Spinal stenosis of the lumbar spine (Lumbar spinal stenosis)
Spinal stenosis is a joint condition that describes tight conditions and narrowing of the spinal cord. Spinal stenosis can be asymptomatic, but can - if conditions become too tight - put pressure on nearby nerve roots or the spinal cord itself. We also recall that you will find a video with exercises at the bottom of the article.
A relatively common reason for it getting too tight in the lower back is Osteoarthrtitis. Also known as osteoarthritis - which involves joint wear, calcifications and the laying of extra bone tissue inside the spinal canal.
Also read: You should know this about Osteoarthritis of the back
Scroll below for to watch two training videos with exercises which can help you with tight nerve conditions in your back.
VIDEO: 5 Cloth Exercises Against Spinal Stenosis
Daily exercise and stretching exercises are essential to prevent further deterioration of already tight nerve conditions in the back. These five exercises can help you to move more, less pain and better back function.
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VIDEO: 5 Strength Exercises Against Spinal Stenosis
Some exercises are very important to do regularly if you are suffering from spinal stenosis. By strengthening the hips, pelvis, gluteal muscles and back - as shown in the video below - we can help reduce nerve irritation and squeezing.
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In severe cases, it can affect bladder and sphincter
This can lead to both pain and neurological symptoms of the affected nerve area - including back pain, leg pain, tingling, numbness, muscle weakness, numbness or the like. Spinal stenosis mainly affects the elderly population due to wear and tear / osteoarthritis and age-related bone deposits in the back or neck joints.
In some, more rare cases, it can also put pressure on the nerves of the bladder and rectum - which can lead to both bladder and sphincter symptoms (lack of sphincter control).
- May cause problems with your sex life and toilet habits
To say this more clearly - such nerve problems can lead to urinary retention (that you are not allowed to start a urine stream or get worse «pressure»), impotence or difficulties with erection (due to lack of nerve signals), as well as lack of control of the bladder (incontinence) and the back end (the stool becomes difficult to hold).
You may also experience decreased sensation (sensory hyposensitivity) in the genitals during intercourse and orgasm - as certain patients may also experience after back surgery that has gone wrong and where there has been nerve damage.
Also read: 6 Early Signs of Osteoarthritis
Spinal Stenosis and Decreased Quality of Life
So, as you can see, this back condition can result in greatly reduced quality of life. Therefore, it is extra important to take care of the back with physical therapy (normally done by modern chiropractor or physiotherapist who both work with both muscles and joints) and exercise (it is important to maintain good movement in the lower back to relieve the nerves ).
Spinal stenosis is common among the elderly population due to age-related wear and tear up over the years. Otherwise, people who have been injured or who have suffered fracture injuries are also at greater risk of developing spinal stenosis, as well as those with rheumatic joint disease (such as Ankylosing spondylitis).
In this article we focus primarily on spinal stenosis in the lower back, the lower back - but in theory, any part of the back can be affected by this joint condition.
Also read: 15 Early Signs of Rheumatism
Definition - Spinal Stenosis
'Spinal' indicates that it is the spinal cord that is affected and the word 'stenosis' means narrowing. The diagnosis usually affects the lower back or neck - when it comes to cervical (neck) spinal stenosis, this is more serious than lumbar (low back) spinal stenosis - this is because some of the nerve roots in the neck control the diaphragm and respiratory function.
Where does lumbar spinal stenosis affect?
Lumbar indicates the area in the lower back, ie the lower back or low back. This consists of 5 vertebrae that start at the bottom of L5 and end in L1 - upper lumbar vertebra. A lumbar spinal stenosis will thus affect structures and nerves belonging to this area.
Causes of Spinal Stenosis
It is said that there are 6 main categories that provide the reason for getting spinal stenosis, these are:
- Aging / old age
- Ankylosing spondylitis / Ankylosing Spondylitis
- Spinal instability (eg spondylysis)
- Cancer / tumors
- Joint disease / joint conditions / arthritis
- Trauma / injury
Also read: Are You Affected by Ankylosing Spondylitis?
So the most common cause is age and stress throughout life?
