Spinal issues and cycling.

[willhub]

Hello,

So firstly, I've had an MRI scan and spoke with a consultant that has basically confirms I have L4/5 Spondylosis, a disc bulge with a radial tear as S1 but no neural compression. "Mild" degenerative disc disease as T12-L1, fatty infiltrations at L4. And L5-S1 facet joint with severely chondral thinning.

As the consultant said, all that above basically comes to "some wear and tear", and advised management is some exercises so I'm going to try pelvic exercises, partial curl-ups, lower trunk rotation and pelvic tilt.

When my back goes, it goes and I'm stuck in bed for a few days, I'm been advised to also take 10mg and work up to 30mg of amitriptyline to from what I can understand mask the pain, but it's also an Anti D so that might help somewhat.

Now I'm not necessarily looking for medical advise, I've been given the information as above, but what the doctors can't advise is how this correlates to cycling, aside that cycling is generally low impact, so perhaps anyone who has had similar diagnosis can give me understanding. Are my long mile bike rides long gone? I get a lot of discomfort now after only 25 miles and hills whilst I can do hills my lower back gets fried and quite tense easily especially out of the saddle.

Also what I can't determine is if this is tied in with how my bicycle problems started, what I consider a "phantom imbalance" on the bike, no amount of bike fitting ever sorted it, and I went to some reputable bike fitters. Basically, it varies from day to do, morning to evening but I struggling to balance myself on the bicycle to the point it could be veering one way or tother, initially starting partially and gradually getting worse from July 2020 onwards, first noticed my left sit bone hovering off the saddle then after that the balance issued became a nightmare to the point I couldn't get power down or keep the bike in a straight line, I've since persevered through points I just wanted to give up cycling, fitness is a lot lower, weight higher now because my mileage has reduced, but I'm keeping at it to some degree e.g 3 days a week commuting to work. Some days good some days bad, no good for anymore than a direct 6 mile journey into work on a morning as all siezed up and can't keep perfect balance.

Anyone else suffering with similar back issues?

 

[simongt]

A common assumption is that when folk do physical movement, they do it in a balanced way throughout their lives. This is rarely the case and after many years of doing even minor repetitive physical movements, one 'side' of you will eventually suffer.
It's tricky to quantify , but a minor example is seeing folk who move a load using a pallet truck. They will invariably pull it with one hand because to them it's appears easier, but in reality they're putting more strain on that side of their body, even with a light load.
It's these sort of things that make the difference.

 

[willhub]

Why do the majority of cyclists not seem to suffer from a random imbalance like this that causes them to struggle controlling a bicycle in a straight line? I'd assume it'd be a massive problem is repetitive cycling gave way to huge imbalance and inability to control a bicycle for the majority of cycling population? One guy said "you look twisted", I feel it kind of, but it's only developed over the past few years. But no one has been able to really say it's a common issue?

And as to degradation of the spin if this means my normal road cycling days are numbered? I'm 34 and not really ready to be pottering about

 

[kingrollo]

Think long term . Follow your docs advise - but I would also recommend enrolling a Pilates class (in person better than you tube)

After you've been doing this for a while - hit the gym and start with some light weights - when you're confident start on deadlifts - they have been a game changer for me.

Fwiw cycling with dropped bars does load the lower back - but the solution isn't not to do it - its to make that lower back stronger.....but hey while you're in the gym why not make your whole body stronger.

There will be setbacks and bumps in the road (pun not intended) but the key is to make your body stronger.

 

[All uphill]

I'm sorry to hear about the problems you are having. Sounds horrible.

I can't give you advice on your back issues, but I'm surprised you are having difficulty cycling in a straight line; we humans generally are very good at compensating for asymmetries in our bodies or bike. Do you have the same kind of problems walking?

Two examples- I know a keen cyclist who has huge injuries to his left side resulting in a high degree of asymmetry, but he cycles in a straight line.

I've ridden bikes with uneven loads, wonky handlebars and bent forks but never had a problem riding a straight line.

Finally I'd be very careful of taking advice and ideas on your precious back from the Internet.

 

[fossyant]

Welcome back Will. Sorry to hear of your issues at a young age. I'm just about to hit my 8 year anniversary of breaking my spine (on the bike RTA). Do you have any nerve impingement, weakness etc. This could be translating by the feeling you aren't on the bike straight. Ami can work, but build up slowly - I don't get on with any of these meds TBH. I'm left with half a T12 after splitting the T12 and L1 in two, and some localised damage to the discs, but, MRI's showed the rest of my back was surprisingly good for my age (45 at the last scans, 53 now).

