Spinal stenosis is the narrowing within the vertebrae of the spinal column that results in too much pressure on the spinal cord (central stenosis) or nerves (lateral stenosis). Spinal stenosis may occur in the neck or in the low back.
The most common cause of spinal stenosis is related to the aging process in the spine. Osteoarthritis is a deterioration of the cartilage between joints. In response to this damage, the body often forms additional bone (called "bone spurs") to try to support the area. These bone spurs might cause pressure on the nerves at the point where the nerves exit the spinal canal.
Normal aging can result in a flattening of the disks that provide space between each set of vertebrae. This narrowed space allows less room for the nerve to exit from the spinal cord.
Spinal injuries, diseases of the bone, spinal tumors, and thickening of certain spinal ligaments also may lead to spinal stenosis.
In most cases, symptoms of spinal stenosis can be effectively managed with physical therapy. Only the most severe cases of spinal stenosis need surgery or spinal injections.
Spinal stenosis may cause symptoms such as pain, numbness, tingling, or weakness in your arms and shoulders, legs, or trunk. Depending on where in the spinal stenosis is occurring, it could result in bowel or bladder dysfunction.
If you have spinal stenosis in the neck (cervical spinal stenosis), you may have weakness, numbness, and pain in one or both arms and often in the legs, depending on which nerves are affected. You may or may not have pain in the neck.
If you have spinal stenosis in the low back (lumbar spinal stenosis), you may have pain, numbness, and weakness in the low back and one or both legs, but not in the arms. Your symptoms may get worse with walking and improve with sitting.
In order to overcome spinal stenosis, the first common-sense recommendation is to take a short break from activity causes radiating pain. This allows for an environment for the irritation to settle down. If pain is persistent, hands-on therapy may be effective to achieve faster pain relief. When the pain subsides, you have the opportunity to address the root causes of what is worsening the radiating pain.
The way to know what is contributing to your pain is to have an assessment performed. In many cases, lumbar stenosis is correlated with inadequate strength of the hip muscles, core, and lumbar spine. Cervical stenosis can be correlated with inadequate of the lats, scapular stabilizers, and thoracic spine. In addition, technical errors during exercise, may lead to faulty spine mechanics and create an exacerbation of pain.
If there is weakness, learning activation exercises to engage muscles that are not firing well is key. Deep neck flexor endurance exercises are crucial for those that suffer from cervical stenosis. Abdominal and lumbar flexion exercises are important for those who have stenosis of the lumbar spine. Examples of these exercises can be found in our video library.
Once pain is controlled and muscles engage better, the next step is learning how to generate tension at the low back, core, and hips with resistance exercise. Practicing movement patterns like the push, pull, and hinge are necessary to develop strength. A strong spine will prevent spinal stenosis from interfering with an active life.
When addressed with a specialized physical therapy program, overcoming spinal stenosis is possible. However, ignoring pain may result in a more serious spine condition. If you have concerns about spinal stenosis, the physical therapists at Movement Solutions would be glad to be a resource for you.
We have a free guide on relieving back pain that can give you further insight into back problems and help kickstart your recovery. We are available for a free 15-minute phone consultation to talk about how your pain is affecting you and discuss your treatment options.
If you’re considering physical therapy, each month we offer a limited number of back pain consultations. This is an opportunity to ask questions, obtain clarity about your back pain, and foster confidence that we can help you. If you want help with your SI problem, request your consultation today.
If you’re in pain and unsure about what your next steps should be, call us at (864) 558-7346 and ask how we can help.