Back pain can make all sorts of physical activities nigh unbearable. Whenever back pain flares-up considerably, our first instinct is to give ourselves a rest. While that is by no means a bad idea, it does become counterproductive at some point: our bodies tend to become shaped by what we do with them, and a lack of activity can often exacerbate causes of back pain, and make flare-ups more common rather than soothe them.
On the other hand, doing the wrong thing can greatly impact how back pain develops, and make a bad situation worse. In cases of spinal stenosis exercises, there is often a fine line between good activity and bad activity – but where good movement can greatly improve strength and stability, bad movement can lead to greater pain, and even surgery. Differentiating between the two is important.
What Is Spinal Stenosis?
Spinal stenosis refers to a significant narrowing of the spinal column. While some narrowing in the spinal column is normal, and part of the natural idiosyncrasies of the human body, any amount that begins to put pressure on the spinal cord itself can lead to flare-ups and significant pain, as well as a reduction in range of motion, lack of strength, and accompanying numbness.
Spinal stenosis can be caused by several issues, some of which are fixable through spinal stenosis exercises and a diligent lifestyle change, and some of which require a more invasive approach due to their irreversible nature. The spinal column itself is made up of bones called vertebrae, connected via spongy impact-absorbing discs, and small stabilizing facet joints. Other elements of the spinal column include ligaments, attaching to important muscles throughout the back and hips.
Changes in the bone itself, inflammation in the ligaments and discs, and injuries can all cause a narrowing of the spinal column, thereby compressing the nerves inside. If a radiologist and spine specialist has ruled out any kind of bony protrusion or removable growth, chances are that injury and/or inflammation contributed to your stenosis. It’s in such cases that certain activities can greatly help reduce pain and swelling – while others can serve to exacerbate it. Some spinal stenosis exercises and activities to consider avoiding or stopping altogether include (but not limited to):
1. Avoid Excessive Back Extension
One of the more common stretches we tend to engage in after a long period spent sitting or hunching over is the standing back extension, or more aptly, the standing lumbar extension. It involves standing up straight, putting your hands on your hips, and leaning back as far as you can. In a few cases, this type of compression on the back of the vertebrae may help make space for the spinal cord by pushing some inflamed tissue out of the way.
However, in most cases, it leads to worse symptoms and more pain. If you tend to experience more pain and numbness following a back extension, try to avoid that stretch – and more importantly, try to avoid any activity that causes your back to go into excessive extension, i.e. anything requiring you to bend over backward. The increased compression can make inflammation worse.
2. Avoid Long Walks or Running
Some spinal stenosis exercises are important, but too much – or the wrong kind – can be detrimental to your pain. While jogging and running are generally seen as an “easy” exercise and associated with low- or mild-impact, jogging and running usually qualify as high-impact exercise, especially if you don’t have access to a soft or loamy trail, but are instead forced to run on pavement.
The repeated trauma to the knees and spine is less than ideal. On the other hand, walking for long periods of time – or long distances, instead – can also exacerbate back pain. Consider starting with shorter, tolerable distances, and make modest increases in pace and distance without breaking into a jog.
3. Avoid Certain Stretches and Poses
The previously mentioned back extension exists in a variety of common poses and spinal stenosis exercises, including the cobra, the bridge, most lower back exercises involving hyperextension (such as the Superman), and more. While it is certainly a good idea to strengthen the muscles of the lower back, it is far better to avoid spinal flexion or extension when doing so. Instead, look at isometric exercises that revolve around stabilizing the back, and keeping it stiff against an outside force.
4. Avoid Loading a Rounded Back
Free weights can be a great boon to someone with back pain, provided they are working with a professional and have received prior clearance from their doctor. Certain exercises can greatly strengthen the muscles that support the spine and make it easier to maintain a healthier posture in a variety of activities and positions. Free weight exercises can also help you address unilateral imbalances in your body, such as uneven strength in the legs, hips, shoulders, and arms, which can translate into more back pain.
But when performed incorrectly, free weight exercises can easily lead to injury. One such example is any exercise requiring hip hinging, from bent over rows and flies to the deadlift. Any rounding in the back can greatly destabilize the muscles around the spine, and cause shearing forces to impact the spine, affecting the discs. Be sure to work your way up in difficulty and weight one step at a time, to avoid any excessive force on the back.