Yes, the most common direct cause of spinal stenosis is age-related wear and tear. Namely, this can cause the vertebral ligaments to thicken, bone deposits to form, the intervertebral discs to be compressed / compressed and bend toward the spinal cord and worn facet joints (where the vertebrae attach to each other). However, it is important to know that such wear is often caused by failure and overload without adequate relief in nearby muscles.
Who is affected by spinal stenosis?
The condition affects, as mentioned, primarily older due to age-related wear and changes in wear - but it can also affect areas that have previously been exposed to fractures / bone injuries. Acute spinal stenosis can also be due to an accident / trauma or major disc herniation - the latter is then due to the soft mass seeping in and out of the spinal canal and taking up space.
If it's a bigger one slipped disc which is the main cause of recess stenosis and spinal stenosis - then it is actually the case that exactly that cause is more common among those aged 20 to 40 years.
Also read: You should know this about Prolapse in the lower back
Symptoms of lumbar spinal stenosis
The patient will usually report pain in the standing position, back bend of the back, walking and the pain sitting on both sides of the back. Neurological symptoms can include back pain, leg pain, tingling, numbness, muscle weakness, numbness - depending on which area and which nerves are affected.
Usually, the symptoms will develop over a longer period of time. This is because the main cause of spinal stenosis is progressive wear and tear. However, a trauma or recently occurring disc prolapse can make symptoms appear more acute.
The symptoms mainly affect the sensory and sensation in the legs. Nerve compression in the back due to stenosis can cause the person to experience "tingling and needles" on the outside of the skin where the nerves are affected. Others experience an increased incidence of leg cramps, sciatica and others may experience that 'water trickles down the legs'.
Another characteristic symptom and clinical sign is that the person must take breaks as he walks. Preferably then by bending forward and leaning against a bench or similar on the road in an attempt to "open up" the lower part of the spine and relieve the pinched area. If you recognize yourself in this, you should consult a publicly authorized clinician for examination and possible treatment of muscles and joints.
Also read: 7 Ways to Cushion Inflammation in Osteoarthritis
Spinal stenosis = Back pain?
A common misconception is that back pain and spinal stenosis always occur together - this is not the case. Normally, people who are affected will experience leg pain and muscle weakness in the legs - preferably both at the same time, but not necessarily back pain.
But of course, it can also cause back pain. If it provides a basis for back symptoms and back pain, then the back pain is normally described as a deep-seated pain that almost feels as if it is "leg to leg" in the lower back.
Deep, nagging pain at the bottom of the lower back is also a relatively common description among this patient group. This is because in many cases there is actually less physical space in the spinal canal due to joint calcifications and osteoarthritis. In severe spondylosis, there may also be sounds and "rubbing" in the lower vertebrae.
Also read: 7 Types Of Inflammatory Foods That Aggravate Osteoarthritis
The symptoms get better in the forward-bent position - and worse with back-bent movements
Another characteristic sign of spinal stenosis is that the symptoms improve as the patient bends forward. This is because in this position the spinal canal will expand and thus put less pressure on the affecting nerves.
This is why people with lumbar stenosis often experience symptom relief and recovery when sitting down or lying with their legs pulled up against them. The explanation for this is actually pretty logical.
Movements such as standing up, stretching for something and walking all cause the spine to be temporarily straightened or slightly bent back. This lumbar position makes the spinal cord narrower, which can aggravate the neurological symptoms. In contrast, you will experience that the spinal canal becomes wider when bending forward - and thus also a direct symptom-relieving effect.
Also read: How Yoga Can Relieve Fibromyalgia
Diagnosis of lumbar spinal stenosis
A clinical examination and history taking will be central in diagnosing 'lumbar spinal stenosis'. A thorough examination of muscular, neurological and articular function is important. It should also be possible to exclude other differential diagnoses.
Neurological examination in lumbar spinal stenosis
A thorough neurological examination will examine strength of the lower extremities, lateral reflexes (patella, quadriceps and Achilles), sensory and other abnormalities.
Possible conditions in lumbar stenosis
Cauda Equina Syndrome
Compression fracture or stress Fracture
Lumbar disc prolapse
In order to make the diagnosis, image diagnostics are often necessary.
