While there is no cure for spinal stenosis, several treatments can help you manage the symptoms and improve your quality of life. One such treatment is physiotherapy. Physiotherapy can help relieve pain, improve mobility and function, and reduce the risk of complications. If you’re considering physio for spinal stenosis, here’s what you need to know.
What is spinal stenosis?
The spinal cord, nerves and arteries are housed by the spine, which acts as a hard-electrical casing to support and protect these vulnerable structures. The spine has a hollow column that allows the spinal cord to run from the brain to the rest of the body. At each spinal segment, nerves exit the spine and supply the body’s tissues. An intricate network of small veins and arteries provides blood to the spinal cord and vertebrae, providing them with the nutrients needed to operate.
Spinal stenosis is characterised by narrowing the spaces that house the spinal cord, nerves, and blood supply. Many factors can cause spinal stenosis; however, it is caused by degenerative changes to the spine as we age. Many people over the age of 60 will have spinal stenosis; however, not all will have pain. Clinically, spinal stenosis is used to describe the painful symptoms of this condition rather than just the narrowing itself.
What are the symptoms?
Pain with walking or standing that radiates into the hips, thighs and even feet is the hallmark of spinal stenosis. Usually, this pain will be reduced with rest and forward movements of the spine. Spinal stenosis is a progressive condition, and symptoms will gradually increase over time. The pain is often described as a deep radiating ache and can be associated with fatigue, heaviness, weakness and numbness. It can affect just one leg; however, it will be felt in both legs more often. There will often be associated back pain; however, leg pain is usually the most severe complaint.
Does physiotherapy help spinal stenosis?
Physiotherapy can be highly beneficial for mild to moderate cases of spinal stenosis. Your physiotherapist can help you manage your pain through hands-on techniques and provide a targeted exercise program based on biomechanical assessment. They can also help you understand and manage your day in a way that helps reduce flare-ups and maintain muscle strength.
Many conditions need to be excluded from a diagnosis. Your physiotherapist can conduct a thorough examination and accurately diagnose this condition. Many people have stenotic spinal changes without symptoms. Surgery to decompress the restricted nerves and stabilise the spine are used in very severe cases.
If surgery is the right choice for you, your physiotherapist can guide you through this treatment pathway, helping you prepare and recover from surgery to get the best outcome possible.
What exercises are good for spinal stenosis?
Exercises that improve range of motion, strength, endurance, and stability are typically part of a successful exercise program for patients with lumbar spinal stenosis. Spine specialists generally advise people with lumbar spinal stenosis to engage in flexion exercises and back-rounding stretching activities. Bending-forward activities/exercises for lumbar stenosis are frequently reported as more comfortable by patients.
Exercises that are low or no impact are good for spinal stenoses, such as:
- Thai Chi
Some exercises are more beneficial to people with spinal stenosis than others. Therefore, it is best to consult with a physiotherapist to help you develop a fitness program tailored to your specific needs. Your physiotherapist can also teach you which exercises and activities to do and those to avoid based on your circumstances.
What activities should be avoided with spinal stenosis?
Patients should avoid high-impact activities such as jogging, contact sports, as well as prolonged standing or walking. Avoid remaining in postures that compress the spine. Additionally, extension exercises (arching your back) should be avoided since they can aggravate spinal stenosis by pinching your spinal nerves.
You should not perform any exercise in the presence of pain or other symptoms. If the activity causes or worsens the symptoms of spinal stenosis, stop immediately and consult with your physiotherapist.
Unfortunately, back pain does tend to return. The primary reason it is thought to reoccur is a lack of rehabilitation. A lack of compliance with exercises targeting deep abdominal and core muscles is especially problematic. Your physiotherapist will help you determine which exercises are best to continue indefinitely. We highly recommend routinely performing these exercises a few times per week.
If you live with lumbar spinal stenosis, know that there is help and hope. A physiotherapy program specifically tailored to your needs may make all the difference in managing your condition and improving your quality of life. Give it a try!