5. Avoid Too Much Bed Rest
It’s tempting to lay in bed whenever possible, but too much bed rest will only serve to atrophy your muscles and place further strain on your back and contribute to inflammation. Staying active can help you reduce pain and improve your quality of life, at the cost of a few minutes a day spent sweating and moving.
6. Avoid Contact Sports
While it’s good to get active, try to stick to sports that avoid sudden impact and contact. Martial arts, football, basketball, and soccer are just some examples of sports where healthy training can very quickly lead to a sudden tear or fracture, especially when you come into physical contact with others.
Spinal Stenosis Exercises and Activities to Do More Of
Spinal stenosis is a serious spinal condition that requires a medical diagnosis and a course of treatment. But when that course of treatment permits the use of physical therapy and exercise as a preferred alternative to something potentially more invasive, there are many options available to you depending on the nature and severity of your condition. Some things to consider include:
1. Consult a Physical Therapist
First and foremost, you should get in contact with a reputable physical therapist with a history of working with patients with back pain, especially spinal stenosis. They may be able to help you find spinal stenosis exercises or activities that suit your interests and circumstances.
2. Strengthen the Core and Hips
Building a strong base for the spine is important when approaching an exercise plan. Strengthening the muscles of the core and hips without compromising the integrity of the spine is key. Planks, side planks, unilateral carries, lunges, and gentle twists are just some examples of spinal stenosis exercises that could greatly improve strength without putting the spine in a position that might lead to more pain.
3. Consider Swimming and Water Exercise
Training in the water can help take the stress off the spine and joints, and it provides a way for some patients to get moving and get some endorphins flowing through them without putting undue stress on arthritic joints and a painful back. Spinal stenosis is a condition that requires medical treatment first and foremost but may be helped considerably by observing a few physical dos and don’ts.
Related
FAQs
What exercises should be avoided with spinal stenosis? ›
- Cobra stretch.
- Piriformis stretch.
- Standing extension stretch.
Hyperextension Stretches
However, stretches and poses involving hyperextension can worsen the condition. Cervical stenosis exercises to avoid include spinal flexion and extensions. In moderation, they may help, but they can also increase pressure on the nerves and result in permanent damage.
Spinal stenosis symptoms tend to worsen the more you walk without treating it since the leading cause is a contraction of the spinal cord, which irritates the leg nerves. The irritation of the terms causes inflammation, and so this should be part of the treatment.
Can exercise aggravate spinal stenosis? ›If you are in pain from spinal stenosis, you probably don't even want to think about exercising. However, as counterintuitive or impossible as it sounds, exercise, stretching, and movement can help relieve your spinal stenosis pain. Exercise, stretching, and movement can help relieve your spinal stenosis pain.
How do you prevent spinal stenosis from getting worse? ›- Get regular exercise. Exercise strengthens the muscles that support your lower back and helps keep your spine flexible. ...
- Maintain good posture. Learn how to safely lift heavy objects. ...
- Maintain a healthy weight.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). If common pain relievers don't provide enough relief, prescription NSAIDs might be helpful.
- Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline, can help ease chronic pain.
- Anti-seizure drugs. ...
- Opioids.
As you've discovered, spinal stenosis does sometimes make it extra painful to walk uphill or climb stairs. Both of those activities cause you to lift your leg higher than normal, and depending on where your nerves are being pinched, this movement can put more pressure on the nerves.
What is the best sleeping position for spinal stenosis? ›Many people with spinal stenosis find the most comfort sleeping on their side in “fetal position” — that is, with knees curled up toward the abdomen. Another alternative is to sleep in an adjustable bed or recliner that allows the head and knees to remain elevated.
How do you sit with spinal stenosis? ›When sitting, avoid leaning forward, make sure there is proper lumbar support for the inward curve of the low back, and keep both feet flat on the ground.
What is the best treatment for spinal stenosis at L4 and L5? ›One of the most effective treatments for treating lumbar spinal stenosis is a procedure called laminectomy. This treatment removes part of the vertebra that's putting pressure on your nerve.
What is the main cause of spinal stenosis? ›
The most common cause of spinal stenosis is wear-and-tear changes in the spine related to arthritis. People who have severe cases of spinal stenosis may need surgery. Surgery can create more space inside the spine. This can ease the symptoms caused by pressure on the spinal cord or nerves.
