Lumbar stenosis is the narrowing of the spinal canal in your lower back. The narrowing can put pressure on the spinal cord and nerves. It most commonly occurs in those over the age of 50. It can be caused by wear and tear, injuries, and age-related changes such as degenerative discs, ligamentous thickening, or spinal arthritis.
Symptoms can include chronic lower back pain that may radiate into the buttocks or legs. Numbness, burning, fatigue, weakness, and heaviness may occur in the legs. Symptoms are aggravated by standing and walking.
Sitting or bending forward when standing decreases the pain. Many will find leaning forward on a shopping cart decreases the pain and allows them to walk longer in stores. Those with stenosis may find sleeping on their sides in the fetal position is more comfortable than sleeping on their back.
Surgery has not been shown to be significantly better than non-surgical treatments, so it is best to try conservative methods such as chiropractic first. Chiropractic treatment goals include restoring mobility, improving function, and decompressing nerves. Forceful adjustments may increases symptoms for those with stenosis so it is important to use gentle adjustments. Flexion-distraction is a low force adjustment that has been proven to increase the area in the spinal canal during adjustments, which takes the pressure off the nerves.
A study comparing the effectiveness of nonsurgical treatment methods in patients with lumbar spinal stenosis looked at 3 nonsurgical interventions. Medical care consisted of medications and/or epidural injections provided by a physiatrist. Group exercise classes were supervised by fitness instructors in senior community centers. Manual therapy/individualized exercise consisted of spinal mobilization, stretches, and strength training provided by chiropractors and physical therapists. The care provided by the chiropractors and physical therapists resulted in greater short-term improvement in symptoms and physical function and walking capacity than medical care or group exercise.1
In addition to in-office care it is also important to do at-home exercises. Water aerobics and exercise bikes are tolerable for those with stenosis. The following stretches can help provide relief for lumbar stenosis. It is best to consult your doctor before beginning any exercise routine. Stop immediately if the stretch causes an increase in your symptoms.
This article is for education purposes and is not intended to replace diagnosis or treatment by a healthcare provider.
Sean Flynn, DC
Sioux City, IA Chiropractor