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Spinal stenosis is a very common issue that many will experience in their lifetime. It’s a spinal condition that often times will cause pain, which can significantly affect your life.
Many spinal stenosis patients find it difficult to stand or walk for any length of time, which can really get in the way of doing what you need to and love to do.
While spinal stenosis pain can occur anywhere in the spine, we’ll be focusing on lumbar spinal stenosis in this article.
In order to best manage spinal stenosis, it’s helpful to know which spinal stenosis exercises to avoid, as well as different activities that could make your pain worse.
Table of Contents
What Exactly is Spinal Stenosis?
Simply put, spinal stenosis is the narrowing of the spaces that form the spine, or spinal canal.
Our spinal bones, or vertebrae, form this protective tunnel that our spinal cord and nerve roots run through.
When the spinal space narrows, this can place too much pressure on the nerves and/or the spinal cord.
As mentioned above, spinal stenosis can occur anywhere in the spine, with the lumbar spine being one of the most common locations.
Spinal stenosis can occur for different reasons, such as from the normal aging process, arthritis, natural wear and tear on the spinal joints, from a trauma, or the way your spine is structured, like with a scoliosis.
Lumbar Spinal Stenosis Symptoms
Lumbar spinal stenosis will commonly cause increased back pain the longer you stand or walk.
Our lumbar spine already has a natural curvature called a lordosis, or an inward curve, when we stand. When you have spinal stenosis, or increased narrow spaces in the spine, this plus the natural lumbar lordosis can cause spinal compression.
Spinal compression alone can create more pain in the back when standing and walking, but it also can lead to compressed nerves or even compression on the spinal cord.
People with spinal stenosis that hasn’t worsened to the point of causing nerve or spinal cord compression will often find relief when sitting, bending forward, and lying down. Standing or walking for prolonged periods will usually increase pain.
Those with lumbar spinal stenosis, who experience shooting or radiating symptoms down one or both legs, likely are dealing with one or more pinched nerves. Besides these radiating symptoms, they may also experience numbness, tingling or weakness in the affected leg.
Someone with severe spinal stenosis that creates compression on the spinal cord will usually have more severe symptoms that need to be addressed immediately.
While spinal cord compression can also create similar symptoms as nerve root compression, such as radiating pain, numbness, tingling and weakness, there may also be more serious symptoms, such as the following:
- Loss of bowel and/or bladder control
- Saddle paresthesia (loss of sensation at the top of the inner thighs)
- Foot drop (inability to actively flex the foot and ankle, which can lead to tripping)
- Severe back pain
- Loss of sexual abilities
- Inability to stand or walk without the legs giving out
If you notice any of the above symptoms in relation to your back pain, then you need to seek emergency medical services right away.
How Can You Prevent Your Spinal Stenosis from Getting Worse?
If you have known spinal stenosis, without severe symptoms like we talked about above, is there anything you can do to keep your stenosis from getting worse?
Yes, there is!
The challenge with spinal stenosis is that your pain is usually worse the more active you are. As a result, you tend to favor positions that help with pain relief, such as with sitting and lying down.
Unfortunately, by doing this, over time you’ll develop greater pain because you’ll no longer be using your spinal muscles on a normal basis.
As a result, you’ll usually develop muscle atrophy and then muscle fatigue when you do try to move and do something. It’s a vicious cycle!
The best thing you can do for your spinal stenosis is to keep moving, but the right way.
This includes knowing which spinal stenosis exercises to avoid, how to stay active without creating added pressure to those already narrowed bony spaces, and other treatment options that can help keep your spinal stenosis from worsening.
Spinal Stenosis Exercises to Avoid
Ultimately, you want to avoid any exercise routine or positioning that forces you to further narrow the spinal spaces. This means avoiding a motion called extension, or arching the back.
When you further extend, or arch, the back with spinal stenosis, this further narrows and compresses the spine. What happens then?… You’ll have more pain!
So, avoid any and all positions in which the spine moves into extension.
It’s not uncommon to encounter extension stretches in activities such as yoga. While yoga can be a great form of exercise for spinal stenosis, there are still certain stretches and poses you should avoid if you have spinal stenosis.
Let’s look at 3 common stretches and poses you’ll want to AVOID with spinal stenosis.
1. Prone on Elbows
In this position, you can clearly see how the spine is hyperextended, particularly in the lumbar region. This will cause increased compression and pressure on the narrowing spinal spaces.
