Sitting on an annular tear

[puma]

I just joined this forum today and feel very encouraged to seek inputs based on the posts I read here.

I am a 45-year old woman with a job that entails being at a laptop for about 7 to 9 hours a day. I had my first MRI last early month after a nagging back pain that got aggravated with any kind of forward bending, sitting, sneezing, and driving. My guess about the reason is that I moved heavy furniture (a 3-door cupboard) by myself. The MRI indicated that my pain most likely is due to an annular tear in my L5/S1 disc, which has a diffuse bulge. I have other issues like curvature not being OK, some disc bulges, and osteophytes.

My ortho doctor, whom I highly respect, suggested that I strengthen my back muscles with some stretches and swimming, to try and lose some weight (I am overweight by about 10 kilos), and to rest the back at least for some weeks for the annular tear. I took his advice and started doing some of these stretches, some yoga, a couple of exercises with a swiss ball, and some time on a cross-trainer/elliptical - a total of about an hour and a half every day. These seem to help and I feel a lot stronger. Even with the best posture on a firm good chair, I cannot sit for longer than two hours without pain though.

I have not had to take time off from work because my manager allowed me to work from home if I could. I manage to work on my laptop lying on my back very well. However, I do need to get back to my work place sooner or later. A standing workstation is not an option that I see as feasible for 7 to 9 hours day. I wish I could sit for many hours, interspersed by short walks. I have just ordered a stability/balance disc that I plan to use on my office chair. Would anybody have any suggestions about this or otherwise on how to be able to sit?

Thanks.

[mmglobal]

Hi Puma, welcome to the forum.... sorry you need to be here.

I've had several clients who've used standing workstations for years as that setup provided them with the most productive environment. With my lumbar problems, standing still was worse for me than sitting. The best kind of work day is sit a little, walk a little, stand very little, walk, sit, stand, repeat. Hopefully you'll find a system that works for you. Note that you may present a moving target and what was best yesterday might not be the best today.

Spine surgery is something that is very good NOT to have.... I'd listen to the conservative voices that recommend ergonomic changes, therapy, strengthening, core, flexibility, weight loss, etc.... (how is that for a buzzword salad?)

Good luck... please keep us posted,

Mark

[Maria]

I have retired due to my back (early) though at my last job I had a modified standing work station (had a seat at the cubicle should I want to to sit) and put a thick mat on the floor and stood barefoot at it while working at my computer station and on the phone (Advice Nurse/Telephone Triage) for up to 8 hours.

At the time I was doing this I had an annular tear at L3, a failed discectomy at L4 with rebulging disc, a rebulge of a discectomy at L5S1 and I just couldn't tolerate sitting hardly at all so this was the only manner I could work with exception of a laptop perched in a certain manner while semi reclining in bed (working from home).

Wishing you the best with however you work it out as best you're able. If your work allows a modified workstation and you can handle it or it suits your purpose ~ go for it!

Take care and good luck with all~ Maria

[puma]

Thanks Mark and Maria.

As I'm overweight by a few kilos, I'd be compromising my knees and ankles by standing for long hours. So, I wouldn't be going that way. :-/

I wonder if you could tell me of a way to sit without putting pressure on discs. Do you know of anybody who has tried a balance/stability disc?

A yogic way of sitting is called vajrasana. It works well for me at home but in the office? Another story or maybe a story a day! :-)

[Maria]

I know plenty of people who even thought they had a similar disc condition as me or at least that's what radiology reports said they could sit and I could not. In fact this was such a big problem for me that I went thru graduate school sitting or semi reclining in a bean bag chair in classes and also lying across a long table in grad statistics class. I could do the clinical part Ok as that involved standing and walking *Nurse Practitioner/MSN degree.

So for a number of years I pretty much avoided sitting as much as possible. If I had to fly back east I would stand for as much of the flight as possible and after 911 when passengers weren't allowed to stand up as much I bought 3 coach plane seats and laid on my side for a 5 hour flight back east to see my parents each way. Again I had to give up much and just do what was necessary with regard to anything that involved sitting.

By the time I had my last job I had undergone a discectomy at L5S1 and that rebulged, I had an annular tear at L3 that was symptomatic for a while and I had also undergone a failed percutaneous discectomy at L4 that left me with horrible burning pain that rain thru my buttocks, my legs and into my feet and it was 24/7. I was told that scar tissue at the sacral nerve roots caused clumping and then set off all the sacral nerves.. hence the horrendous burning pain that at one time labeled "arachnoiditis" but this pain eased off completely after 17 years (various treatments used during this period).

Ok so when I got my last job I weighed about 110 lbs.. I forgot to mention I have super flat feet (now have a prob re tendons because of that) and I had 2 surgeries on my right knee.

I tried the stability ball for sitting at home because it was sort of like a softer version of a rocking chair and it seemed to not bother my tailbone as much as sitting on anything else. I found a contraption that could be rigged to add a back to it for support however that was too difficult to maintain in place so just took it off and "sat" on my stability ball sort of rolling it about underneath me. Very good for CORE exercises.

