Bad Back

[Anonymous]

Anyone ever wear a back brace while backpacking? I have a L5-S1 herniated disc that causes me issues (lower back where spine meets the sacrum). I am starting physical therapy on it soon but was wondering if anyone ever backpacks with a brace on or can recommend ways to minimize discomfort while backpacking. Thanks.

[Max Dilthey]

Not sure, but those packs that put 1/2 the weight on your front seem to get really good reviews for reducing back strain.

Someone here remembers the name.

[Mole J]

I had the same problem (L5 S1) years ago and still have chronic problems in the area/SI joints and Hip abductors. I wore(wear) a brace for work then (and occasionally now) but was advised by my chiropractor and physio not to wear it all the time. I never used it for walking – ever.

I found the things that helped:

1) Treatment, Physio -inc. traction. Plus Some Chiropractic and Dry Needle therapy

2) Valium (low dose helped control spasms – I had to ask for it after getting advice, but after a brief discussion my doc agreed to prescribe – it really helped)

3) Walking poles. Used the proper way with the straps. (i.e. points mostly kept behind you as you walk on general terrain – keeps you upright and helps lift that lower back.) When bad I needed them all the time just to stand up and walk. for several days. :(

4) Walking walking walking (not sitting which always makes it worse for me)

5) Lighter pack!

6) Short and Long term for strength and recovery: Regular Yoga (Iyengar style is more focussed on anatomy and precise alignment. Not a jumping/flow style – too dangerous for those with back issues/less suppleness/strength/understanding/ability) Pilates is good too)

[Daryl and Daryl]

I herniated a disk in my lower back about 5 years ago. Currently gives me no problems when backpacking. Here's what I do, in no particular order, that I think may be helping me.

(1) I go to the gym every day and include every physical therapy exercise that was shown me when I initially had the problem and got pt. I plan to do this the rest of my life. I'm 68 years old.

(2) I use a myog pack that places all the weight on the waist belt and the waist belt wraps around me below the previously herniated disc.

(3) I also use a myog front pack so I'm not straining forward to keep my load balanced.

(4) I wear and load the backpack so the majority of the weight is below my shoulders. I don't want a pack with a high center of gravity because it tends to move side to side and irritate the injured area. This is particularly important when I'm off trail, on irregular trails, going up and down trail stairs or climbing up ropes.

(5) I cinch up the backpack shoulder straps and front bag straps tightly when I'm in conditions and for the same reasons as described in # 4 above.

(6) I have learned to move differently on a day to day basis so I don't strain the previously injured area.

(7) If I feel any soreness in the area I back off, ice it and take aspirin or ibuprofen.

(8) I avoid situations where I can't do #7 (i.e. going at someone else's pace or distance).

(9) I shoot for something like 8 miles or 4 hours (whichever comes first) of hiking per day when backpacking. If I do more I do it at my option and only if I feel like it.

[Lee Oz]

I cannot comment on the use of a brace but I have a herniated disc. Some time ago, it would cause me to be stuck in bed for a few days, rolling to my side would be a 3 steps-10 sec process and any effort to get up and walk around would cause excruciating pain. I would zombie-walk my way to the supermarket to feed myself (scaring kids in the process). Since then I got a minor surgery (not advocating it, of course) and I feel better but still go through the same routines because the stiffness and soreness do come back.

I took up yoga and exercise lightly at home with a handful of moves (pilates, PT or weights) targeting the lower back muscles group. Always be mindful to have good postures when using adequate weights. Then stretch once home and ice it if sore/stiff.
When kayaking/canoeing, I always stretch for a few minutes before and after the effort. At the end of the day, if possible, I'll immerse in the water to cool off the lumbar region.
When backpacking, same stretching routine before and after. If walking downhill or on rocks, I'll try my best to walk in a 'soft' manner, avoiding 'stomping' the ground at each step, sending vibrations through my spine.

This is not a fun condition, having in the back of your mind the fear that you could be in a terrible pain in a few days, but there are ways to contain the outcome. I hope you find yours.

[Valerie E]

Unfortunately, I have 2 herniated and 2 bulging discs (L3,4,5 and S1).

Physical therapy is probably the best option (needless to say, be very careful to get a good therapist – they are NOT all the same). They will give you exercises to strengthen your "core" (learn to love the Plank), and that WILL help.

The other thing is to make ABSOLUTELY sure that you have the lightest backpack possible — WITH the most support possible. This means no frameless packs, and taking a lot of time to try out different framed packs with actual loads, until you find one that really conforms to your lower back as closely and comfortably as possible. A brace would just get in the way.

However, if you want to keep hiking/backpacking at a relatively high level (longer mileage days, faster pace), you'll be facing some pain, inevitably. I rarely go above 15 miles/day because the pain (even with Alleve) is simply not worth it at that point.

But to me, getting out and doing (most of) the stuff I love to do is worth dealing with some pain.