Can you reverse spinal stenosis naturally? ›While spinal stenosis can't be reversed, treatment is available to address your pain.
Is massage good for spinal stenosis? ›Several types of massage are excellent for alleviating the symptoms of spinal stenosis. Deep tissue massage can help to release built-up tension in muscles, tendons and ligaments, greatly releasing the pressure on the spine.
What stretches are good for spinal stenosis? ›Top 5 Lumbar Spinal Stenosis Exercises & Stretches - Ask Doctor Jo
Does spinal stenosis ever get better? ›Spinal stenosis can't be cured but responds to treatment.
"Unfortunately, nothing can stop the progression of spinal stenosis, since it is due to daily wear and tear," said Dr. Hennenhoefer. "The symptoms of spinal stenosis typically respond to conservative treatments, including physical therapy and injections."
The most common surgery in the lumbar spine is called decompressive laminectomy, in which the laminae (roof) of the vertebrae are removed to create more space for the nerves. A neurosurgeon may perform a laminectomy with or without fusing vertebrae or removing part of a disk.
How does spinal stenosis affect the bowels and bladder? ›Lumbar spinal stenosis, a condition characterized by a narrowing of the spinal canal in your lower back, can also cause back pain, weakness or numbness in your legs, and loss of bowel or bladder control.
What are the symptoms of L4 l5 stenosis? ›Common symptoms of lumbar spinal stenosis include low back pain and lumbar radiculopathy. Widely known as sciatica, lumbar radiculopathy is pain, numbness, weakness, and/or tingling that radiates from the low back down into the buttocks, legs, and calves.
What foods are good for spinal stenosis? ›- Healthy Proteins such as lean meats, fish, eggs, and tofu are great selections as they play an important role in healing and also repairing and maintaining bone and cartilage.
- Calcium is a mineral that plays an important role in maintaining strong bones as you age.
- Nonsteroidal Anti-inflammatory Drugs. Nonsteroidal anti-inflammatory drugs—commonly called NSAIDs—relieve pain by reducing inflammation of nerve roots and spine joints, thereby creating more space in the spinal canal. ...
- Corticosteroids. ...
- Neuroleptics.
What nerves are affected by L4 and L5? ›
The sciatic nerve consists of the L4 and L5 nerves plus other sacral nerves. Your sciatic nerve starts in your rear pelvis and runs down the back of your leg, ending in your foot.
Is heat or ice better for spinal stenosis? ›Heating over tight muscles in the lower back is often an effective way to achieve relief from spinal stenosis pain, as heating relaxes the muscles. Heating the affected area stimulates blood flow, which promotes and accelerates the healing process.
Can a chiropractor help spinal stenosis? ›Chiropractic adjustments are a natural, non-invasive way to help stenosis that's aggravated or caused by a spinal misalignment. Manual adjustments can correct vertebral misalignment and disc displacement so that the facet joints, ligaments, back muscles, and bones experience less stress.
Is swimming good for spinal stenosis? ›“Swimming and other aquatic activities are great for spinal stenosis because you use the buoyancy of water to your advantage,” Dr. Bolash explains. “Water workouts are easier on the spine and all the joints. At the same time, the resistance in the water helps you strengthen your muscles.”
How do you decompress a spine while sleeping? ›Lie on your back, and bend your knees slightly, putting a pillow beneath them at a 30-degree angle to support your lower back and decompress the spine. Add a pillow to support your neck and keep your head in a neutral stance.
Is CBD oil good for spinal stenosis pain? ›Cannabidiol (CBD) has also been observed to have anxiolytic, anti-inflammatory, antiemetic, and antipsychotic behaviors. CBD may provide greater nonsurgical treatment options for the pain associated with spinal stenosis while minimizing the need for opioids.
What are the symptoms of L5 nerve damage? ›A pinched L5 nerve root usually results in radiating pain in the foot. This pain can come in the form of numbness, tingling, weakness and shooting and is commonly felt in the big toe, inside of the foot, top of the foot and ankle. Radiculopathy of the L5 nerve may also cause loss of coordination in the foot and toes.
What vitamins help with spinal stenosis? ›Eating foods rich in calcium, vitamin D, and magnesium is the best way to build strong spinal bones and prevent debilitating health problems, such as spinal fracture and osteoporosis.
