Slipped Lumbar disk and walking

Patient

Q: I was diagnosed yesterday with a slipped disc, L5. I know I need to rest for a day or two but the consultant also told me to keep moving. I have a horse who also has a bad back and needs to go for walks everyday to build his back muscle up. In particular, walking up and down hills. I wondered if it would be ok to take him (walking him, not riding), and if this might help my back too? What other forms of exercise would you suggest?

Doctor

A:    Before, in the past years, the absolute rest was the rule, but the current trend is that you can do your daily living activities as tolerated without straining the lumbar spine, meaning: that if walking your horse at your own pace does not produce pain or discomfort you can go ahead. Degenerative disc disease produces changes in the vertebrae that along with the bulging disc are causing a nerve compression which is the cause of the pain. The treatment options depend on the age, severity of the pain, neurologic symptoms present and if you have some other associated health issue. The first approach is conservative as a Physical Therapy program aimed to control pain and inflammation along with anti inflammatory medication, if there is no improvement and with time the pain is worse and intractable you should get a re evaluation by an orthopedic surgeon to decide if Surgery might be considered as a treatment option for you.

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