Maybe one day, they'll develop some good artificial discs…

[Dena Kelley]

I have a herniated disc in my lower back. I was totally disabled for a while. With a combination of acupuncture, stretching, and back strengthening exercises I am pain free and fully mobile on most days. The key for me is to not get lazy about my stretching and strengthening. It's easy to forget when I feel good, but when I forget is when I start having problems. If I do what I should every day- and watch how I lift- I have no problems.

[Ito Jakuchu]

"Not sure, but those packs that put 1/2 the weight on your front seem to get really good reviews for reducing back strain."

Those are Aarn Bodypacks

[David Maxwell]

I've been in the same boat for years. I've even gone through three back surgeries. .. Before I got my pack weight down the best thing while on the trail for me was stretching before and after. The other biggest help was using an external frame pack. I still use that pack 50% of the time. I'm ready for a new lighter weight pack and I keep coming back to Zpacks arc blast. It seems that this would help the same as my old external, just a lot lighter.

[Sam Farrington]

Very informative thread. About Daryl's second item:

"(2) I use a myog pack that places all the weight on the waist belt and the waist belt wraps around me below the previously herniated disc."

I've found the best way to get the weight off the back and onto the hips is the design perfected by Jack Stephenson from his Jackpack. There are two sidearms on the pack that wrap the belt around the crests of the hipbones. Most of the pressure is on those crests, and very little if any on the small of the back and front points of the hip bones. An older MYOG model looks like this:

Have been working on a much lighter model made of Easton 340 tubing and elbows, and will post it on MYOG when done and tested. Really miss using my old jackpacks, but as several point out, it is absolutely essential to minimize the weight when there are back problems, so hope to get the new and much lighter pack done soon.

[Marc Kokosky]

Also have a couple of bulging discs in my lower back, near my sacrum. As others have mentioned, being proactive about it and keeping your core strong and flexible are key.

First, as an immediate measure, if you haven't already, get injections. They are a series of 3, given every 2-4 weeks. They/re basically epidural injections where they'll inject cortisone directly into the sacrum and in the discs (I think?) This will take care of most of the immediate pain and swelling.

Follow up with physical therapy to treat lingering issues

And then make yoga part of your weekly routine. I do it 2-3 times a week now. Coupled with regular stretching and exercise it will make a world of difference in your long-term back health.

If it starts to act up, take a few OTC ibuprofen or aspirin and you should probably be OK.

Good luck!

[Jennifer Mitol]

Ok all. You knew it was coming…so now I chime in. I apologize in advance if I step on toes…I honestly don't mean to.

First of all, wait on the injections. Several huge studies have just come out that says they are no better than regular physical therapy for your back, especially for chronic issues. I do sometimes recommend them to my patients, but ONLY if what we are doing is not helping.

Secondly, go to physio and make sure your PT actually does hands on treatment. No hot packs, no ultrasound, no electrical stuff…it's all garbage. Yes people will swear it helped them, but there are plenty of randomized controlled trials out there that show they are no better than placebo. You will do just as well sitting on the couch watching Oprah. Will people here swear that's what fixed them? Yep. But that's correlation, not cause-effect – they would have gotten just as better without it. And why not try, you ask? Because it takes time and attention away from the interventions we know to be effective (joint mobilization and manipulations, and very specific exercise).

People here do a great job of telling you the exercises they do to get better – that's great. But every back is a bit different…and while walking may have felt great for one group of people with "herniated discs," it may completely aggravate another group whose MRIs look identical.

Since you are going to a physio – listen to him/her, and make sure the PT is a good one (there is a boatload of crappy treatments for back pain out there).

Do NOT NOT NOT ever wear a back brace. Our bodies are inherently lazy and if a muscle doesn't have to work it won't. When you wear a brace, all the core muscles of your back and your abdomen turn off. Completely. So every time you take it off your body has to re-establish all those connections between your brain and the core (which is a tenuous connection for most of us)…and there is a strong likelihood that it won't turn back on sufficiently. There is actually a great deal of literature about construction workers who wear braces while lifting heavy objects – their rate of back injury is actually higher than their counterparts.

As for backpacking – everyone here who mentioned dropping pack weight is right. Pack weight, body weight…all of it. The less downward forces through your spine the better it will feel and the easier it will be to control your core.

Good luck mate….

