Spinal stenosis: a leading cause of back pain

Spinal stenosis is a narrowing of the spinal canal those results in the compression of the spinal cord and nerves. The compression results pathognomonic symptoms such as Pain, numbness, intermittent claudication while walking or standing for a long time.

Type of spinal stenosis

According to site:

  1. Cervical (neck region) spinal stenosis
  2. Thoracic (mid back) spinal stenosis (very rare)
  3. Lumber (lower back) spinal stenosis
  4. According to etiology:
  5. Congenital (symptom having from birth) spinal stenosis
  6. Acquired (symptom acquired at a certain age such as after 40) spinal stenosis

Cervical spinal stenosis: In this condition, the narrowing occurs in the part of the spine in your neck.

Lumber spinal:  stenosis: In this condition, the narrowing occurs in the part of the spine in your lower back. It’s the most common form of spinal stenosis.

Subtype of spinal stenosis

  1. Central stenosis
  2. Lateral stenosis
  3. Foramina stenosis
  4. Extra-foramina stenosis

Risk factors:

Most people with spinal stenosis are over the age of 50. Though degenerative changes can cause spinal stenosis in younger people, other causes need to be considered. These include trauma, congenital spinal deformity such as scoliosis, and a genetic disease affecting bone and muscle development throughout the body. Spinal imaging can differentiate these causes.

Clinical presentation:

  • Lumber spinal stenosis:

Neurological claudication / pseudo claudication: neurological claudication refers to leg symptom encompassing the buttock, groin and anterior thigh as well as radiation down the posterior part of the leg to the feet. Leg symptom include – fatigue, heaviness, weakness and paresthesia.

  • Nocturnal leg crams
  • Neurogenic bladder symptom: Symptom may be unilateral or bilateral.
  • Back pain but leg pain and discomfort is irritating.
  • Standing and walking difficulty.          

Treatment: a lot of treatment option including

  • Drug treatment
  • Physiotherapy approach
  • Injection therapy
  • Surgery
  • Post-surgery rehabilitation.

Here I mention some physiotherapy approach for lower back spinal stenosis:

  • Child pose:

Step 1: Kneel on the floor with your toes together and your knees hip-width apart. Rest your palms on top of your thighs.

Step 2: On an exhale, lower your torso between your knees. Extend your arms alongside your torso with your palms facing down. Relax your shoulders toward the ground. Rest in the pose for as long as needed.

Knee to chest

  • Lie on your back with your knees bent and your feet flat on the floor.
  • Bring one knee to your chest, keeping the other foot flat on the floor (or the other leg straight, whichever feels better on your lower back). Keep your lower back pressed to the floor. Hold for at least 15 to 30 seconds.
  • Relax and lower the knee to the starting position. Repeat with the other leg.
  • Repeat 2 to 4 times with each leg.
  • To get more stretch, put your other leg flat on the floor while pulling your knee to your chest.

Exercise tip: Do not do the knee-to-chest exercise if it causes or increases back or leg pain.

Dead bug exercise

  1. Lie on the mat with your arms extended straight over your chest so they form a perpendicular angle with your torso. Bend your hips and knees 90-degrees, lifting your feet from the ground. Your torso and thighs should form a right angle, as should your thighs and shins. This is the starting position
  2. Engage your core, maintaining contact between your lower back and the mat. You want to make sure your spine maintains this steady and neutral position throughout the exercise.
  3. Keep your right arm and left leg exactly where they are, then slowly reach your left arm backward, over your head and toward the floor as you simultaneously extend your right knee and hip, reaching your right heel toward the floor. Move slowly and steadily, breathing in as you perform the extensions, avoiding any twisting or movement of your hips and abs. Stop the movement just before your arm and leg touch the ground.
  4. Reverse the movement and return your left arm and right leg to their starting positions. Move slowly and steadily, exhaling as you go.
  5. Perform the same movements to the opposite sides, this time keeping your left arm and right leg steady as you extend your right arm and left leg.
  6. Do the same number of repetitions on each side. When you complete a full set, simply return your feet to the ground and sit up.

Exercise tips:

  1. Don’t move too fast
  2. Don’t keep your lower back arching away from the floor.
  3. Talk to a physical therapist for options if the dead bug simply isn’t working for you.

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