Back pain, surgery, resistance training.

Hi Drs.,

1 year ago, my mum (60yrs) experienced progressive worsening of chronic back pain with leg numbness/foot drop. A slew of medical imaging identified a host of degenerative disc-related conditions in the spine. They were mainly focused on the L4-L5 and included disc desiccation, a large disc extrusion with rostral extension, and peripheral extension to the intervertebral foramen. Coupled with Facet joint arthropathy (OA) and mild canal stenosis, the cumulative effect is the compression of the right L4 nerve root. The surgeon has proposed an L4-L5 posterior lumbar decompression. The doctors don’t seem to have any other major concerns.

Symptom-wise, she experiences chronic back pain with occasional flare-ups, managed by NSAID/paracetamol. Recently, pain and numbness down the leg have had a greater impact on quality of life. She spends a fair bit of time on her feet at work and around the house, but most evenings are spent on the couch managing symptoms. Other than this habitual activity she is otherwise untrained. When symptoms are manageable, she has good mobility, but lacks strength. The physiotherapist recommended a few exercises including squatting to a box, but I feel they failed to emphasize the actual importance of continued resistance training and progression.

In your experiences, what is the prognosis of similar conditions with, and without surgery? What is the role of an appropriate resistance training program at this stage of her condition?

I’m sure any insight that could ultimately aid in restoring her quality of life will be very useful.

Thank you kindly!

The radiology findings alone are not going to reliably predict how your mom does. Additionally, your mom will benefit from graded exercise (including resistance training) whether she has surgery or not from not only a pain perspective, but overall health.

Your mom may or may not be amenable to hearing this from you from a behavioral change standpoint, unfortunately. If she is open to discussing exercise and other lifestyle changes, she may benefit from seeing another professional who’s into this stuff.