Spinal Stenosis And How To Fight It

Sports Medicine and Physical Therapy Clinic In Brookyn, NY Helping Treat Spinal Stenosis And Other Musculoskeletal Conditions

Has your low back been bothering you in recent weeks, months or even years? Do you have pain in your legs when you stand or walk?  How about long outings where you know you’ll be stuck on your feet – been avoiding them? These are all signs that you may be experiencing Spinal Stenosis.

What is Spinal Stenosis?

Lumbar Spinal Stenosis is a process that happens over time and is mostly present in the older population. Your nerves and some vascular structures exit your spine through canals called foramina. Stenosis is the narrowing of these canals. This narrowing can lead to symptoms in the back and in the legs including pain, tension, and even weakness. Oftentimes, these symptoms are felt during standing and walking and relieved with sitting. Lumbar Spinal Stenosis happens gradually over time. As with any other type of long-standing lower back pain, your brain plays a significant role in how you process pain. It’s important for you to remember that pain is an output of the brain and there are things you can do to influence that output. Exercise can improve your function significantly. Our team of physical therapists will explain and teach you the right exercises.

Can you cure spinal stenosis?

There is no cure for spinal stenosis, but there are treatments to help relieve symptoms. 

• Over-the-counter anti-inflammatory medications can ease swelling and pain. If they don’t do the trick, pain management doctor can prescribe higher-dose medication.
• Your doctor may also recommend cortisone injections. This pain management procedure is performed in-office. Anti-inflammatory drug is injected directly into the area of the spinal stenosis. Cortisone can significantly ease inflammation and pain. Its effects may be temporary, however, and you shouldn’t have more than three injections in a single year.

What Are The Spinal Stenosis Treatment Options?

• Exercises. A suitable program of physical therapy and exercise is a component of almost every spinal stenosis treatment program. While the spinal stenosis exercises are not a cure, it is important for patients to remain active as tolerated and not become additionally debilitated from inactivity.

• Epidural injections. An injection of cortisone into the space outside the dura (the epidural space) can temporarily relieve symptoms of spinal stenosis. An epidural steroid injection (ESI) is a combination of a corticosteroid with a local anesthetic pain relief medicine. Corticosteroids are strong anti-inflammatory medicines. Relieving swelling and inflammation can take pressure off nerves and other soft tissues, which can relieve pain. The local anesthetic medicine helps give you immediate pain relief. Corticosteroid medicines take longer to have an effect.

Spinal Stenosis Surgery vs. Conservative Treatment

At some point, if you haven’t already, you might have a discussion with a doctor about the option of surgery for spinal stenosis. We are always in favor of seeking ways to avoid surgery if there are other, less invasive, successful spinal stenosis treatment options available.

How do the outcomes compare – lumbar stenosis surgery vs. conservative treatment for Spinal Stenosis?

Long-term results are often no different between those who opt for surgery and those who are treated non-surgically for Spinal Stenosis. Looking at 8 to 10 year follow-up studies, patients who received spinal stenosis surgery compared with those who underwent conservative treatment for lumbar stenosis had similar results for:

• Low back pain relief
• Predominant symptom improvement
• Satisfaction ratings

The surgery group did have slightly better results when it came to:

• Leg pain relief
• Back related functional status

What would happen if you didn’t seek any treatment for Spinal Stenosis? Common sense would suggest your symptoms would get worse over time, right? Actually, a recent study looked at the natural course of Spinal Stenosis over 4 years and found:

• 70% of people had unchanged symptoms
• 15% of people’s symptoms improved
• 15% of people’s symptoms worsened
• No proof of deterioration was found

Seeing that you have a good likelihood of improving with conservative treatment and a good likelihood of NOT worsening over time, it makes good sense to try conservative treatment first – and to give it all you’ve got. There’s always the option for surgery later, and even then, outcomes are good.

How Can Our Physical Therapists Help You Treat Spinal Stenosis?

In addition to educating you about what you can do on your own, our Physical Therapists can help by providing some proven hands-on, manual therapy techniques. These techniques mainly focus on improving the mobility in your:

• Lumbar spine (lower back)
• Thoracic spine (mid and upper back)
• Pelvis
• Hips

By improving your mobility – not only in the lumbar region, but in surrounding body regions, as well – can dramatically improve your function. Knoweldge of what you can do to help yourself might be the most valuable tool of all. Here is some advice:

• Identify activities and situations that cause you discomfort and discuss with your Physiatrist and Physical Therapist how to modify your movement strategies and find positions of comfort.
• Change positions frequently. Try not to sit or stand for too long. Keep moving
• Always look for ways to increase your function.
• The more functions you can perform, the less your brain will perceive those functions as threatening and that will lead in reduction in the pain level.

Exercise is Key for Spinal Stenosis

Exercise has positive, symptom-reducing effects and is very important in the plan of care for Spinal Stenosis

Which types of exercises are best for spinal stenosis?

Cycling has been proven to be very effective. Try a stationary recumbent bike. This type of bikes are available at our Physical Therapy Clinic and at any gym.

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