But I have to say the only manner I could take pressure off my discs and my tailbone seemed to be in a semi reclining position with the beanbag chair yet that would not have worked at my computer station. Also I found that sitting like this rather upset my neck.

There are chairs at Relax the Back and some other stores that are pretty heavy duty the way they're made and one can sort of recline with knees bent and legs elevated (which should be very good for your lower extremities and feet re avoiding dependent pressure and swelling). Then you would have to have a monitor sort of suspended above you or use a laptop.

What you might find however is that you will have some increased strain and tiredness on your arms and wrists at a sort of funky angle. Also you have to have your neck supported well so that you don't increase the potential of inducing neck pain while trying to take care of your back pain.

These would be my suggestions based on my own experience. Good luck. I'm sure you can find some way to modify a station and work at it however not sure if your employer will go along with it though I would hope as long as you're able to do your job they will (re ADA and all that).

[puma]

Maria, I really appreciate the time that you took out to post your response. Very generous of you. Advice based on personal experience is so much more precious and priceless!

I am hoping that exercise will cure me of my disc pain in a month or two. Meanwhile, I am asking for a lighter laptop and plan to commute by bus rather than drive down or take a cab to my workplace. I hope that and the balance disc will help. If they don't, I will get on to Ayurvedic treatments. Here, in India, we believe a lot in the power of Ayurveda.

[Maria]

Puma,
Please share more if you've time and are so inclined. I have always been fascinated with India and wished I could travel there however my various injuries (esp. my back) have sort of squashed that dream.

I have in the past during phases of my back stuff (from age 28 to now at age 60) taken the bus on occasion and find that it is rather rough travel for me with great bouncing and jolting. Same with the train travel. It does however allow me to move about a bit more than if I were driving and stuck in one position for however long.

I used exercise thru out my injuries pretty much to help stay in shape. I now suffer from something called posterior tibial tendonitis in both feet and while I used to walk and walk and walk (which greatly helped my back) I now can hardly walk due to painful inflammation of the tendons that support my ankles.

Meanwhile trying to be mentally OK with this and just do what I have to get over a flare up (which I just threw myself into Monday after doing better with several months of PT for my feet).

Anyway wishing you the best with your endeavors to improve your spine or health in general~ and again if you feel like sharing please do! Maria

[puma]

Maria, surely I'll share how things turn out for me.

I'm so sorry to hear about your ankle. Knowing all that you've been through and tried, I probably can't tell you anything new. You can probably get a lot of benefit from some Pilates or Yoga positions that you can do lying down though.

I have always been a rather lazy person but resting when I'm not exercising is so depressing! I hope you're able to walk comfortably again soon.

[puma]

As promised, I'm back here to let you know how my back is. I am currently trying out our ancient Indian Ayurvedic medicines, which people have a lot of faith in, in India for centuries and now globally.

I am happy to say that it has been working well for me. I feel stronger and should be able to start driving to work twice a week from the coming week and then of course step it up gradually.

I know in western societies, most people wait for FDA approval and lots of research for all medication, which is very sad IMO because they lose out on things that might actually work for them. Sometimes, science gives us blinkers and we readily put them on.

If you're interested, the medicines I'm having are of this institution:

Just for you to get an idea of the specifics, I'm pasting below a list of my medicines with links to pages that describe what they have:
Dhanwanthararishtam: Dhanwanthararishtam - Benefits, Dosage, Ingredients, Side Effects
Rasnasaptakam: back pain lumbar | all about ayurveda.....
yogaraja guggulu vatika: Joint Pain Herbal Treatment - Joint Pain Treatment - Swami Ramdev Medicines - Herbal Treatment For Joint Pain
Sahacharadi Tailam: Sahacharadi Thailam - Benefits, How To Use, Ingredients, Side Effects
Mahamashatailam (for massage. all medicines except this one need to be taken internally): Mahamasha Thailam - Benefits, How To Use, Side Effects, Ingredients

This bunch is not what would work for everybody. One must consult with a Kotakkal Ayurvedic doctor for medicines that they need.

If my post violates any rules of this wonderful forum, please go ahead and delete it.

Take care.

[puma]

As promised, I'm back here to let you know how my back is. I am currently trying out our ancient Indian Ayurvedic medicines, which people have a lot of faith in, in India for centuries and now globally.

I am happy to say that it has been working well for me. I feel stronger and should be able to start driving to work twice a week from the coming week and then of course step it up gradually.

I know in western societies, most people wait for FDA approval and lots of research for all medication, which is very sad IMO because they lose out on things that might actually work for them. Sometimes, science gives us blinkers and we readily put them on.

