Inside the ‘hidden epidemic’ that’s paralysing under-50s – as woman, 35, reveals true cost of common crippling condition
BACK pain is long seen as something that comes with age.
It starts in your 30s, worsens in your 40s, and is simply a given once you hit 50.
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But disc herniation - a crippling and debilitating condition - can negatively affect the young, as Ruchi Bhuwania Lohia discovered aged 35 when simply getting dressed for work.
Then an office worker, she remembers: “It was March 2018 and I froze because I had shooting pains from my hip going down my right leg.
“I didn't really know what it was because I hadn't experienced anything like that before.
“It wasn't an injury, I didn't have a trauma or a fall, but I couldn't stand straight.
“I was just hopping around in my flat. I was in quite a lot of pain. I didn't quite know what was going on.
“I managed to get a massage therapist to look into it and then I went back to work. But over a period of a couple of weeks it continued to trouble me.”
Ruchi thought she had simply pulled a muscle so she visited a physiotherapist for help.
“I needed them to tell me what was actually wrong with me,” she says.
“When I searched my symptoms online, I figured out that perhaps I was experiencing sciatica, though I didn't really know what that was back then. I don't think I'd even heard the word.
“But it turned out that the sciatica was basically a symptom of what I was actually experiencing - an impinged nerve.”
Ruchi saw a consultant who carried out an MRI which revealed a herniated, or slipped, disc - when some of one of the rubbery cushions that sits between the bones that stack to make the spine pushes through a tear in the outer layer.
It’s something typically associated with older people, though it can happen at any stage of life.
Dr John Burke, chief medical officer at AXA Health, says: “In general, the risk of spontaneous disc herniation increases as we age as our spinal discs naturally deteriorate and lose flexibility.
“However, it can occur at any age, and younger people are just as susceptible, especially as the main cause is inactivity and sitting for long periods of time.”
It can be so agonising, the NHS lists slipped discs as one of the 20 most painful health conditions you can suffer from.
Ruchi says: “My consultant was quite shocked actually at how I was even standing because it was a large herniation and according to the scans, they thought I should have been in a lot more pain than I was.
“I generally have a high pain threshold, so I was still able to somehow get myself moving.
“I think I just sort of kept dealing with it, but it was nowhere like the nerve pain I then started experiencing.
“It just happened very suddenly, and the pain quickly increased in intensity.”
I could not comprehend what doctors were saying. I kept thinking they had mixed up my scan with somebody else's report
Ruchi Bhuwania Lohia
For 12 weeks, Ruchi tried physiotherapy and hydrotherapy, as well as steroid injections, to try to ease her pain.
But instead of dissipating, her discomfort only worsened.
“I tried to nip it in the bud, but it actually got worse,” she says.
“When you have nerves that are impinged, you can only really wait a maximum of 12 weeks otherwise you risk permanent damage.”
She was told she would need surgery on her back, which left her feeling confused and scared.
“I was absolutely terrified at the prospect, and I think the fact that it was spontaneous also meant I wasn't prepared,” she adds.
“I could not comprehend what doctors were saying because I just could not believe it.
“I kept thinking they had mixed up my scan with somebody else's report.”
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Ruchi had the procedure in May 2018 and, thankfully, it was a success.
She then began a nine-month rehabilitation process, which was when she started to embrace the wellness world.
Ruchi adopted several lifestyle tweaks, such as strength training and diet alterations, to help keep herself pain free.
This included muscle-building mobility exercises, particularly focused on the lower back and pelvic region, such as hip raises, side kicks, donkey kicks and weight squats.
These were so successful, she even climbed a mountain in Oman - something she could never have imagined months earlier.
“I think had I known how strenuous the trek was going to be, I probably wouldn’t have gone through with it,” Ruchi says.
“I would have constantly worried that my back was going to snap at some point.
“But when I came back and I was fine, I thought, ‘OK, actually, you know what? I think I’ve healed’.”
She adds: “I think once you encounter something like this, you understand a little bit more about the mechanics of the body.
“When you have a disc herniation, you basically need to have the muscles to keep everything in the body where it’s supposed to be to support your skeletal system.
“That’s something I understand now far more than I did before.
“This whole saga was the turning point in my life because prior to it, I worked in finance and it’s when I changed career and retrained as a nutritionist for four years - and that’s now my job.”
Using what she learnt during her studies, as well as during her recovery, Ruchi has overhauled her life.
If your back pain never subsides, or if it's getting progressively worse, despite putting practices in place to try and ease the pain, then book an appointment with your GP who will be able to guide you on the next steps.
It’s also wise to see your GP if the pain is disrupting your day-to-day life or if the pain is sharp and radiating into others areas of the body, as this could potentially indicate something more serious.