Is lying down good for spinal stenosis? ›Spinal Stenosis
With this condition, it may be preferable to sleep on the sides with the knees curled up (in the fetal position). This helps relieve pressure on the nerve root. Sleeping in a reclining chair or an adjustable bed that allows the head and knees to remain elevated can also relieve pressure on the nerve.
Recliner Chair
For example, people with pain from lumbar spinal stenosis or degenerative disc disease often will feel most comfortable in a reclined position with feet propped up on a footrest. For these people, one option may be to use a recliner while working.
Is Climbing stairs good for spinal stenosis? ›
As you've discovered, spinal stenosis does sometimes make it extra painful to walk uphill or climb stairs. Both of those activities cause you to lift your leg higher than normal, and depending on where your nerves are being pinched, this movement can put more pressure on the nerves.
Can you do squats with spinal stenosis? ›– Lower body exercises:
initially exercises like leg press, wall squats, leg extension and leg curl should be able to be performed as the lumbar spine is supported.
Most beneficial are flexion exercises such as situps, which bend the spine, Mr. Hagen said. "These are helpful because they open the space in the spinal canal and the lateral foramin." Swimming and water exercises are very good, too, Dr.
What stretches are good for spinal stenosis? ›Top 5 Lumbar Spinal Stenosis Exercises & Stretches - Ask Doctor Jo
Is massage good for spinal stenosis? ›Several types of massage are excellent for alleviating the symptoms of spinal stenosis. Deep tissue massage can help to release built-up tension in muscles, tendons and ligaments, greatly releasing the pressure on the spine.
Is heat or ice better for spinal stenosis? ›Heating over tight muscles in the lower back is often an effective way to achieve relief from spinal stenosis pain, as heating relaxes the muscles. Heating the affected area stimulates blood flow, which promotes and accelerates the healing process.
How do you fix spinal stenosis without surgery? ›- Nonsteroidal Anti-inflammatory Drugs. Nonsteroidal anti-inflammatory drugs—commonly called NSAIDs—relieve pain by reducing inflammation of nerve roots and spine joints, thereby creating more space in the spinal canal. ...
- Corticosteroids. ...
- Neuroleptics.
The most common cause of spinal stenosis is wear-and-tear changes in the spine related to arthritis. People who have severe cases of spinal stenosis may need surgery. Surgery can create more space inside the spine. This can ease the symptoms caused by pressure on the spinal cord or nerves.
Can a chiropractor fix spinal stenosis? ›Chiropractic adjustments are a natural, non-invasive way to help stenosis that's aggravated or caused by a spinal misalignment. Manual adjustments can correct vertebral misalignment and disc displacement so that the facet joints, ligaments, back muscles, and bones experience less stress.
Can you reverse spinal stenosis naturally? ›While spinal stenosis can't be reversed, treatment is available to address your pain.
How do you strengthen your core for spinal stenosis? ›
- Lay on your back with your knees bent.
- Slowly roll your pelvis backward as if you were flattening out your spine. Hold this position for 3 seconds.
- Slowly return to the starting position.
- Repeat 10 times.
Lumbar spinal stenosis, a condition characterized by a narrowing of the spinal canal in your lower back, can also cause back pain, weakness or numbness in your legs, and loss of bowel or bladder control.
How do you sleep with spinal stenosis? ›Spinal Stenosis
With this condition, it may be preferable to sleep on the sides with the knees curled up (in the fetal position). This helps relieve pressure on the nerve root. Sleeping in a reclining chair or an adjustable bed that allows the head and knees to remain elevated can also relieve pressure on the nerve.
Exercises to relieve and treat lumbar spinal stenosis pain are usually flexion-based (forward-bending). This position opens up the constricted bony canals, decompressing the nerve root(s) and enabling patients to perform the exercise more efficiently with lesser pain.
Why does leaning forward help spinal stenosis? ›In spinal stenosis, people typically experience less pain with leaning forward, and especially with sitting. Studies of the lumbar spine show that leaning forward can increase the space available for the nerves. Pain is usually made worse by standing up straight and walking.
Is stationary bike good for spinal stenosis? ›Spinal stenosis: For patients with spinal stenosis, leaning forward on an upright exercise bike (rather than a recumbent bike) is an ideal form of aerobic exercise, as they tend to feel more comfortable flexed forward rather than sitting or standing up straight.