Physical Therapy for Spinal Stenosis

August 08, 2022  /  Kepros PT

Has your doctor told you that you may have spinal stenosis? This diagnosis can sound scary, but what does it really mean?

Typically, you may be diagnosed with spinal stenosis after reporting lower back or neck pain to your doctor or physical therapist. Your doctor may send you for an x-ray, and the radiology report will reveal if there is stenosis or any other bone conditions present. Even if you haven’t had an x-ray, there are certain things in your patient history that may lead us to suspect spinal stenosis.

Common signs and symptoms of spinal stenosis include:

  • Low back pain

  • Sciatica - (pain from the back down the leg)

  • Cramping or heaviness in the legs

  • Numbness or tingling into the legs

  • Weakness

  • Pain is worse when standing, walking, or walking downhill

  • Pain improves when sitting, bending forward slightly, walking with a shopping cart or walker, or walking uphill

Spinal stenosis is a narrowing of the space where the spinal cord sits. It can be caused by arthritis, broken bones or injuries near the spine, a cyst, or tumor. The most common cause is arthritis. If it is suspected that you may have stenosis, your doctor may refer you to physical therapy.

Physical therapy may include working on your spinal mobility, flexibility, and muscle strength. Spinal mobility refers to helping the joints in your back move well with each other. This can help alleviate pain and improve your range of motion. Flexibility will focus on the hamstrings and hip flexors. Stretching these muscles can allow you to stand up straighter and again, alleviate some pain in the low back. Strengthening the muscles of your core, low back, and gluteal muscles (hips) can help support your low back and improve your symptoms all without requiring surgery. We may also try some unweighted walking (at KPT we have a harness on the treadmill that can take off 20% of your body weight to make walking and aerobic exercise easier – insert link to previous blog on light speed). Unweighted walking allows you to get aerobic exercise to improve blood flow and encourages gentle rotational movements of the spine which can help pain as well.

There are some instances where surgery may be indicated, but it is not typically the first treatment option and one that many patients are able to avoid. Your doctor will be more likely to refer you to a surgeon for a consultation if you have leg weakness, loss of bowel/bladder function, or if your symptoms are simply unbearable. If you do require surgery, your surgeon will usually send you to PT after surgery for treatments that are very similar to what we’ve described above. This is why it is a good option to try physical therapy first – the more strength and mobility you have going in to a possible surgery, the better off you are for your recovery. Studies have shown that there are no significant differences in outcomes between those who choose PT versus those who undergo surgery at 2 years after intervention. Both groups demonstrated improvements in pain and function.

If you have low back pain and think you may have stenosis, let us know and we will come up with a plan to help you feel better!