Back pain is very common. Physiotherapist Sammy Margo, part of the expert hub behind Mind Your Back, previously told The Sun it is usually injury to a muscle or ligament.
She said: “These strains may occur for many reasons such as poor posture, improper lifting [including during exercise] or being too sedentary and not having enough exercise."
But back pain with chest pain is a good reason to seek urgent medical help.
It could be the sign of a heart issue or heart attack.
The signs of a heart attack are chest pain, and pain that can spread to other parts of the body, including the back, feeling lightheaded or dizzy, shortness of breath, sweating and nausea.
If you have back pain plus any of these symptoms, don’t delay - call 999 or go to A&E.
Sudden loss of bladder or bowel control (unable to hold it in) is another red flag that the NHS says you should call 999 for.
Cauda equina syndrome, when nerves of the spinal cord are compressed, can cause numbness of sensation in the buttocks — as well as genitals — and incontinence.
Meanwhile, in men, lower back pain could potentially be a sign of prostate cancer.
Other symptoms of prostate cancer include blood in the urine, abdominal pain, difficulty urinating and needing to pee more often.
Men should see their GP if they have these symptoms or are worried about their risk factors for prostate cancer: Use this online risk tool.
Meanwhile, kidney stones can cause agonising back pain, and you should phone NHS 111 if the pain is severe or if you have blood in your urine. Otherwise, see your GP.
“When I came out of rehab I used the tricks I'd learned with the physio, but then also nutrition and lifestyle to help me recover,” she says.
“I think I had to really dig deep in the months preceding the surgery to withstand and to cope with the pain.
“I have made sure that I've continued with my strength training. I try to do that three to four times a week.
“Posture is very important especially when we’re lifting heavy things, so I’m extra careful about that too.
“I also changed my diet - reducing my gluten and dairy intake and increasing my omega-3, and I think synergistically that’s all had an impact.”
Crucially, Ruchi wants everyone to know that they could be at risk, but there are steps you can take to lower your chances - and ways of overcoming issues if they do arise.
In her mid-30s, she knows she didn’t fit the typical profile of a herniated disc patient, but she says it can happen to anyone.
Even now, she shudders at the thought of what she went through, but insists there is hope.
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“When I first went to see the specialist and they saw my MRI scan, they said that I didn't fit the profile because I was generally in good health,” she says.
“I was in good shape, I was leading an active life in terms of exercise and movement outside of my work, and I was just on the cusp of my 36th birthday.
“But I was in a lot of pain. I couldn't believe that human beings could encounter that kind of pain and also withstand it; it was absolutely debilitating.”
Now in her 40s, Ruchi, who runs Wellness with Ruchi as a registered nutritionist and workplace wellbeing specialist, says she is doing everything she can to remain well and not end up back where she was - and she implores others to do the same.
“I'm going to do everything I can not to have to go down that path again,” she says.
“I don’t want to feel that pain ever again; I wouldn’t wish it on anyone.”
Recent figures from the Office for National Statistics show 2.9million people in the UK have problems with their back or neck - up from 2.6million in 2019.
It's one of the leading causes of disability, and musculoskeletal conditions are the third most common reason for working days lost.
Herniated discs affect about one in 1,000 people every year in the UK, according to Amersham Chiropractic Clinic.
Lower back pain is the most common symptom, but other signs include: numbness or tingling in the shoulders, back, arms, hands, legs or feet, neck pain, problems bending or straightening your back, muscle weakness, and pain in the buttocks, hips or legs.
If left untreated, it can lead to nerve damage, loss of bladder and bowel control, and in severe cases, permanent paralysis.
But many people suffer in silence, leading some experts to describe the dire situation as a hidden health crisis or epidemic.
Dr Burke says: “Spinal discs provide soft cushioning to the spine, providing shock absorption and flexibility.
“Spontaneous disc herniation is a condition where the soft tissue between your spinal vertebrae begins to rupture or herniate.
“Because it occurs without any direct injury or trauma to the spine, it can be hard to directly pinpoint the causes.
“However, there are some common factors that can increase the risk of it happening.” These include:
- Ageing
- Exercising too hard
- Lifting heavy objects the wrong way
- Sitting down or driving for long periods of time
- Being inactive or overweight
Dr Burke adds: “While ageing is a cause, it’s not just older generations that can experience this condition, as injuries and inactivity are also factors, which younger people can encounter.
“Therefore, when diagnosing younger people, factors other than ageing need to be considered to avoid under-diagnosis among younger sufferers.
“Lifestyle factors such as activity levels, stress, genetics, weight and posture can increase the risk of spontaneous disc herniation for all ages, therefore it is crucial to take early precautions to protect the spine and maintain a healthy lifestyle.”
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