Dealing with Herniated/Prolapsed Disks in the lower back

Hello Dr. Michael and Dr. Miles

I have been training for at least 1 year and a half following the Starting Strength program. It is with much interest that my strength has increased so much on the three main lifts, and I felt so great while lifting considerable weights. Although I had my forms checked on r/startingstrength on Reddit and they said it was ok and I should keep it up, it was not until last September that I encountered such severe lower back pain that prevented me from doing anything on my regular basis.

At first, I thought that was normal without perceiving it would be able to get worse gradually. I went to see a orthopaedist, was scheduled for an MRI scan and aware that things cannot get any better. Then I got my MRI results, been diagnosed with Herniated disks in the lower back and even degenerative intervertebal discs. My orthopaedist recommended me not to train and offered a physical therapy program for about 3 months.

Lately, I’ve felt a little bit better but I could not hit my peak performance like before. I still want to train with an idea of appropriate way to deal with my current issue, perhaps I can get helps from you and it would be so much more blissful if you can give me some reviews on my pathology.

Hey Ryan! Sorry to hear that you are dealing with this

There are a few things to address here and I feel that the start should be with disc pathology as a whole. Right off the bat, disc pathology does not equal pain and symptoms. Just because you have disc herniations on MRI does not mean that they are what caused your low back pain. We know that with resistance training, it is much more likely that you had an acute overload or some error in stress management which likely brought on your low back pain acutely rather than the herniations. Second, we have great evidence to show that there is a large population of people with disc changes on imaging very much like yours without symptoms whatsoever! They dont feel anything abnormal! We also have good evidence to show that MRIs can be misinterpreted quite easily and that what your radiologist says he sees may be completely different from what another one sees!

Unfortunately your ortho told you not to train anymore which seems to be against what most rehabilitation professionals would recommend for someone in your position. I personally dont see anything in your post to indicate that you cannot continue to train the way that you want. While you may not be at peak performance like you were before, getting back into your routine will very likely help you to start to feel better. Modifying your movement range of motion, exercise selection or weight can all help to have you continue to train while you get back to a point that you feel comfortable in discarding the modifications and doing your regular moves. This is if you cannot perform your regular moves due to lack of being able to tolerate them. If you can tolerate your regular moves, do them! If you cant, get as close as you can to them and go from there.

Lastly, I wouldn’t consider your disc herniations as pathology. They are pretty normal. Coming from someone who has a few and no symptoms at all :slight_smile: