Spinal Stenosis
What is spinal stenosis? Let’s start with the term stenosis. Stenosis simply means a narrowing of a canal. When a canal in our body narrows, this can disrupt or irritate the tissue travelling in that canal. For our lumbar spine, we are talking about our central spinal canal (the canal made by our vertebrae where our spinal cord travels or our Cauda Equina, the terminal nerves of our spinal cord) or the lateral foremen made by our vertebra where our lumbar nerves travel after branching off of our spinal cord.
The narrowing of the lumbar spine is most often related to degeneration, otherwise known as wear and tear or Osteoarthritis. As our discs, ligaments, and other tissue wears down, the space between our discs narrows. This can lead to a folding of ligaments (like ligamentum flavum) and osteophyte growth (boney outgrowth from our vertebra) can lead to narrowing of both our central and lateral canals. Once our cord or nerves are compressed, this can lead to symptoms such as tingling, burning, numbness, weakness, and pain in the low back, buttocks, and legs. These symptoms are most commonly brought on by upright posture (such as standing or walking). As we stand up straight, the shape of our canal is in a less open position than when we are bent forward like biking (hence why patients with stenosis sometimes find cycling easier than walking or running).
One thing to note is the commonality between hip degeneration and spinal stenosis. Both of these conditions can cause hip pain so it is always important to have a healthcare provider look into both your low back and your hip. You can have both stenosis and hip Osteoarthritis (this is known as hip-spine syndrome).
With spinal stenosis, patients often see this condition in their parents or their grandparents before being diagnosed. Although stenosis may not be hereditary, having a more narrow spinal canal to begin with or having more aggressive degeneration are linked to hereditary causes which can lead to an earlier stenosis diagnosis.
Unfortunately there is no cure for spinal stenosis, not even surgically. Surgery can improve leg symptoms but can lead to further complications down the road. Conservative care can help with pain, walking ability, and overall function in both the short and long term follow up. Treatment for spinal stenosis includes education, manipulation, mobilization, soft tissue therapy, strength and stretching exercises, needle acupuncture, and medications.
When looking at adding exercise, consider adding some stretches such as ones that target quadriceps, psoas, hip flexors, and erector spinae. You also want to add strengthening exercises for muscles like your abdominals. Finally, you want to keep up your overall fitness and your lower extremity conditioning by adding something like cycling into your fitness routine. For further information and detail, consult a licensed healthcare practitioner familiar with evidence-based rehabilitation for stenosis.
The best thing you can do for your stenosis is to participate in your healthcare plan and stay active (even with a little pain, within reason). If you experience any pain at rest, loss of bowel/bladder function, sudden progressive weakness, unexplained deformity, swelling or redness of the skin, fever, chills, feeling ill, pain at rest, sudden inability to do normal activities, or unexplained weight loss or loss of appetite you should contact your healthcare provider.
For more information on stenosis check out www.spinemobility.com or www.ccgi-research.com or email hello@madetomove.ca with your questions! Stenosis can be challenging due to its degenerative nature, but with the right support team, you can lead a very full and active life.