If you're interested, the medicines I'm having are of this institution: : : : ARYA VAIDYA SALA - Kottakkal : : :

Just for you to get an idea of the specifics, I'm pasting below a list of my medicines with links to pages that describe what they have:
Dhanwanthararishtam: Dhanwanthararishtam - Benefits, Dosage, Ingredients, Side Effects
Rasnasaptakam: back pain lumbar | all about ayurveda.....
yogaraja guggulu vatika: Joint Pain Herbal Treatment - Joint Pain Treatment - Swami Ramdev Medicines - Herbal Treatment For Joint Pain
Sahacharadi Tailam: Sahacharadi Thailam - Benefits, How To Use, Ingredients, Side Effects
Mahamashatailam (for massage. all medicines except this one need to be taken internally): Mahamasha Thailam - Benefits, How To Use, Side Effects, Ingredients

This bunch is not what would work for everybody. One must consult with a Kotakkal Ayurvedic doctor for medicines that they need.

If my post violates any rules of this wonderful forum, please go ahead and delete it.

Take care.

[Maria]

Thank you for returning and letting us know how you are doing and with the use of eastern vs. western medicine.

I could say quite a bit here with regard to the prescribing of medicine in the US but will not because I would go on and on.. so instead will just say that I'm glad to read you're making progress and hope that you will continue to do so.

I am wondering if you are directly under the care of a physician (as in the site you posted) which I take it would a physician that practices Allopathic medicine? Do you have physicians that are licensed as Western medical practitioners and practitioners of allopathic medicine or are they separate usually? If they are separate do the physicians that practice western medicine have respect for those that practice allopathic medicine? If a physician is dually licensed would he or she perhaps prescribe both types of medicine or would one first try allopathic medicine and then prescribe western meds if allopathic ones didn't help?

Thank you for posting the medicines and their contents. I would have to read something these types of medicines to have a better understanding of what they're used for and if there were any conditions they'd be contraindicated in and /or in terms of possible allergens.

Which medicines do you use for what type of pain or to alleviate or help treat which kind of pain or condition with regard to your spine?

thanks again for posting as it's very interesting to bring up a perspective such as this and use of this type of medicine/medical practice.

[puma]

Maria, thanks for your response.

I hope I didn't come across as a person not having respect for Allopathy or Western medicine because I do indeed have immense respect for them. It's just that I'm equally open to other modalities. In my experience, for some conditions, Allopathy is more suitable and for some, other systems.

I'm happy to answer your questions to the extent that I'm able to...

I am directly under the care of an Ayurvedic doctor (called a Vaidya for centuries in India). Nowadays, Ayurvedic doctors typically have go through a course spanning at least four years. I think they do have subjects that might overlap with Western medicine courses, such as Anatomy. Sometimes, heirs of bigger Ayurvedic institutions might also undergo a standard 4-year course in Western medicine, which equips them to suggest x-rays and other diagnostic tests and to also interpret their results but they don't prescribe Allopathic medication. Very often, they suggest that their medicines be considered as complementary to the main Allopathic treatment. Typically (probably all over the world), Allopaths don't recommend any modality other than Allopathy. Because Ayurvedic medication is considered to be less invasive and with fewer side effects, people who believe in them prefer to go to an Ayurvedic doctor first (after diagnosis) and then go to an Allopath.

Incidentally, medical tourism is big in India, particularly Kerala. It attracts Western tourists is huge numbers. They are able and willing to pay very well (way better than the average Indian) and Ayurveda is becoming more and more expensive now, especially the elaborate massage-based treatments.

The medicines I listed in my previous post have been suggested as part of a fairly strict regimen. A couple of them are to be had on an empty stomach twice a day and a couple after meals. I need to apply the oil mentioned at the end, warmed (not in a microwave oven but in a double-boiler or just poured into a heated metal vessel), on my spine half an hour before a bath.

I'd like to add that both the Ayurvedic doctor and the Allopath I met (who is quite conservative and whom I highly respect) had the same main advice for me - which is that I should strengthen my back through exercise, especially swimming.

I hope this helps.

Disclaimer: I am not an authority on Ayurveda, just an appreciative recipient of what it can offer.

[Maria]

I am surprised you could decipher what I was asking as I kept writing allopathy when I meant ayurvedic!

Thanks again for answering my questions (esp. when they must have sounded somewhat ridiculous if not confusing).

Do you have any books or references you would recommend on Ayurvedic practices/medicine? Perhaps something that you would read or use as a guide yourself? Some of the Ayurvedic medicine components you listed sounded like things I've seen in listed in some Homeopathic medicines (which I'm not very familiar with just may have seen in passing looking at labels somewhere).

Core strengthening exercises are generally recommended here to help build strength and support for the spine. Swimming is good and I used to do that on a regular basis for a number of years.

The oil you're using for your back sounds interesting. Again good luck and I hope the ayurvedic practices will work for you and you won't have to employ the use of pharmaceuticals and especially not have to consider surgery if at all possible.

[puma]

Please don't fret that you got some words mixed up! It wasn't really difficult to understand you. My mails also have typos.

I have never tried to study Ayurveda (it's a vast ocean) and don't really have a book that I can recommend. The Internet is full of great resources though for anybody who wants to understand some aspects. I found this site for you - https://www.ayurveda.com/online_resource/ It would probably help you get started. All the best! :-)

Thanks for your wishes. I do still have a while to go before I can say I'm fine but yes, I do feel lucky that I can most likely avoid surgery as of now. This was a good wake-up call for me to start exercising.