7 Exercises For Your Spinal Stenosis, Lateral Stenosis & Why You Have Sciatica
Do you have Spinal Stenosis or Lateral Stenosis causing lower back pain and sciatica?
Do you get leg pain that gets better when you use a shopping cart or when you sit down?
Have you been told that there is nothing you can do about spinal stenosis except for surgery?
In this issue of Bodi Empowerment.com I will go over the meaning of spinal stenosis, lateral stenosis, why you might be feeling leg pain, and finally seven exercises that are helpful for spinal stenosis.
Typically if you have spinal stensosis you have more pain with standing, which can give you pain down one or both legs to your feet. Your pain is often, relieved with sitting.
The reason the pain goes away when you sit is that, the sitting position bends your spine forwards and opens up the space for the nerve in your back thus un-pinching your nerve.
What is Spinal Stenosis: Definition
Spinal stenosis is pinching your spinal cord or your spinal nerve (nerve that comes out between vertebrae). Your spinal canal (Green ) – the opening or tunnel formed by your vertebrae, gets narrowed squeezing your spinal cord.
Image you are in a cave. It’s like one wall or more walls of the caves slowly starts closing in on you. You are the spinal cord and the walls of the cave are the spinal canal. Similarly nerves from your spinal cord get squeezed as your spinal canal gets smaller and smaller with age.
Lumbar spinal stenosis is spinal stenosis that happens in the lower back or lumbar spine.
Why Do I have Spinal Stenosis Or Lateral Stenosis?
The quick answer is degeneration of your spine also called osteoarthritis. For a more detailed explanation click on the links below.
Osteoarthritis essentially causes 4 things to happen.
#1 Disc Herniations: Disc Osteoathritis >>Disc Herniation>>Stensosis
Your doctor might have told you that you have Degeneration of the disc, osteoarthritis or Degenerative Disc Disease. (DDD) They all mean the same thing essentially. Osteoarthritis makes the disc weaker.
Your disc is made of the nucleus and annulus. Like a doughnut the nucleus is the jelly and the annulus is the doughy part. The annulus (doughy part) becomes weakened and cracked. With cracks and fissures the nucleus (jelly) starts to bulge out of the disc and eventually pushes through all of the layers of the annulus.
A bulging or protruded disc will make the spinal canal or vertebral foramen (hole between vertebrae for your spinal nerve) narrower contributing to spinal stenosis.
Sometimes when the nucleus herniates right through the annulus causing spinal stenosis all on its own. Most of the time the spinal cord gets squeezed from two or more sides.
# 2 Facet Osteoarthritis: DDD>>Facet>>Stenosis
Facets are part of the vertebrae that make up the joints in your spine. [Picture above] Facet Osteoarthriris is the wearing out of your facets seen on the right side of the picture above. Osteoarthritis causes more pressure to be put on your facet joints. With more pressure the joint wears out faster. To stabilize all this wearing out of the joint the bone starts to grow bigger and sometimes forms spurs.
The spurs start to grow bigger and bigger until they push on the spinal cord or spinal nerve.
# 3 Ligamentum Flavum>>Stenosis
Your ligamentum Flavum is simply a ligament that is found in-between vertebarae. (Red in the picture above) Your ligamentum flavum becomes thickened from osteoarthritis. Your ligament thickens narrowing your spinal canal eventually pinching the spinal cord.
Spondylolithesis is when your vertebrae slips forward. Most of the time your vertebrae is fractured putting pressure on the nerve. The fracture can happen when you have a fall or get in a car accident but quite often it’s also from degeneration we talked about before.
Degeneration will cause enough wear and tear near the back of the vertebrae. Like a rope rubbing over rocks with enough pressure the vertebrae eventually snaps. You may or may not have pain at this time.
Quite often you have pain when the vertebrae slips forward. When the vertebrae slips forward enough the tunnel for the spinal cord gets smaller. Again it’s like one side of a cave you are in closes in on you.
What Treatment Helps Spinal Stenosis?
For spinal stenosis you should always get conservative care first before embarking on surgery except in the most serious cases.
In a 10 year study of patients with spinal stenosis most patients got relief within 3 months of starting conservative care, although for some it took up to 1 year. After 4 years, excellent or fair results were found in half the patients with conservative therapy (therapy other than surgery), while four fifths of the patients getting surgery got the same results. After 10 years things didn’t change much.
If you have 1/2 a chance of getting better within 3 -12 months while avoiding surgery it is worth the effort as surgery has complications.
Exercises For Spinal Stenosis
Walking is great for spinal stenosis. You probably would answer that you have pain if you walk 100 m (100 yards approximately) distance at which point you have to stop and sit down for a minute before you can go on.
The problem is you need to change your posture while you are walking or standing. If you are already in a cane or walker it would be more difficult but it is possible to change your posture.
Normally you want to have a ideally curved arch in your lower back. Not too much and not too little. When you have spinal stenosis the opening between spinal canal is narrowed or the vertebral foramen (hole between vertebrae) is narrowed.
With spinal stenosis you should strive for no arch or very little arch in your lower back to increase the space for your nerves.
How Do You Increase The Narrowed Space In Spinal Stenosis?
You can either stay in the flexed position while you are walking, like when using a cane, walker, shopping cart or you can decrease the arch in your lower back.
Decreasing the arch in your back puts your lower back in a slightly flexed or bent forward position. This opens up the space for your spinal cord or your nerve root (nerves that comes out between vertebrae).
