What's the best for bad backs? Focus on keeping weight low, or muscle / strength?

ElJefeChief · September 2016

I've been hovering around the 190s, BMI in the high 24s for the last few months since I've basically halted my weight loss and gone on maintainence.

I also have a bad spine. Have talked about it before. I have a fairly high propensity towards bulging discs and flareups in my neck and lower back.

Years ago, when I weighed 35+ pounds more, I had a couple of flareups (neck and back) and the pain was considerably worse. I have had another set of flareups, though. Fortunately, the pain is definitely better than what I used to experience - I owe that to being in much better health and likely because I weigh a lot less.

My neck issue has recently resolved, but I have since traded that for a sciatica-type lower back issue (probable bulging disc). Am in physical therapy and I'm improving. They have me doing tons of core work (which is great!). But, at the same time, on my own, I've also been adding back in large-muscle-group excercises in the gym (pushups, chins, leg extensions, etc). I've been gaining a little weight as I go - watching the scale creep up. I'm pretty sure this isn't me suddenly forgetting how to count calories.

Is this a bad thing? Is it better for people with bad backs and spines to weigh as little as possible, or is it OK to weigh more, if it's muscle? Obviously core strength is non-negotiable either way.

Opinions appreciated.

SonyaCele · September 2016

its best for anyone with or without a bad back, to be a healthy weight. Extra weight is never good. And weighing as little as possible isn't good either. Find your healthy weight and stick to that. And its best for everyone to do some strength training . If you have a bad back building up a strong core and body is really really good. And learning how to bend over and lift properly and have good posture is important. Its good for everyone.

GottaBurnEmAll · September 2016

My back issues aren't as severe as yours. I have disc degeneration (both cervical and lumbar) and scoliosis along with arthritis. I know for me that the lower my weight is, the better off my back has been (this is true for all of my joints and it's why I'm trying to lose more weight even though my BMI is already low at 21.8). Saying that, exercise is crucial for me too. I can't separate one issue out as being more important than the other in controlling my joint/spine health.

Lofteren · September 2016

I am a neurophysiologist and work primarily in spine surgery. Very, very rarely do I see a patient who is strong, otherwise healthy and at a healthy weight. When I do see patients like that, they are usually victims of some sort of trauma such as an automobile accident.

Also, the patients who I see clinically who take initiative, start exercising, eating healthier and being proactive in the management of their condition often times don't wind up in the OR.

Proper weight, flexibility, mobility, posture and strength are extremely important for people with spine injuries. However, in order to know what type of exercise you can perform and at what intensity, you must first have a detailed understanding of the cause of your symptoms. This will require an MRI and a nerve conduction study/EMG.

If you don't have these studies then you don't really know what you can do in the gym without undo risk. So, for now, I would stick to bodyweight exercises, stretching, soft tissue and mobility work. I would also avoid doing situps or crunches as they place a lot of stress on the lowback. Dips and pullups are great options for upper body as they deload the spine rather than compress it like barbell lifts. When squatting (bodyweight), be sure that you do not have posterior pelvic tilting in the hole as this can really irritate any problems around L4-S1.

If you happen to have reports from an MRI or an NCV/EMG send me a PM and I will take a look at them for you and give you my opinion.

DavPul · September 2016

With your very specific back history this isn't a question for forum randos

minniestar55 · September 2016

I have degenerative disk in cervical & lumbar spine; suffered with pain & stiffness from it. Steroid injected into area of lumbar spine @ a military pain clinic some years ago calmed that area down, & anti inflammatory plus massage help the neck. Best continuing "treatment" has been Stott reformer Pilates, has helped to create space in my back, plus really improved core strength & support without compromising by back.

sijomial · September 2016

My personal experience with badly degenerated lumbar discs from multiple disc herniations.....

Losing weight (c. 30lbs) on its own reduced my pain, reduced severe pain episodes, improved function.

Working hard (but very progressively over a long time period) on core and abs strength made a huge difference. Gym ball was my main "weapon of choice". A lot of what I do is ultra high reps for strength endurance rather than outright strength. I cycle long distances so strong core with very good endurance is important to me.

Limiting exercise that compress the spine also helps although I'm able to tolerate greater vertical loads now than any time in previous 20 years. As an example I tend to do OHP single-handed to halve the weight I could otherwise do with both hands.

(Your experience will be unique of course, but good luck.)

psychgirl_02 · December 2016

Pilates are very good for flexibility and core strength. The bodybuilder that invented them had spinal issues! I do Pilates to help my back pain. I have serious scoliosis and DDD. 2 surgeries and metal rods have left me with chronic pain and periformis syndrome. Pilates and swimming both help my core strength and with weight loss. I found that, for me, losing weight while building muscle helped the most. Good luck!

Michael190lbs · December 2016

sijomial wrote: »

My personal experience with badly degenerated lumbar discs from multiple disc herniations.....

Losing weight (c. 30lbs) on its own reduced my pain, reduced severe pain episodes, improved function.

Working hard (but very progressively over a long time period) on core and abs strength made a huge difference. Gym ball was my main "weapon of choice". A lot of what I do is ultra high reps for strength endurance rather than outright strength. I cycle long distances so strong core with very good endurance is important to me.

Limiting exercise that compress the spine also helps although I'm able to tolerate greater vertical loads now than any time in previous 20 years. As an example I tend to do OHP single-handed to halve the weight I could otherwise do with both hands.

(Your experience will be unique of course, but good luck.)

I can't agree more and do the same workouts I might add that as someone ages moving more toward this style can be beneficial.

mgalovic01 · December 2016

The best thing for your back is good form.

lorrpb · December 2016

Lose weight, strength train with good form and moderate weight.

What's the best for bad backs? Focus on keeping weight low, or muscle / strength?

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