2. Cobra Pose
Cobra pose begins like the prone on elbows position, but you then straighten the elbows and press up into an even more hyperextended position.Once again, more narrowing of the joint spaces!
3. Cow Pose
In this position, you’re on your hands and knees hyperextending the spine.It may not need mentioning again, but… you’re still narrowing the spine even with this exercise!
In addition to stretches and positioning that places the spine in hyperextension, those with spinal stenosis pain will also want to be careful with their strengthening and weight training exercise regimen.
Do your best to avoid overly strenuous exercises that could cause stress or strain in the back. This is even more important to remember if you’re trying to start an exercise routine after having been leading a more sedentary life.
Remember, the less active you are, the greater the chance your back muscles have grown weaker and can fatigue more easily.
While strengthening them is a good idea, avoid jumping into too much too soon. This is especially true if what you’re trying to do is causing you more pain.
Activities to Avoid with Spinal Stenosis
We’ve talked about spinal stenosis exercises to avoid, but what about general activities to avoid with spinal stenosis?
Recall that long walks or standing for too long will usually make you hurt more.
This doesn’t mean stop standing and walking altogether, but you may need to limit your time in these positions.
Try going for multiple short walks each day. You could also pick an area where you know there will be options to sit during your walk, such as a park or even the mall, that way you can sit and take a break when you need to.
If you know you have a lot of errands to do that will require a lot of standing and walking, you may need to break them up into separate trips or split them up to do on different days.
High Impact Activities
When you have spinal stenosis, try to avoid high impact activities.
This will include anything that involves running or jumping.
These high impact activities can and usually will increase pain when you have spinal stenosis. Keep in mind, that static standing and low impact long walks are already activities that usually worsen spinal stenosis symptoms.
Add a higher impact activity into the mix, such as running and jumping for long periods, and this will very likely make you feel worse.
Instead, try out some low impact exercises or activities that won’t make your symptoms worse.
This might include swimming or bicycling.
Swimming is a great low impact form of exercise that will help keep you moving and challenge your muscles, without making your pain worse.
Bicycling is a great exercise that promotes more of a flexed position for the spine, which actually can help you find pain relief for your spinal stenosis symptoms.
Other low impact activities to consider would also be Tai Chi and Pilates.
Too Much Rest
While it’s important to avoid too much of the wrong activity, remember that doing too little can be just as bad for you.
Recall that being too inactive can cause muscle atrophy, muscle fatigue, poor flexibility, and further limit your activity level when you do try to get up and move.
It’s important to find a balance between maintaining active lifestyles and resting when appropriate.
Contact sports, such as football, soccer, and hockey, aren’t the best when it comes to spinal stenosis.
Similar to the concepts behind why you want to avoid high impact activities, contact sports not only can place too much stress and strain on the spine, but can also increase your chances of injuring yourself.
Try your best to avoid these things.
Instead, try something less risky. We’ve already talked about the benefits of swimming, but if you like group activities you could try water aerobics, water polo, or water volleyball.
Similar with bicycling, if you like group events, you could train specifically for a bicycling event or race.
There are lots of options!
What Else Can Help Spinal Stenosis?
We’ve talked a lot about what spinal stenosis exercises to avoid and activities to avoid with this condition, but what else can help spinal stenosis?
Encouraging the right kind of active lifestyle and exercise routine can greatly help relieve your spinal stenosis symptoms.
Promoting flexion exercises, such as gentle flexion stretches, is a great way to give pain relief.
Let’s take a look at a few examples.
1. Cat Pose
- Positioned on your hands and knees (can be on your bed or floor), breathe in then exhale as you draw in your belly button, allowing the back to round.
- At the same time, you should tuck your pelvis under, as well as tuck your chin in towards your chest.
- Hold this position for up to 5 seconds, then relax the spine to neutral.
- Repeat 10x for 2-3 sets.
For a better visual as to how you should time your breathing during the cat pose, watch the video below for a demonstration.
2. Child’s Pose
- Begin on your hands and knees for this one as well.
- Slowly sit your hips back towards your heels, while keeping the arms stretched out in front of you.
- Once you’ve achieved the full position, hold for up to 30 seconds. Return to your starting position to rest, then repeat the stretch again.
3. Seated Flexion Stretch
This one feels so good for spinal stenosis!
- Sitting in a chair with the fleet flat on the floor, allow your back to round as you reach your hands towards the floor. Make sure to allow the head and neck to relax.
