What is spinal stenosis?

 We see lots of patients with a condition called spinal stenosis, which refers to the narrowing of the canals within the spine. Physiotherapy can be really useful for this painful condition, so here we discuss more about the symptoms and how we can help!

Spinal stenosis is a condition where the spaces within the spine become narrower, placing pressure on the nerves traveling through the spinal column. This issue commonly affects the cervical (neck) and lumbar (lower back) regions and can lead to various symptoms that disrupt daily activities. Gaining a clear understanding of spinal stenosis is essential for managing its effects and enhancing quality of life.

What are the symptoms of spinal stenosis?

The symptoms of spinal stenosis depend on the location and severity of the narrowing. Common symptoms include:

• Pain: Typically felt in the neck or lower back, often radiating to the arms or legs.

• Numbness or tingling: Usually occurs in the hands, arms, feet, or legs.

• Weakness: Muscle weakness in the arms or legs, which can impact balance and co-ordination.

• Cramping: Leg cramps, particularly after prolonged standing or walking.

• Reduced mobility: Difficulty walking or standing for extended periods due to pain or discomfort.

What causes spinal stenosis?

• Degenerative changes: Age-related wear and tear, such as osteoarthritis, may result in bone spurs that narrow the spinal canal.

• Herniated discs: Bulging or ruptured discs can compress the spinal cord or nerves.

• Thickened ligaments: Ligaments within the spine may thicken over time, contributing to narrowing.

• Congenital conditions: Some individuals are born with a naturally narrow spinal canal.

When should I seek help for spinal stenosis?

While some mild symptoms may improve with self-care and rest, there are certain warning signs that should prompt you to seek professional medical help. These include:

• Persistent pain: If you’re experiencing ongoing pain in the neck, back, arms, or legs that doesn’t improve with rest or self-care, it’s essential to consult a specialist. Chronic pain can indicate worsening spinal stenosis and may require targeted treatment.

• Numbness or tingling: Sensations of numbness or tingling in your arms, hands, legs, or feet that interfere with daily activities should not be ignored. These symptoms may suggest there is some nerve compression caused by spinal stenosis.

• Weakness: Noticeable weakness in your arms or legs, especially if it affects balance or coordination. Muscle weakness can be a sign of nerve damage and requires professional evaluation and advice.

• Difficulty walking: If pain or discomfort makes it challenging to walk or stand for extended periods, it’s time to seek medical attention. These mobility issues can significantly hinder your daily life and may worsen without treatment.

• Loss of bladder or bowel control: This is a medical emergency. If you experience sudden loss of control over bladder or bowel function, seek immediate medical help from your local A+E department. This could indicate a serious condition known as cauda equina syndrome, requiring urgent intervention.

Is surgery a good option for spinal stenosis?

Surgery may be an option for spinal stenosis if conservative treatments, such as physiotherapy and medication, fail to provide adequate relief or if symptoms severely impact your quality of life. The goal of surgery is to alleviate pressure on the spinal cord or nerves and restore function. Common surgical procedures include:

• Laminectomy: This involves removing part of the vertebra (the lamina) to create more space within the spinal canal, reducing pressure on the spinal cord or nerves.

• Foraminotomy: In this procedure, the foramina (the openings through which nerve roots exit the spine) are widened to relieve nerve compression.

• Spinal fusion: This surgery involves joining two or more vertebrae to stabilize the spine, often used when spinal instability accompanies stenosis.

The decision to pursue surgery should be made in consultation with a healthcare professional. Factors such as the severity of symptoms, overall health, and individual preferences play a critical role.

How can physiotherapy help spinal stenosis?

Physiotherapy is a key component in managing spinal stenosis, focusing on relieving pain, improving mobility, and enhancing overall functionality. Here are some ways physiotherapy can assist:

1.   Pain Management: Techniques such as manual therapy, heat therapy, and electrical stimulation help reduce pain.

2.   Strengthening Exercises: Specific exercises target the muscles supporting the spine, improving stability and reducing strain.

3.   Flexibility and Stretching: Stretching routines enhance flexibility and alleviate tension in muscles and ligaments.

4.   Posture Correction: Training in proper posture and body mechanics minimizes stress on the spine.

5.   Functional Training: Exercises simulating daily activities improve functional mobility and independence.

What exercises can I do for spinal stenosis?

1.   Bridging

• Lie flat on your back with your knees bent.

• Engage your abdominal muscles by tightening them.

• Lift your hips off the ground until they align with your knees and shoulders.

• This exercise strengthens the glutes, hamstrings and core and supports the lower back.

2.   Cat-Cow Stretch

• Start on all fours, with your wrists under your shoulders and knees under your hips.

• Inhale, arching your back like a "cow," lifting your chest and dropping your belly. Look up slightly.

• Exhale, rounding your back like a "cat," tucking your chin and pulling your belly button towards your spine.

• Repeat these movements, flowing with your breath. This stretch enhances spinal flexibility, eases back tension, and boosts spinal mobility. 

How we at First Line Physio clinic can help?

At First Line Physio, we are committed to offering personalised care for individuals living with spinal stenosis. Our experienced physiotherapists provide comprehensive assessments to create customised treatment plans tailored to your specific needs and goals.

We offer a variety of services, including:

• Manual therapy to alleviate pain and improve mobility.

• Exercise programs designed to strengthen and support the spine.

• Education on managing symptoms and maintaining progress at home.

Our team is here to help you manage your symptoms effectively and regain your quality of life. Whether you seek pain relief, enhanced mobility, or guidance on managing your condition, we are with you every step of the way.

This is absolutely not written to substitute medical advice and it is always important to see a qualified healthcare professional for a formal diagnosis. If any of the exercises cause pain during or after the exercise, discontinue and consult a physiotherapist.