasionally she had mentioned sciatica, back pain caused by pressure to the sciatic nerve, but she knew how to manage it with gentle movements and stretching. Then one day, about two months into the pandemic, she emailed me about a sharp radiating pain that spread from her buttock and down her left leg.
This new pain felt different, sometimes like an electric throbbing in her low back, buttock, and leg. It was especially bad when lying in bed. She was scared to move, but scared not to move.
What was going on in her life? I asked. Nothing. Nothing was going on in her life! Since the pandemic started her acting work had dried up. So had social outings. She hardly left her apartment. Like many others, she had put on weight. She was sitting almost all day on a brand-new sofa and watching nonstop Netflix and Crave.
The pain she described was so bad that I urged her to see a physio at once. The physio suggested rest and ice; gentle stretching and heat. She urged Laura to get an upright chair, and avoid her new sofa. These instructions helped, but only marginally. Eventually her family doctor sent her for an X-ray.
The diagnosis was Degenerative Disc Disease (Severe) and Osteoarthritis in two facets in her lower spine. Laura had no idea she had these problems. Her body was not perfect: she’d had one hip replaced in 2002 and the other in 2006, but both surgeries and recoveries had gone well. She was in her mid-seventies but still able to get down to and up from the floor, do her acting gigs, and stay as active as possible. What caused her formerly mild and manageable disc problems to flare up into searing ongoing pain, and to be diagnosed as ‘severe’?
The answer was simple: too much sitting and too little exercise.
Gravity, Ageing etc.
Degenerative Disc Disease (DDD) is not really a disease. Many physios refer to it as a ‘natural’ process of change in the spine. It is attributed mostly to ageing, gravity and faulty repetitive motions. It is one of the most common causes of pain in the low back or neck. (Spine-health.com)
Between each small spinal bone that forms the backbone is a spongy disc (think of a rubber washer or cushion) that acts as a sort of shock absorber. Because of age and other factors, these ‘washers’ or ‘cushions’ between the vertebrae lose water and compress together and/or rub against the surface next to them. Another problem can be when small movements between the vertebrae occur due to instability caused by the ‘cushions’ not working as they should. Wear and tear on these discs can happen in the low back or neck; Laura’s were in the low back.
Disc degeneration can lead to other spinal problems such as osteoarthritis (OA). Also visible in Laura’s X-ray, OA presents when changes occur in facet joints. The protective cartilage has worn thin, and one small joint makes contact with another. DDD and facet joint problems can hasten the onset of Spinal Stenosis—narrowing of the spaces within the spine which in turn causes nerve root or spinal cord pinching. Another common disc problem that many of my students have suffered from over the years is Spondylolisthesis: when one vertebral body (spine bone in low back) slips forward over the bone directly beneath it. Symptoms are persistent lower back and thigh pain, and tight hamstrings and buttock muscles. (Spine-health.com)
What could make all these ‘natural’ or not so natural disc problems worse? Sitting. Prolonged Pandemic Sitting!
Laura is not the only one of my students whose back health had deteriorated because of Pandemic Sitting! Perhaps you’ve heard the expression: sitting is the new smoking. It is well known that sitting weakens the cardiovascular system, causes gluteal and leg muscles to waste away and can cause an increase in all sorts of health conditions and diseases. In addition, sitting and sofa slouching causes poor posture and further compression in the discs. Sitting puts more pressure on lumbar discs than any other position.
Laura found out that she was booked for lucrative film work early in the new year; exciting but daunting at the same time. She needed a new physio and new exercises to get her out of the mess she was in. Her goal was to relearn how to use core muscles to stabilize the problematic segments of her low back. But she could not see a physio in person and after she met up virtually with one, she was not as clear about the exercises as she hoped. Next week’s blog focuses on Laura’s struggles to build back her body, and includes a video of the exercises that helped heal her disc pain.