Spinal stenosis occurs when the gaps between the canal that houses the spinal cord in the spinal column are reduced. The condition is caused by the closure of the passage between the vertebrae, which puts pressure on the spinal cord nerves responsible for supplying blood to your legs and arms. Spinal stenosis may not be easily visible. However, it can turn into a serious health condition if left untreated. Our team of licensed physiotherapists at Suarez Physical Therapy offers the best physiotherapy services for those suffering from spinal stenosis. If you need more details or are looking for physiotherapy services in Las Vegas, NV, get in touch with us now.
An Overview of Spinal Stenosis
Spinal stenosis occurs when there is excessive pressure between individual vertebrae in the spinal column, putting too much strain on the spinal cord (in the case of central stenosis) or the nerves (in the case of lateral stenosis). A spinal stenosis condition can occur in either the lower back or neck.
Most cases of spinal stenosis can be traced back to issues associated with the aging of the spine, such as the following:
- Osteoarthritis involves a deterioration of cartilage between the joints. As a result of the deterioration, the body frequently develops more bones, known as "bone spurs," to help support the affected area. Such spurs can put a strain on the nerves near where they exit the canal of the spinal column.
- Normal aging can cause the disks that serve as the gap between the sets of the vertebrae to flatten. The narrowed area makes it more difficult for the nerves to exit the spinal column.
- Spinal stenosis can also be caused by spinal tumors, bone illnesses such as Paget's disease, spinal injuries, and the thickening of specific spinal ligaments.
Physiotherapy and other conservative measures can effectively control the symptoms and signs of spinal stenosis in most cases. Most individuals suffering from spinal stenosis don't need treatment until the condition worsens significantly.
Signs and Symptoms of Spinal Stenosis
Spinal stenosis can result in the following signs and symptoms:
- The legs, trunk, arm, and/or shoulders hurt, tingle, or feel weak.
- Occasional issues with the bladder or bowel function.
If you're suffering from cervical spinal stenosis, you could feel numbness, pain, and weakness in either one or both arms, as well as pain in your legs, based on which nerves were affected. You might or might not feel pain in your neck.
If you're suffering from lumbar spinal stenosis, you might feel numbness, discomfort, and weakness in your lower back as well as one or both of your legs, but not the arms. Your symptoms could deteriorate while you walk and improve when you sit.
Exercises for Spinal Stenosis
When it comes to physical therapy for spinal stenosis, the two primary goals include reducing discomfort and allowing you to get back to your day-to-day activities. Your physiotherapist will assess which workouts are most appropriate for your specific case. It's important that you strictly adhere to a physical therapist's advice.
The exercises listed below are some that a physiotherapist would recommend as part of a routine at-home program for treating a spinal stenosis condition.
This type of exercise stretches the muscles in your lower back and puts the spinal column into flexion, which serves as a comfortable position for individuals suffering from spinal stenosis. It can assist in reducing pressure in your lumbar spine and opens the central spinal column.
To carry out the exercise, you need to do the following:
- Lay on your back, knees bent, and feet flat on the floor.
- Raise both legs, bringing the knees closer to the chest, and grasp them with both hands.
- Hold the knees into the chest for at least three seconds, and then draw them back out slowly to the starting point.
- Repeat these three reps, for a total of 10 times.
This type of exercise strengthens and activates the transverse abdominis, which is a broad core muscle that aids in the stabilization and support of your lower back as well as the improvement of spinal alignment. If the transversus abdominis isn't actively engaged while standing, lying down, or sitting, the pelvis tilts forward, causing the lower back to stretch out excessively.
In patients with spinal stenosis, an anterior pelvic tilt, and excess lumbar lordosis might exacerbate pain. By bringing you into a posterior pelvic tilt, this exercise seeks to correct your spine and pelvis. This entails lowering your pelvis and keeping a straighter, neutral spine.
To carry out this exercise, you should:
- Lay flat on your back with both knees bent and feet flat on the floor.
- Contract the abdominal muscles and tilt the hips under to force your back flat against the surface you're lying on. This can be considered the opposite of arching the muscles in your back. The top of the hip bones should move down toward the surface you're lying on, whereas the bottom of the pelvis gets scooped up and under.
- Keep this contraction going for ten seconds. Your shoulders, head, hips, and back should all remain flat all the time. You should feel a little tension in your abdominal muscles as you contract to maintain this position.