[Sunny Waller]

This has been my experience..I use to lead backpacking trips using my gear. I discovered that some backs liked packs with stays in the frame sheet..others liked the molded "s" curve..my back loved the padded frame sheet without stays or the molded "s" curve like you find in some Granite Gear packs. I hurt my back and was not able to backpack anymore. After reading Ray Jardine's book I decided to try out some of his suggestions and they worked for me. I am able to backpack with light weight if I do not use a hipbelt. I started out by pulling the hip belt off my Granite Gear Pack…now I have a custom Zpacks Blast with a pad pocket on the inside. Some other people I know with bad backs are crazy about Osprey packs. Your mileage WILL vary. If you live near an REI or an outfitter with a variety of packs go load some up with about 10 lbs and try them on..you back will tell you what it likes. Pay attention to the features on those packs..the frame sheet..the shoulder straps..the hip belt..ect. From there you may be able to find a light weight pack that works for you. good luck

[Anonymous]

Thanks for all the replies, this has been very helpful

[Derrick White]

I have one severely herniated discs and several bulging discs in my lumbar spine. All are pressing to the posterior, which means my daily exercise includes arching backwards. It was explained to me by the therapist the backward arching compresses the back of the spine and opens the front, which pushes the disc forward, reducing the bulge, and containing the herniation. In practice this works and I have gone from being bedridden for 3 months 3 years ago to hiking last month with a 60lb backpack for 8 days, doing approx. 30Km a day off-trail in the wilderness.

In fitting and carrying my pack (HMG Porter 4400)I focus on a posture which keeps my back straight or even arches it backward a little. Using trekking poles causes me to arch forward and this aggravates my condition so I avoid them when possible. I carry the load on my hips as much as possible and rarely tighten my shoulder straps fully unless I am crossing a river or doing other tedious movements where a shifting load could cause a fall.

Most important for me when backpacking is to ensure that I do not spend a lot of time sitting on the ground or bending over as this aggravates my back and increases the likelihood of injury once loaded.

I realize the coping techniques of others may not confirm this approach, but it works splendidly for me.

Derrick

[Jennifer Mitol]

Never mind.

Too snarky sounding and I didn't mean that.

[Sam Farrington]

Jennifer,
Not snarky, maybe a little pedantic. But this pot is not going to call kettles black.
After suffering all last winter with sciatica, confirmed as a bulging disc on an MRI, and doing daily exercises, the only way I could function at all with the pain was by doses of diluted Cobra venom extract, which I resorted to only from utter desperation, and because I knew my doctor would not prescribe opiates. Then I had one corticosteroid injection to the site of the bulging disc. Pain gone. Problem solved. Did go back 6 weeks later for another injection at the advice of the specialist, and did continue the exercises for several months.

My doctor's approach appeared similar to yours, as he only referred me for the injection when nothing else worked. From the whole experience, I don't think that, like many maladies, these disc issues are very well understood by medical science.
I did note that most of the patients getting injections when I did had beer bellies and looked like regulars at our local biker bar. And while I seldom use alcohol at all anymore, I did have occasion to twice drink excessively not long before the sciatica began.

So I don't think there are any clear rules with this problem. Each of us has to try all options and see what works best. And avoid self-destructive behavior.

[David Maxwell]

Hmmmm …. Liqour seems to help my pain ;)

[Worth Donaldson]

I have the same problem. After I blew it the third time I had to receive injections to walk. I now go to the chiro, gym and have lost 60 lbs. By the end of the day I can feel the slight burn in my butt and thigh. Going light and wearing a proper fitting waist belt makes a difference. When my back tires I will loosen the belt and briefly use a tump line to give my back a rest. Lack of sleep is probably my number one aggrevator besides sitting with my legs extended in a driving position.

[Eric Blumensaadt]

I have "moderately large L-4 & L-5 disc hernias".

MY SOLUTIONS

1. Lighter pack base weight – natch.

2. core strength building physical therapy & coontinuing home training/therapy program (Strong ab muscles are very important to support your back.)

3. inversion table (Works for me but maybe not for you. Each case is different.)

4. Good hipbelt and intelligent use of all harness straps.

5. LUCK in not having further inuries.

[BPLwiia]

I'm experiencing horrific pain as I author this email. So I understand what you're going through. It happens infrequently but is brutal.

For me, I have lightened the load tremendously. A ZPacks Blast pack with front pouches which help to distribute weight to the front. It really does help alot.

I try to reduce every ounce possible.

[VA S]

Hello – new to the forum here, so please forgive me if I step on any toes but your post compelled me to get off my butt and join (have been reading and learning for ages, thanks to you all)>

I hike with a back brace on – sometimes two! I have a congenital birth defect and have had two surgeries so far (need at least 2 more). My back doctor does NOT support my hobby, lol. But, it gets me through my hikes, that get me through life.

I agree, that in general back braces are not a good substitute for physical therapy; exercise to strengthen the 'core' is the only thing that TRULY helps me, in the sense of trying to be strong and having less pain. But, when in an 'acute' phase ibuprofen and braes get me thru the pain and inability to walk.

I have tried to bp without a brace and within an hour I am incapacitated and in increased (VERY severe) pain and find I can not function (cant work, walk, etc). With a brace I on can do 10-15 mile days for a weekend trip once a month.

Well, I can go on and on but, for me, it makes it so I can enjoy something that brings me great joy, that I could not experience otherwise. Good luck – no fun trying to figure it all out.

[Author]

Posts