What are herniated, slipped, or bulging discs? They are all names to describe a painful condition caused by compression of the cushioning discs of the spine, which can cause radiating pain to various parts of the body. The spine is made up of a stack of individual bones, known as the vertebrae, and in between the vertebrae, there are jelly like discs that support a healthy range of motion in the spine.
As described in more detail by the Mayo Clinic, “a spinal disk has a soft, jellylike center called a nucleus. The nucleus is encased in a tougher, rubbery exterior, known as the annulus. A herniated disk occurs when some of the nucleus pushes out through a tear in the annulus. A herniated disk is sometimes called a slipped disk or a ruptured disk.”
Per the Sanamotion Pilates Institute blog, “in simple terms, a herniated disc occurs when the cushioning jelly oozes out of its original placement (outside of the vertebrae) and touches a nerve, causing pains, tingling feelings, numbness or general weakness in the arms, back and legs.”
Because the disc may be pressing on a nerve which connects to other parts of the body, pain can be experienced in areas outside of the back and often, people may not immediately realize that their pain is related to a spinal issue. For example, in my own personal experience, I felt pain in my hip and glutes which I thought perhaps was muscular (so I kept trying to stretch it out), or a case of bursitis. Only when the pain was so intense that it impaired my ability to walk or stand comfortably, did I consult a physical therapist, who diagnosed me with a bulging disc in my lower back.
However, not everyone experiences symptoms, in which case the issue can advance undetected. This is why it is important to consider Pilates for injury prevention and spine health.
According to the Mayo Clinic, exercise (especially strengthening the muscles in the torso), maintaining a healthy weight, and having good posture can help prevent disc injuries. Pilates can help with all of these things! Especially because some people do not experience symptoms, paying attention to spinal health can reduce the risk of injury.
Disc issues are most common in the lower back and cervical spine. They can be caused by genetic pre-disposition, but they are not a congenital defect. Common causes include age or degeneration, overuse or strain of the back muscles, posture which creates pressure on the discs, (such as frequent driving, being sedentary, or general misalignment), and being overweight.
While some doctors may suggest surgery in very advanced cases, most often the best approach is physical therapy and lifestyle modifications. In rare cases, a large herniated disk might injure nerves to the bladder or bowel. That may require emergency surgery. For nonemergency cases, surgery is an option when other treatments fail. (The Cleveland Clinic). Surgery would involve removal of the disc, or partial removal of the disc. Post surgery, movement is limited during the healing process, and physical therapy may be necessary to strengthen the back. Pilates can be an effective approach to post surgery recovery, as well as a non-surgical approach to relieving a disc issue.
The National Institute of Health published a study in 2022 that found that 6 weeks of clinical Pilates exercise was an effective and safe method to achieve decreased pain and functional disability while improving flexibility and quality of life in symptomatic patients with lumbar disc herniation. According to Lindsay Hirst, a clinical Pilates instructor & physical therapist at yourpilatesphysio.com, “moving the spine and building strength in the muscles that support the spine are all essential when recovering from a disc problem.” The silver lining of my own disc injury was that my physical therapist addressed my need to increase core strength by training on a Reformer. By using Pilates based strength training, I was able to build strength to support my spine and improve posture, as well as use extension exercises to create space as needed to reduce pressure on the surrounding nerves. With this approach and regular Pilates 2-3 times a week, my pain decreased, and has not progressed. As a case study, I might compare my experience to that of my older brother, who encountered disc issues around the same time as me. While we may both be genetically predisposed, and we both did physical therapy, he continued to do exercises that were high impact and very weight bearing in the back, and his symptoms worsened significantly over the course of 3 years. While there are many things that can exacerbate disc issue pain, mindful, low impact exercise such as Pilates can definitely help relieve and prevent it.
Because Pilates workouts promote healthy movement of the spine in it’s four natural directions, a physical therapist or experienced Pilates instructor can suggest exercises that can provide relief from pressure on a bulging disc, or help strengthen the body for better posture and alignment.
Joseph Pilates said, “a man is only as old as his spine”. Pilates offers an effective way to both prevent injury, as well as recover from it. According to the Club Pilates Blog, "Creating a lifestyle involving Pilates will supply a client suffering from herniations or bulging discs with more strength, flexibility, balance, and overall movement. Pilates allows people to use the range of motion that is most beneficial and concentrates on giving members more mobility and energy. Overall, Pilates can help you live with fewer limitations and experience less pain."
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