Image diagnostic investigation of lumbar spinal stenosis (X-ray, MRI, CT or ultrasound)
X-rays can show the condition of the vertebrae and other relevant anatomical structures - unfortunately it can not visualize current soft tissue and the like.
En MRI examination is what is most frequently used to diagnose spinal stenosis. It can show exactly what is the cause of nerve compression. In those patients who cannot take MRI due to contraindications, CT can be used with contrast to evaluate the conditions. Contrast fluid is then injected in between the vertebrae of the lower back.
X-ray of lumbar spinal stenosis
MRI image of lumbar spinal stenosis
An MRI examination does not contain any X-rays, but instead uses powerful magnets to create a visual image of both soft tissue and bone structures in the back.
This MRI examination shows spinal stenosis in the lumbar spine L3 and L4 due to a disc prolapse. You might see how the intervertebral disc pushes back against the nerves?
CT image of lumbar spinal stenosis
Here we see a contrast CT image showing lumbar spinal stenosis. CT is used when a person cannot take MRI imaging, for example due to metal in the body or implanted pacemaker.
Treatment of spinal stenosis
There are a number of treatments for spinal stenosis - and it will also vary based on how extensive the cause of the compression is. Here is a list of treatments used for spinal stenosis.
The treatment can be carried out, among other things, by public health care practitioners, such as physiotherapists and modern chiropractors. It is also recommended that the treatment is always combined with exercise and customized exercises that match you and your back condition.
Overview of various treatment methods used for spinal stenosis
It is important to remember that you still have to adhere to the advice on enough exercise and mobility even though you have been diagnosed with spinal stenosis. In fact, many would like to emphasize that it is actually even more important with enough training and functional improvement measures for someone who has been given such a back diagnosis.
Many people with spinal stenosis often combine self-training and treatment at an authorized clinician. Due to the physical changes that they have in the lower back, it is also true that many in this patient group also benefit from regular treatment (often around once a month) to help maintain good back function.
Physical treatment: Massage, muscle work, joint mobilization and similar physical techniques can provide symptom relief and increased blood circulation in the affected areas.
Physiotherapy: It is generally recommended that patients affected by spinal stenosis receive guidance to exercise properly through a physical therapist. A physiotherapist can also help you with symptom relief.
Chiropractic joint treatment: Joint function and back mobility are particularly important for keeping your back healthy. Customized, gentle joint mobilization can help keep you moving and contribute to more joint fluid in the facet joints between the vertebrae.
Surgery / surgery: If the condition worsens significantly or you do not experience improvement with conservative treatment, surgery may be necessary to relieve the area. An operation is always risky and is the last resort.
Traction bench / cox therapy: Traction and traction bench (also called stretch bench or cox bench) is a spinal decompression tool that is used with relatively good effect against spinal stenosis. The patient lies on the bench so that the area to be pulled out / decompressed ends up in the part of the bench that divides and thus opens up the spinal cord and relevant vertebrae - which we know provides symptom relief. The treatment is most often performed by a chiropractor or physiotherapist.
Self Action: What can I do even against pain?
1. General exercise, specific exercise, stretching and activity are recommended, but stay within the pain limit. Two walks a day of 20-40 minutes make good for the body and aching muscles.
2. Trigger point / massage balls we strongly recommend - they come in different sizes so you can hit well even on all parts of the body. There is no better self help than this! We recommend the following (click the image below) - which is a complete set of 5 trigger point / massage balls in different sizes:
3. Training: Specific training with training tricks of various opponents (such as this complete set of 6 knits of different resistance) can help you train strength and function. Knit training often involves more specific training, which in turn can lead to more effective injury prevention and pain reduction.
4. Pain Relief - Cooling: Biofreeze is a natural product that can relieve pain by cooling the area gently. Cooling is especially recommended when the pain is very severe. When they have calmed down then heat treatment is recommended - it is therefore advisable to have both cooling and heating available.
