I suf­fer from cer­vical spon­dyl­osis. I joined a small gym, doing car­dio and weights, but after a couple of months my neck pain worsened and I star­ted get­ting pins and needles in my arm and leg. Since I stopped the gym my pain is less but I am put­ting on weight and feel leth­ar­gic. Can you advise?

Your spon­dyl­osis (a kind of neck arth­ritis) is a com­mon con­di­tion of age­ing, the res­ult of degen­er­a­tion and abnor­mal bony growth on the neck ver­teb­rae. Because the spinal cord is closely packed at the neck, it is easy for nerves to get irrit­ated, caus­ing symp­toms such as the pins and needles.

Anyone with a health con­di­tion or dis­ab­il­ity needs to be very choosy about their gym mem­ber­ship. Although things are chan­ging, gyms are still mainly set up for “healthy” people who want to get fit, rather than people with med­ical con­di­tions. Indeed, every­one who joins any gym should be asked to fill in a health ques­tion­naire, and to get GP clear­ance for any con­di­tions you declare.

This is not just a form­al­ity. Basic train­ing for gym instruct­ors does not cover med­ical con­di­tions, so these staff are not com­pet­ent to advise you on your gym pro­gramme.

Follow this advice before you sign up with any gym:

• Ask if any instruct­ors are qual­i­fied in “exer­cise refer­rals” or “gym for dis­abled people”
• Ask whether the suit­ably qual­i­fied instructor will be avail­able to carry out your induc­tion and set up your train­ing pro­gramme, and then check your pro­gress and change your pro­gramme every couple of months

If the gym can­not guar­an­tee this, try else­where.

You could take a dif­fer­ent approach, though. For instance:

• hire a suit­ably qual­i­fied per­sonal trainer (they still need the same cer­ti­fic­ates men­tioned above) to work with you at home. As this is more expens­ive, you might only be able to afford them for three months, but they could set a home-​exercise main­ten­ance pro­gramme, and then you would pay them for a couple of updat­ing ses­sions every three months there­after
• seek out a “thera­peutic pil­ates” stu­dio where you can get one-​to-​one ana­lysis and exer­cise instruc­tion, prefer­ably by a pilates-​trained physio or advanced exer­cise trainer. Again, this is expens­ive, but the very spe­cific strength­en­ing work you do and the follow-​up advice should enable you to return to a gym or home exer­cise routine, con­fid­ent you are not going to worsen your pain.

Try to con­tinue car­di­ovas­cu­lar train­ing, whether at the gym or at home. A sta­tion­ary bike with a back­rest may work best, or try tread­mill walk­ing (start gently and build up) – or a mini-​trampoline (rebounder), which can be an excel­lent home car­dio altern­at­ive.

Keep away from weight train­ing until you have had spe­cific instruc­tion in strength­en­ing your neck muscles, along­side mobil­ity and stretch work for your neck, shoulders and mid-​spine. If cor­rectly tar­geted, this may help relieve your day-​to-​day pain. You should also tar­get abdom­in­als and low-​back work to help your over­all pos­ture against the com­bined effects of your desk job and neck con­di­tion.