Spinal stenosis is a condition where the opening for the spinal cord or nerves begins to narrow. This is a slow progressive condition, which generally happens in older individuals. There is no timetable for how slowly or rapidly it may progress. Also, there are varying degrees and symptom presentations of the condition. The narrowing of the spinal canal results in compression of the spinal cord or nerves causing the individual to experiencing any or all of the following symptoms: numbness/tingling or heaviness of the legs, intolerance for standing/walking, and progressive decline in walking tolerance.

An individual’s preferred position will likely be sitting where symptoms tend to disappear rapidly. This happens because when one sits, the spine flexes opening more space. This increased space reduces pressure on the nerves or spinal cord and results in reduction or elimination of symptoms altogether. People with stenosis often prefer walking bent over as this creates more space similar to sitting. You will see these folks happily bent over their grocery cart. They may struggle to get through a store without the aide of a cart or sitting frequently. Their intolerance for walking tends to get worse as the condition progresses.

Can anything be done to help individuals with spinal stenosis? The answer in part depends upon how advanced the condition is. However, even in an advanced stage a good manually trained physical therapist has tools to help improve your quality of life. One must be patient with the process as changes are not likely to be immediate. The condition did not develop overnight and will likely take weeks of hard work (both in PT and at home) to reap the potential benefits. Just what are these benefits? This could be anything from standing taller, increased time walking before one gets pain or numbness and even less intense pain.

What if you have had therapy before and did not improve? Unfortunately that happens, but chances are more can be done. A global and active approach to treating spinal stenosis is necessary. Based on research, the old way of treatment just doing flexion exercises and traction has been proven ineffective on its own. In order to get real lasting benefits, restoring spinal and hip mobility must be done in addition to a general strength and conditioning program.

Why the hips? As one walks, your hip must extend past vertical in the late part of the stance phase. This is often lost in older individuals and those with spinal stenosis. It is one reason step length becomes shorter, meaning more steps to walk a familiar distance As a result, the spine compensates for this lost motion by extending which further exacerbates the symptoms. Thus, improving hip extension decreases the amount of spinal extension necessary and consequently will reduce the speed of symptom onset.

So what should you do if you have this diagnosis? You can begin by clicking HERE to get some general guidelines for back conditions like spinal stenosis. Alternatively you can take the next step by scheduling a consult with a manual physical therapist to learn more. The only thing standing in the way of feeling better and being able to stand and walk longer is getting your body moving.

Should you have any specific questions, please reach out to me via phone 717-440-6197 or email andrew@zangpt.com. We can discuss your situation and potential treatment options.