5. Pain Relief - Heating: Warming up tight muscles can increase blood circulation and reduce pain. We recommend the following reusable hot / cold gasket (click here to read more about it) - which can be used both for cooling (can be frozen) and for heating (can be heated in the microwave).
Recommended products for pain relief
Biofreeze (Cold / cryotherapy)
Exercises and Training against Spinal Stenosis
Exercises aimed at relieving symptom of spinal stenosis will primarily focus on relieving the affected nerve, strengthening the relevant muscles and especially deep core muscles. Among other things, we recommend that you focus on to train your hip muscles, as well as the core muscles - and regular stretching of the gluteal muscles.
VIDEO: 5 Exercises against Narrow Nervous Conditions and Sciatica
In this article, you have, among other things, gained a better understanding of spinal stenosis and how tight lumbar nerve conditions can provide the basis for sciatica pain and nerve symptoms. Through the video below you can see exercises that can help maintain good functionality in the nerves in the lower back and seat.
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Yoga exercises for spinal stenosis
Many people feel that properly performed yoga and yoga exercises can lead to symptom relief and functional improvement. Here are some examples. Another good example of gentle training against spinal stenosis is training in a hot water pool.
Also read: How To Help Exercise In Hot Water Pool Against Fibromyalgia
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Recommended self-help for this diagnosis
Compression Noise (for example, compression socks that contribute to increased blood circulation to sore muscles)
Trigger point Balls (self-help to work the muscles on a daily basis)
Asked questions regarding lumbar spinal stenosis / spinal stenosis of the lower back
Have questions or comments? Feel free to use the comment box below.
Why do I get more pain from having spinal stenosis?
Many people with spinal stenosis in the lumbar spine report worsening symptoms and pain - including muscle spasms in the legs - when lying flat. This is due to less space in the already exposed, narrowed area around the nerve. Often lying on the side in the fetal position with a pillow between the legs relieve the symptoms, but this varies from person to person.
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Was operated on for spinal stenosis in May 2017. Got a worsening a few months ago. Does not get out of bed without great pain and with the help of aids borrowed at the aid center.
Has also received fat infiltration into bone tissue, sacrum and ilium. Could it be the latter that bothers me the most?
I am a 52 year old woman who struggles with back, neck and also has fibromyalgia and migraines. Can also mention that I have a crooked back. I struggle with daily pains, and at times there is even more pain. Pain radiation down the right foot, such as sciatica pain. I am under investigation for possible back surgery, bracing / spinal stenosis.
This is what the surgeon has written in report to me:
Assessment: Regarding her L5 appearance, the undersigned is considering an MRI
for lateral recess stenosis, but there is also reduced reduced space foraminally for the right L5 root,
but even narrower conditions for right L4 root (where, however, spontaneous fusion is suspected,
occurred or en route). It is not completely ruled out that intraspinal decompression right side
L4 / L5 could have a positive effect. The undersigned is basically a little more skeptical
foraminal decompression, due to her multilevel problem foraminal, and since
foraminal decompression at the same time will require back stabilization, which in turn will increase
strain at adjacent levels, with the risk of moving the problem and providing the need for further
surgery. If you in this round choose to go for foraminal decompression with
fixation procedure, is it perhaps most sensible to include L4-L5-S1? - incl TLIF procedure, both due to craniocaudal nerve root compression, and to get re-established lordosis.
Intraspinal decompression L4 / L5 is considered soluble to have about 50% success rate, but at the same time 15%
risk of deterioration in the short or long term.
I very much doubt whether I should go for such an operation, as the chances of improvement are relatively low. Can mention that in the last two months I have been doing some exercises specifically for spinal stenosis, and have gotten a lot better. I can not walk more than 10 minutes before I have to stretch my back, and if I stand, I can not stand it for long at a time.
Is there an opportunity for improvement with regular exercises over time, or should I stiffen my back?
Hope you can give me a tip on what might make sense in the middle of the case.
Hello. I see you recommend trigger point treatment with ball, but see no specific "exercises" you recommend. Do you have more information? I am waiting for surgery for spinal stenosis (and possibly also listese in L4 / L5), but all that is now put on hold pending the corona crisis being handled.
Thank you in advance!