- If you feel super tight, you may want to only hold for up to 5 seconds, return to your starting position, then repeat about 10 more times.
- If this feels incredibly good, then you can hold the stretch up to 30 seconds, return to where you started, and then repeat a second time.
Seeing as standing for too long tends to increase spinal stenosis pain, many find that seated exercises are more tolerable and still allow you to work on your strength and flexibility.
You see, it’s very possible to effectively exercise with spinal stenosis! You just have to learn what works best for your back.
Besides exercise, it’s important to take a look at your overall lifestyle and see if other changes need to happen.
For example, if you are struggling with your weight, this is actually something that can place further stress and narrowing on the spine.
Maintaining a healthy weight via proper nutrition and exercise is very important.
If you’re not sure how to do this, there are many healthcare providers you can consult with! This includes your primary care physician, a nutritionist or dietician, a physical therapist or a personal trainer.
Remember too what we’ve talked about regarding balancing activity and rest. You have to have the right amount of both. Too much of one or the other won’t help your situation and can even make it worse.
Another something to consider is to pay attention to your posture when you stand! It’s easy to sink into a sway back, or hyper lordosis, especially if you’re naturally built this way.
While standing, try to keep equal weight on both legs, versus favoring standing more on one leg. Also try to engage your core with a bracing sensation around your abdomen.
The video below will tell you more about the right and wrong way to stand with spinal stenosis.
Sleep Positioning with Spinal Stenosis
It can be tough to know the best way to sleep with spinal stenosis, but all of the same rules apply that we’ve already talked about!
No matter what position you’re in, try to avoid hyperextending the back. This usually means NO sleeping on your stomach. This position will so easily compress the spinal spaces even further, and you won’t be a happy camper.
Side sleeping, especially with a pillow between the legs, is a great neutral position for the back to sleep in.
Sleeping completely flat on the back may not be the most comfortable, but if you place a pillow under the legs, this will help to take any unwanted pressure off the back for a good night’s sleep.
How to Manage a Spinal Stenosis Flare Up
Even when you’re trying to do all the right things, sometimes a spinal stenosis pain flare up can happen. When it does, it can be incredibly uncomfortable and limit your movement.
Here’s a few tips for how to manage a spinal stenosis flare up:
Practice decompressive positioning
Find a good surface to lie down on. This can be the floor, your bed or couch.
- Lie flat on your back with the legs supported either by a wedge or about 3-4 thick pillows under the knees.
- This will naturally decompress the spine, taking excess pressure off those already-narrowed spinal joints.
- You can lie this way for however long feels comfortable, but after about 30 minutes, try to get up and move around just to stimulate your joints and muscles a little.
Practice log rolling
Log rolling is a common technique many physical therapists will teach to safely maneuver in and out of bed, while keeping the spine in a neutral position.It’s actually good to get in the habit of practicing log rolling even outside of a spinal stenosis flare up to avoid irritating the back in the first place.
Take a look at the video below, which will demonstrate how to correctly perform a log roll.
If you’re experiencing a spinal stenosis flare up, there’s a good possibility that there might be some inflammation occurring in the spinal joints.In a case like this, ice is usually more productive than heat.
You can even lie on a flat ice pack, such as a gel pack, in your decompressive position mentioned above.
Try not to ice for more than up to 20 minutes and take at least a 30-minute break before icing again.
Move without causing pain
Even while in a flare up, try to keep moving around a little.The most important thing to remember is don’t move so much or for so long that you create more pain for yourself.That defeats the purpose, right??
While spinal stenosis can try to be a nuisance, it doesn’t have to be!
Make sure to keep in mind spinal stenosis exercises to avoid, as well as the other tips and tricks we talked about.
By doing so, you’ll be sure to keep a healthy and happy spine!
Will I need surgery for spinal stenosis?
If your spinal stenosis has become very severe and is causing debilitating pain or serious red flag symptoms (e.g., bowel or bladder changes, foot drop, etc.), then decompression surgery may be needed from a spine specialist.
Keep in mind though, not all cases of spinal stenosis need surgery.
Can I weight train with spinal stenosis?
Yes. Just make sure to be mindful of proper positioning and avoiding lifting so much weight that you create stress or strain on the back.
If sitting feels good, can I sit all day?
Not really. While sitting provides temporary relief of spinal stenosis pain, too much of it can cause your muscles to become weak and fatigue easily.
It’s better to keep yourself moving a little at a time throughout the day to still stimulate your joints and muscles, without making your pain worse.