Disc disease and a weighted vest: Still a good idea?

I just posted a blog about how walking/hiking with a weighted vest can be an integral part of helping to stabilize bone density with those who suffer from Osteopenia or Osteoporosis.  However, I received a great question,

“ Hi Ed, I have degenerative disc disease in my spine. I get some intermittent nerve symptoms in my left leg L4-5,S-1 distribution and I’m thinking it’s due to the disc disease with some nerve compression. My question is whether a weighted vest would be advisable with degenerative disc disease.  I don’t want them to be squished anymore than they already are. But on the other hand, I don’t like the idea of osteopenia, thanks”

Like many things in medicine, the answer is complicated and lies somewhere in the middle.  For example, as a Physical Therapist, we were taught the importance of how to lift to avoid back injury, “use your legs to protect your back”.  Pretty standard advice and it makes sense at a certain level. However, if you look at the literature, flexing or stooping to lift is not a significant risk factor for back pain.  What is more important are other factors such as overall level of fitness and strength, flexibility, age, how many times will you be lifting and at what frequency.

The body needs “stress” (weight) to develop stronger muscles, bones, ligaments, and tendons, that is the magic of exercise.   The lack of stress or load can be damaging to muscles of the spine as studies on astronauts discovered that significant paraspinal muscle mass was lost during a long-duration mission in microgravity and was not recovered following return to Earth.  Lower back pain is a common complaint of astronauts after their return to Earth and a loss of paraspinal strength is the suspected cause.

Back to the above asked questions, I would still consider using a weighted vest as a way to increase spinal muscularity, bond density,  and balance, but I would do so very carefully, with a thought out plan.

Guidelines for using a weighted vest for those with spinal stenosis or disc disease:

  1. Read my introductory article on using a weighted vest for increasing bone density.
  2. Do not start using a weighted vest if you are currently experiencing an acute episode of back or leg pain. Resolve the current issue and try to get back to “baseline” first.
  3. Make sure you have already started to  strengthening the multifidus muscles of the lumbar spine by doing specific core exercises.
  4. When you do start to wear your vest, make sure you start slowly, 4-6 lbs at the most, in order to give your body a chance to adapt to the new “stress”. Your goal is about 10-15% of your body weight.
  5. The weight needs to be equally distributed in the front and back
  6. Walking or hiking up and down hills may be more challenging, seek out flatter terrain when first starting out with your vest.
  7. If you do experience an increase in pain, try to reduce the weight in your vest and do not increase the weight until you no longer experience the increased levels of pain.

 

I hope this clarifies the issue, but please let me know if you have any additional questions,

Ed Deboo, PT

Integrative Physical Therapy,

Bellingham, WA

 

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