I am 73. I have osteo­porosis, a slipped disc and sci­at­ica in my right leg. I recently had an epi­dural which hasn’t really done much to improve the pain. Can you recom­mend any exer­cises? Would Pilates or any other classes be of any bene­fit?

Our spines aren’t simply there to keep our skel­et­ons upright, they also house and pro­tect much of the body’s nervous sys­tem, which is one good reason why back prob­lems can be dis­pro­por­tion­ately pain­ful. If any part of your back is injured, there’s a high chance that some nerve or other will be irrit­ated or trapped as a res­ult.

“Slipped disc” can give the mis­lead­ing impres­sion that some­thing has lit­er­ally slipped out of place and needs to be phys­ic­ally or sur­gic­ally pushed back in. In real­ity the shock-​absorbing disc is likely to have torn and leaked or bulged out a bit, set­ting off irrit­a­tion of tis­sues and nerves around it, includ­ing that unpleas­ant “sci­atic” pain that can go right down one leg.

It sounds as though your back has been pain­ful for a while. As you have men­tioned that you have osteo­porosis, you and your GP need to be con­fid­ent that the source of your pain is indeed a slipped disc, rather than a spine frac­ture. I am sure this will have been checked out, so now may be a good time to try some self-​help in the form of exer­cise.

Here are two simple strength­en­ing exer­cises you can do at home. They are not guar­an­teed to cure your pain, but are worth a try (it may be some weeks before you feel any bene­fit).

Lower stom­ach: lie face down on a mat, towel or rug, your head rest­ing on your hands. Give a little cough and when you feel your lower stom­ach muscle (below the tummy but­ton) tighten, suck it upwards hard, ima­gin­ing you are pulling it up to your spine. Hold, count to 5, then relax. Try this 10 times every morn­ing and even­ing. Each week increase the length of hold by 5 seconds, until you can hold the muscle for 30 seconds or more. It is extremely import­ant that you teach your­self to breathe nor­mally while you are hold­ing the muscle in, which may be hard at first. Click here for the full exer­icse

Back: Lying face down, place your palms on the floor, fin­ger tips point­ing for­wards, just wide of your ears. Elbows should be neatly in by your sides. Breathe in and as you breathe out, push down with your hands and try to lift your chest off the ground, eyes down so you do not move your neck back­wards. Hold the pos­i­tion as high as you can (it may only be a few cen­ti­metres off the ground at first), count 5, then care­fully lower down. Repeat 10 times. Do this exer­cise three times a week. Click here for the full exer­icse

With your par­tic­u­lar con­di­tions I would not sug­gest a gen­eral Pilates class, but some one-​to-​one “clin­ical” Pilates ses­sions may be another way of help­ing to ease your pain.