These exercises are helpful for mild to moderate spinal stenosis. If you have severe spinal stenosis it may still be helpful but it will not likely give you full relief.
The first two exercises are to designed to help you give relief from walking and are designed to be the basis for the next set of exercises.
#1 Pelvic Tilt While Sitting
The picture is of a person while lying down the but the movement is exactly the same.
- While sitting in a chair put your hand in the arch of your lower back.
- Push into your hand by pulling your tummy in, and pulling your buttock up slightly for a count of 10 seconds at first.
- Gradually increase the count to one minute.
#2 Pelvic Tilt While Standing
Once you get good at this exercise while walking, you can do this exercise when you feel pain. You should feel an immediate difference. The problem is you probably won’t be able to hold this position for long.
To get longer lasting relief you need to change your posture. Once you have changed your posture you will be able to go for longer walks.
- Stand up with both feet shoulder width apart.
- Put your hand behind the arch of your lower back
- Push back against your hand just like you did while sitting holding for a minute or as long as you can.
Change Your Posture For Walking and Standing
A: Arch Your Lower Back Like The Cow Pose in Yoga – Stretch your low back erector spinae (low back muscles).
- Get on all fours with your hands under your shoulders, your knees under your hips.
- Arch your upper back and lower back like a cat does when it’s scared.
- Hold for 30 seconds – do 3 sets.
- If you have a disc problem, or it hurts to arch and flex your back, this exercise is not for you.
A: Child Pose: Second stretch for your low back erector spinae (low back muscles).
- Get on your hands and knees.
- Sit back onto your heels with your arms reaching out as far as they will go.
- Your head is looking down – neck down.
- Hold for 30 seconds – do 3 sets.
A: Lunge Pose: You need to stretch the hip flexor muscles (psoas muscles)
- Get down on your knees.
- Put one leg forward with the knee bent to 90 degrees.
- Other leg is back with the knee very slightly bent resting on the floor.
- You should feel the stretch in the front part of your hip.
- Hold for 30 seconds and do 3 sets.
Second, strengthen your gluteus maximus (your butt shaping muscle) and abs (your rectus abdominis muscles or six pack muscles)
I will give you two exercises to strengthen your gluteus maximus. The squat and the single leg squat.
B: The Chair Squat To Strengthen Your Gluteus Maximus
- Stand with your back to the chair.
- Your feet should be a shoulder width apart with your knees turned out slightly more than your feet turn out.
- Stick out your butt as far as you can but keep your lower back arched.
- Touch the chair and come right back up 10X – do 3 sets.
B: Single Leg Squat To Improve Your Posture. When you can do three sets of the chair squats easily, try single leg squats.
- Always stand near a wall so, you can support yourself if you lose your balance.
- Stand on one leg.
- Stick out your butt as much as you can while bringing your other leg back, dragging it on the floor to keep balance.
- Go as far as you can with the back leg.
- Don’t let your knee go forward past the big toe
- Do 3 sets of 10.
Strengthen Your Abs To Help Your Posture
B: Front Planks strengthen your abs without putting dangerous pressure on your discs like crunches and sit-ups do.
- Lie face down.
- Toes together and your arms shoulder width apart.
- Hold this position without raising your butt too high
- Your body should form a straight line. Look in the mirror.
- Hold for up to 1 minute at a time. – do 3 times.
B: Advanced Abs Strengthening To Help Your Posture
- Get a basketball or medicine ball.
- Get in the front plank position.
- Balance with your forearms on your medicine ball/basketball.
- Pull your arms in toward you while balancing on the ball.
Aerobic Exercises For Spinal Stenosis
#1 Walking For Spinal Stenosis
Walking is good, for spinal stenosis. Once your posture is changed enough the distance that you can walk will increase. If you can walk without pain with your new posture you are ready for the next step.
Speed Walking increases the muscles strength and energy your body has to use and also increases your cardiovascular (heart) health to boot.
#2 Swimming For Spinal Stenosis
Swimming takes the pressure off your joints and your lower back. Watch out for the common breast stroke. This puts your spine in extension and could aggravate some people despite the buoyancy provided by the water.
For those aggravated by breast stroke you should try side stroke or front crawl, which puts your lower back in flexion. Butterfly stroke is too vigourous and puts your spine in repeated extension much like breast stroke.
#3 Biking For Spinal Stenosis
Biking especially in the arrow position (race position which you bend from the hips) is especially good for those of you with spinal stenosis. The further you bend forward the larger the space created in your spine.
Just don’t do it for too long or you will likely create a neck problem. After 1/2 an hour I would take a break from the arrow position.
If you are going outside beware of bumps and potholes as a sudden jolt can aggravate your back and leg pain. Otherwise indoor stationary biking is the best for you.
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1. Amundsen T1, Weber H, Nordal HJ, Magnaes B, Abdelnoor M, Lilleâs F, Lumbar spinal stenosis: conservative or surgical management?: A prospective 10-year study Spine (Phila Pa 1976). 2000 Jun 1;25(11):1424-35; discussion 1435-6.
2. Anne B. Newman, MD, MPH et al, Association of Long-Distance Corridor Walk Performance With Mortality, Cardiovascular Disease, Mobility Limitation, and Disability, JAMA. 2006;295(17):2018-2026. doi:10.1001/jama.295.17.2018.
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