Lumbar stenosis is a result of lumbar spine degeneration and resultant narrowing of the foramen (holes) that the spinal nerves exit from in the lumbar spine. This condition can cause significant functional limitations, such as decreasing the time able to stand and walk without symptoms. Possible symptoms include leg weakness, pain, numbness or tingling in the legs, with or without a complaint of back pain. Many patients complain of a heaviness felt in their legs with weight-bearing, with symptoms worsening the longer they are on their feet.
Lumbar spine degeneration causes boney changes to the vertebrae that decreases space for the spinal nerves as they are about to exit the spine and travel down the leg. In the lumbar spine, normal curvature of the spine includes slight concavity (swayback). Excessive swayback posture further decreases the hole for the exiting spinal nerves, which can contribute to increased symptoms. Other conditions in the body can also cause excessive swayback posturing in standing/walking, which includes hip and knee stiffness, sacroiliac hypomobility, as well as other spinal stiffnesses (in the thoracic and lumbar spine).
Physical therapy for lumbar stenosis is a great first-line intervention to help improve function and decrease stenotic symptoms. A physical therapist helps identify the regions of the body that are affecting the patient’s lumbar spine. Exercises are designed to promote positions which open up the spinal foramen and relieve spinal nerve pressure. Treatment to the other body regions which are contributing to the patient’s symptoms help further improve biomechanics, which can help with the long-term success of treatment. The exercises are tailored specifically for the impairments identified for each patient. Manual therapy, including joint mobilizations and manipulations, helps improve joint mechanics, and is a good addition to specific exercise for treating spinal stenosis.
Exercises which feel good for patients with spinal stenosis are ones which improve the pressure on spinal nerves and decreases the excessive swayback in the lumbar spine. They are good for short-term relief, and should be used as needed to help improve symptoms associated with spinal stenosis.
Child’s Pose Stretch
Double Knee-To-Chest Stretch
Sitting Forward Trunk Flexion Stretch
Posterior Pelvic Tilting on your back
These should be performed at least 3x/day for 5 reps of 10 seconds. Physical therapy is individualized for each patient, and the exercise program will be tailored to reflect those individual findings identified in the examination process.