What Is Spinal Stenosis?
Spinal stenosis is a 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 lower back.
The most common causes of spinal stenosis are 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 as they exit the spinal canal.
Normal aging and wear and tear can result in a flattening of the discs that provide space between each set of vertebrae. This narrowed space allows less room for the nerve to exit from the spinal cord, and sometimes pieces of disc material cause pressure on the nerves.
Spinal injuries, diseases of the bone (such as Paget disease), 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 and other conservative treatments. Only the most severe cases of spinal stenosis need surgery or more aggressive treatments.
Signs and Symptoms
Spinal stenosis may result in such symptoms as:
- Pain, numbness, tingling, or weakness in your arms and shoulders, legs, or trunk
- Occasionally, problems with bowel or bladder function
If you have spinal stenosis in the neck, you may have weakness, numbness, and pain in the arms and often in the legs, depending on which nerves are affected. You might not have any pain in the neck itself.
If you have spinal stenosis in the lower back (lumbar spinal stenosis), you might have pain, numbness, and weakness in the lower back and legs, but not in the arms. Your symptoms might get worse with walking and improve with sitting.
How Can Physical Therapy Help?
Your physical therapist’s overall purpose is to help you continue to participate in your daily activities and life roles. The therapist will design a treatment program based on the evaluation and your personal goals. The treatment program likely will be a combination of exercises.
Relieve Pain and Increase Movement
Your therapist will design:
This might sound like a lot of exercise, but don’t worry: research shows that the more exercise you can handle, the quicker you’ll get rid of your pain and other symptoms.
Your physical therapist also might decide to use a combination of treatments:
Research shows that in all but the most extreme cases (usually involving muscle weakness or high levels of pain), conservative care, such as physical therapy, has better results than surgery.
Can this Injury or Condition be Prevented?
Spinal stenosis usually is a natural result of aging. Research has not yet shown us a way to prevent it. However, we do know that you can make choices that lessen the impact of spinal stenosis on your life and even slow its progression:
- Regular exercise strengthens the muscles that support your back, keeps the spinal joints flexible, and helps maintain a healthy body weight. All of these factors help reduce the wear and tear on the spine.
- Using supportive chairs and mattresses and avoiding activities that can lead to injury—such as heavy lifting—can help protect your back.
Your physical therapist can help you develop a fitness program that takes into account your spinal stenosis. There are some exercises that are better than others for people with spinal stenosis, and your therapist can educate you about what you should avoid. For instance, because walking is usually more painful than sitting, bicycling may be a better way for you to get regular physical activity. Trunk strengthening exercises often need to be modified to avoid movements such as backward bending that might cause extra pressure on the nerves.
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