Lumbar Spinal Stenosis and Physical Therapy
by Jay McCallum, PT, DPT, OCS
If you or a loved one is experiencing back and leg pain that is made worse with walking and standing, you do have options other than injections, drugs, surgery, or just living with it. Physical therapy, and in particular an intensive program of manual therapy and exercise, can make a very real difference. And given that one of the best predictors of longevity and quality of life is a person’s ability to keep moving and walking, this is a case where physical therapy can literally be a lifesaver.
Do I have Spinal Stenosis?
Spinal stenosis is a condition that affects primarily patients over the age of 65 and is characterized by back and radiating leg pain that is made worse with standing and walking and is generally better with sitting. ‘Stenosis’ is the expensive medical term for ‘narrowing,’ and the part of the spine that narrows is the space around the nerves in the back. The narrowing is usually caused by arthritic changes in the spine including bulging discs and enlarged joints, and the position of standing further narrows the space around the nerves so that pain is generated. Many more patients experience a similar pattern without the radiating leg pain, reporting primarily back pain that is made worse with standing or walking and relieved by sitting.
How can physical therapy help me?
Medical literature supports the idea that a comprehensive program of physical therapy directed at maximizing spine mobility and hip mobility, and improving a patient’s trunk, hip, and leg strength can significantly decrease a patient’s level of pain and increase their ability to stand and walk.
Because the diagnosis of spinal stenosis is based on structure – that is, the loss of space around the nerves in the spine – many patients and other medical providers do not tend to think of physical therapy as an option. After all, there is nothing that can be done in therapy to un-degenerate a disc or decrease the enlargement of an arthritic joint. However, because patients by and large are less concerned with the look of their CT scan or MRI and much more concerned with the pain they experience with walking, then physical therapy it becomes more clear that physical therapy can help. The literature does support the idea that a comprehensive program of physical therapy directed at maximizing spine mobility and hip mobility and improving a patient’s trunk, hip, and leg strength can significantly decrease a patient’s level of pain and increase their ability to stand and walk.
Want to know more?
One of the best examples of this research was published in the prestigious journal Spine in 2006. To read this article of Spinal Stenosis, please click here.
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