- Take a break then repeat 10 times with a ten-second hold in between.
Lower Trunk Rotation
This type of workout improves the lower back and surrounding muscle mobility. By minimizing extension, this position can enhance the spinal column's mobility while minimizing pain.
To carry out this exercise, you need to:
- Lay flat on your back, legs bent, and feet flat.
- Allow the legs to move to one side while maintaining your knees locked together.
- Let the knees fall towards the surface you're lying on.
- Hold your stretch-out position for ten seconds before returning your legs to the initial position.
- Repeat this on the other side, and keep your legs together. You can spin the legs in the opposite direction. Hold the same position for ten more seconds, before returning to your starting position.
- Repeat this exercise ten times on both sides, holding the position for ten seconds every time.
Diagnosis For Spinal Stenosis
An accurate diagnosis is crucial since the signs and symptoms of spinal stenosis often resemble those of other age-related health conditions. A physical therapist will conduct a comprehensive evaluation, which includes examining your medical records and using screening instruments to assess the risks associated with spinal stenosis.
Your physiotherapist can:
- Ask you detailed questions regarding the exact spot and type of pain you are experiencing, the weakness, and any additional symptoms.
- Request that you complete a body diagram indicating specific regions you're feeling numbness, pain, and tingling.
- Measure the degree of pressure placed on the nerve roots, and perform muscle strength and sensory tests.
- Check your body posture and focus on the way you move and engage while carrying out other tasks.
- Check your spinal, limb, and overall mobility by measuring your range of motion.
- Manual therapy can be used to assess the mobility of your spine's joints and muscles.
- Assess the strength of key muscle groups.
If you're experiencing loss of sensation, muscle weakness, or significant pain, diagnostic testing like an MRI or an X-ray could be necessary. Physical therapists collaborate closely with doctors and other medical professionals to get the right diagnosis and appropriate therapy.
Conservative management, like physical therapy, outperforms surgery in all except the most severe cases of spinal stenosis (which usually involve muscular weakening or significant levels of discomfort).
Treatment of Spinal Stenosis
Spinal rehabilitation, or physical therapy consists of two kinds of treatments:
Passive therapy can include the following:
Deep Tissue Massage
A deep tissue massage refers to a hands-on method that effectively addresses both chronic and acute muscle tension. A physical therapist applies friction and direct pressure to the soft tissues (muscles, tendons, ligaments) of the back or neck to relieve tension and stiffness. This form of massage can aid in the reduction of pain and inflammation.
Cold and Hot Therapies
Heat therapy helps to increase blood flow to the spine's target region. Enhanced blood flow transports more nutrients and oxygen while also removing cellular waste. This is necessary for healing and can aid in the reduction of muscle spasms, inflammation, and discomfort.
Cold therapy is used to alleviate symptoms in places that are internally inflamed or visibly swollen. Hot and cold therapy can be combined for optimal results.
Transcutaneous Electrical Nerve Stimulation (TENS)
TENS is often used as a standalone device at a physical therapy clinic, with leads attached to the patient's neck and back with patches. The level of stimulation can be adjusted. This therapy uses a gentle and calming electrical current to stimulate the creation of endorphins, which are the body's pain relievers.
Small TENS devices are accessible for usage at home. However, a TENS device can be a useful therapy, no matter how small or large it is. Keep in mind, though, that TENS isn't an ideal option for chronic discomfort. According to an American Academy of Neurology study, TENS machines are ineffective in addressing chronic lumbar backache.
This method uses high-frequency sound waves to reach tissue deeply beneath the surface of the skin. Your physical therapist can administer a gel to allow the ultrasound wand to travel over the sore area of the back or neck without irritating. Ultrasound generates a moderate heat that stimulates the circulation of blood and could be helpful in the relief of muscle cramps or spasms, edema, stiffness, and discomfort.
The following are some of the advantages of passive physical therapy:
Passive physical therapy can help with acute injuries as well as short-term goals like managing pain when conducted by a skilled medical practitioner. However, it is vital to emphasize that passive therapy is insufficient for long-term therapy.
Using passive techniques over an extended period could lead to more damage than good. It can make you feel reliant on your physiotherapist, who therefore feels primarily accountable for your pain management. Although passive physical therapy could prove beneficial in the short run, you should have active control of your medical care.
