Spinal stenosis is a relatively common diagnosis that we see in the physical therapy clinic.
By definition, spinal stenosis is a narrowing effect, or a narrowing of the spinal column causing a pressure into the spinal cord, or a narrowing of the openings where the spinal nerves travel. Those are called the foramen and when the spinal nerves are traveling out of those openings, they can be compressed and, thus, cause a lot of neurological signs and symptoms in the leg.
The signs and symptoms can include all the kinds of things you see with your other nerve route problems, such as pain, numbness, weakness, and pins and needles.
The cause of the spinal stenosis is often a flattening out or degenerative process in the discs, pushing into these structures, narrowing these tissues and causing the symptoms.
The hallmark of a spinal stenosis patient, though, is very, very different from the classic herniated disc and sciaticas that we see in that the spinal stenosis patient will have a big problem with their standing and their walking tasks.
When you stand and when you walk, that's when the degenerative disc presses further into the structures, pressing into the nerve roots causing the symptoms. These patients classically cannot stand.
Standing and walking, they can't tolerate it and, almost like magic, they can feel 100% better in a sitting or a stooped position. And when you hear that, you're starting to think spinal stenosis. It does require a fair amount of degeneration, so usually a stenosis patient is going to be a little older, 40's, 50's, 60's, et cetera, because you need a little bit of a drying out effect in the disc, and that takes time.
So, you're going to look for an older patient, maybe and or these symptoms associated with standing and walking being the hallmark.
It is very treatable, and usually what we treat these patients is to try to utilize some flexion stretches, pulling your knees into your chest or just simply bending to touch your toes, and using these kind of exercises just before heading out to do errands or do chores, and certainly when you get back home to try to find some time to do it again to turn off some of the symptoms that may have occurred during the walking. So, a pre and a post walking, sort of, stretching plan. That usually helps these patients quite a bit.
If you're finding it to be spinal stenosis, and the diagnosis is correct, strengthening exercises have little effect on the tissue. It's really knowing what muscles and ligaments and structures to stretch and, more importantly, when. When to stretch them.
If you're at home watching television for most of the day, you're not going to need to do it. You're not going to feel the symptoms, because you're just sitting all day. But as soon as you know you're about to head out, that's when you're going to want to try to stretch and exercise.