Spinal stenosis is the process of narrowing of the channels that the spinal cord and nerve roots pass through. As these passages become narrowed by abnormal bone growth, the nerves can become compressed causing pain, numbness, tingling or weakness. Spinal stenosis can refer to central canal stenosis, or foraminal stenosis. Central canal stenosis is the narrowing of the canal the spinal cord passes through as it travels from our brain down to around the second lumbar vertebrae. Stenosis of the central canal in the lumbar spine can cause radiating pain, weakness, numbness and tingling in the back and into our legs. Depending on which part of the spinal that is being compressed, the symptoms can be on one side or both. These symptoms are typically made worse when standing, walking and lumbar extension, which all close the canal down to a greater extent. They are made better with sitting, or lying down with the knees bent.
Foraminal stenosis refers to the narrowing of the channels on the side of the spine that our nerves pass through to exit the spine. Stenosis of the foramen can occur on one side or both, causing symptoms similar to central canal stenosis. Foraminal stenosis is also made worse from standing, walking, and lumbar extension.
Although physical therapy cannot change the bone formation, we can change posture, which plays a big role in lumbar stenosis. Poor postures, especially hyperlordosis (excessive arching of the low back), causes the canals to narrow further exacerbating the symptoms. We change our patients postures by teaching corrective postural exercises, and neuromuscular retraining. We also perform specific manual therapy techniques to increase mobility in the lumbar spine, as there are often movement deficits.