Do try the various exercises, I find I end up in pain if sat still too long.

 

[Tomm Williams]

I feel your pain quite literally…… I’m undergoing the knife on Monday to repair damage to two lumbar sections and get a cage and screws between L5 and S1.
I’ve been unable to walk more than about 1-2 miles for a long time but can still cycle a century. 4-6 months recovery time is going to set me back significantly but I’ve really no choice at this point.

 

[OldShep]

A word of warning re amitriptyline. A year ago I was prescribed it for nerve pain. It didn’t work and I also ended up at 02:30 one morning wanting to be shot. IME it’s evil stuff but I understand it’s cheap.
+1 Pilates

 

[oldwheels]

I cannot comment on your back problem although I do suffer some pain myself and I do have difficulty with cycling on two wheels. My solution is a recumbent trike.
To keep you mobile if all else fails would a recumbent trike appeal?

 

[Tail End Charlie]

Have a look at the Health Section thread there's a recent thread about physios, osteopaths and chiropractors and there's lots of good advice and encouragement.
I had a similar issue (L5/ S1 disc) when aged 42. I spent three and a half months off work, but managed to avoid surgery. In my case gentle flexibilty exercises and pilates/yoga type things helped enormously but you've got to keep doing them. I had had a warning when aged 36 but once it had cleared I went back to my old habits which paid me back with interest six years later.
Your long distance cycling days are not over, I built up mine very slowly but did regular 200k rides after a few years and still do so now over twenty years later. Be patient and make stretching part of your life. It doesn't have to be much, ten minutes twice a day is fine.

 

[numbnuts]

A word of warning re amitriptyline. A year ago I was prescribed it for nerve pain. It didn’t work and I also ended up at 02:30 one morning wanting to be shot. IME it’s evil stuff but I understand it’s cheap.
+1 Pilates

Been on amitriptyline for years due to spinal damage at one time I was on 100mg per day just to ease the pain.
They are good, but you maybe on them a long time, some 34 years later I'm still on 30mg at night just to get a good nights sleep and relax my muscles

 

[a.twiddler]

As @oldwheels suggests, even if it's only a temporary measure. a recumbent trike might keep you on the road while you deal with the physical issues and hopefully return to your former two wheeled capabilities. Excellent back and body support, no balance issues, a different way of seeing things.

As an aside, coincidentally, or not, Amitriptyline is a medication from the tricyclic family of drugs.

 

[ebikeerwidnes]

Is there such a person as a Osteopath or Psyso (or whatever) that has spent a lot of time with cyclists?

Clearly there must be specialists that work on such things with pro teams - but they might be overseas and expensive - but are there some general ones that have spent a lot of time with cycle clubs or whatever?

just wondering!

 

[Once a Wheeler]

Over 20 years ago I had some excruciating disc problems but since then have got to the point where I very seldom suffer any problems at all — perhaps a sleepless night or two due to back pain every couple of years. On the bike, the fact that the upper body gets support from the handlebars seems to do the trick so long as I do not stick in a single position all the time. Changing between tops, drops, hoods or stem-sides keeps the back happy.

The big pain-maker, I discovered, was not biking but sitting. On the advice of an NHS physio I went to see an ergonomist who measured me up and gave me a list of dimensions for my seating, in particular the exact height of seat, writing surface, computer screen and so on when at work. The single most effective element the ergonomist introduced me to was a cushion called a Putnam Wedge:

I have half-a-dozen of these, usually two or three at home, one at work and one or two with relatives with whom we frequently stay. It will depend on your specific back condition whether this is suitable for you; but for me it has been transformational — virtually no back pain for over 20 years. But if I am away from a Wedge for more than a fortnight, I normally start to get niggles and stabs in the back just to remind me to sit on a Putnam again.

Every case will be different but a visit to an ergonomist should be well worth it. Ask your physio to advise — and the physio is likely to know far more about this than your GP. Good luck.

 

[Chief Broom]

I found a very upright riding position was obligatory for my back problem and a adjustable stem helps me get it right. If im careful i can avoid the agony but any deviation means serious trouble...