Your physiotherapist understands that not all spinal stenosis cases in the neck or low back are similar. Physical therapy is tailored to the individual patient's needs and abilities. Individuals who haven't exercised in a while or are just starting with active therapy might need more time to build up their fitness levels. As a result, a physical therapist can customize an individual's active therapy regimen.
Active therapy could offer the following advantages:
- Learn safe stretching and workout techniques.
- Gain flexibility and move (such as walking and stair climbing) easier.
- Gain physical strength.
- Develop solid abdominal muscles, the core of your body's strength.
- Produce endorphins, which are the body's pain relievers.
- Improve your posture.
- Improve your balance and stability to reduce the risk of falling.
In physical therapy, your therapist will keep track of your improvements and setbacks and report them to your physician.
How a Physiotherapist Can Help
The main objective of a physiotherapist is to assist you in continuing to engage in your life roles and everyday activities. He or she can prepare a treatment plan based on the evaluation findings as well as your objectives. The treatment plan will most likely consist of a variety of workouts.
Your physiotherapist can develop a customized treatment plan to match your specific requirements and goals. Your program could include the following elements:
- Gentle movement— a physical therapist can show you specific moves that can help relieve pain by relieving pressure on the nerve root.
- Range-of-motion and stretching exercises— you can learn specialized exercises to promote mobility in your spine's and extremities' muscles and joints. Improving joint motion often serves as the first step to relieving pain.
- Strengthening Exercises— Strong legs and arm muscles play a role in relieving pressure on the spinal column joints, while strong trunk muscles support the spinal joints.
- Aerobic exercise— you can practice aerobic exercise motions to boost your tolerance for tasks like walking that could have been impaired by spinal stenosis.
Research suggests that the more activity you can tolerate, the faster you will be able to alleviate pain and other associated symptoms. Your physiotherapist can also choose to utilize a combination of various treatments, such as:
- Manual Therapy— your physiotherapist can use manual (hands-on) therapy, like massage, to increase the flexibility of rigid joints that could be responsible for your condition.
- Utilization of Rehabilitation Equipment—your physical therapist could recommend you try out rehabilitation equipment, like a specific harness gadget that connects to a treadmill to assist with alleviating pressure on your spinal nerves when walking.
- Postural education— you can learn how to alleviate nerve strain by simply changing how you sit, walk and stand.
Can This Condition or Injury Be Avoided?
Spinal stenosis is commonly associated with the aging process. There is currently no method for avoiding it. However, there are ways to manage the symptoms and reduce the progression of spinal stenosis that you're able to handle.
Regular exercise helps to strengthen the muscles and ligaments that support the back and keep the spinal column joints flexible while maintaining healthy body weight. To protect your back from injury, it is important to use supportive furniture such as chairs and beds. Additionally, it is advisable to avoid engaging in dangerous activities such as lifting heavy objects or performing uncomfortable and repetitive lifting.
Your physiotherapist can assist you in creating a fitness plan that considers your spinal stenosis condition. Certain exercises are more beneficial than others for individuals suffering from spinal stenosis, and a physical therapist may teach you which tasks and exercises to avoid.
For example, since walking can often be more uncomfortable than sitting, cycling could be more suitable for you to receive daily exercise. Every person's low back discomfort is unique and different. Based on your mobility test, health profile, and goals, your physiotherapist can develop a customized workout program for you.
Which Type of Physical Therapist Will Best Suit My Needs?
All physiotherapists are educated and trained to treat patients with spinal stenosis. However, you might want to take into account the following:
- A physical therapist who has worked with clients suffering from orthopedic, pain, or musculoskeletal issues
- A physiotherapist who is a board-approved clinical expert or who has completed an orthopedic physiotherapy fellowship or residency. This type of physical therapist holds extensive understanding, expertise, and skills that could be relevant to your issue
When seeking out a physiotherapist, keep the following in mind:
- Seek advice from your loved ones, as well as healthcare professionals.
- When making an appointment with a physical therapy facility inquire about the physiotherapist's expertise in treating individuals with spinal stenosis.
- When seeing a physical therapist for the first time, it's important to be able to describe the symptoms you are experiencing in great detail and to identify any aggravating factors.
Find a Professional Physical Therapist Near Me
Our team at Suarez Physical Therapy understands that being diagnosed with spinal stenosis could be upsetting for you or those you care about. Our skilled pediatric physiotherapists can provide you with rehabilitative therapy to improve your mobility and general function. If you're in Las Vegas, don't hesitate to call us at 702-368-6778.