Q: I am experiencing back pain. My doctor mentioned the term spinal stenosis. Does this diagnosis mean I will have to endure surgery?
A: It's estimated that as many as 75 percent of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery, and conservative care such as physical therapy usually gets better results than surgery. Spinal stenosis is one cause of back and neck pain. It affects your vertebrae (the bones of your back), narrowing the openings within those bones where the spinal cord and nerves pass through.
Spinal stenosis is a narrowing within the vertebrae of the spinal column that results in too much pressure on the spinal cord (central stenosis) or nerves (lateral stenosis). Spinal stenosis may occur in the neck or in the low back. The most common causes of spinal stenosis are related to the aging process in the spine.
In most cases, symptoms of spinal stenosis can be effectively managed with physical therapy and other conservative treatments. Only the most severe cases of spinal stenosis need surgery or more aggressive treatments.
Q: What are the symptoms of spinal stenosis?
A: The most common symptoms include: Pain, numbness, tingling, or weakness in your arms and shoulders, legs, or trunk and occasionally, problems with bowel or bladder function. If you have spinal stenosis in the neck, you may have weakness, numbness, and pain in the arms and often in the legs, depending on which nerves are affected. You might not have any pain in the neck itself.
If you have spinal stenosis in the low back (lumbar spinal stenosis), you might have pain, numbness, and weakness in the low back and legs, but not in the arms. Your symptoms might get worse with walking and improve with sitting.
Q: How does a physical therapist help with spinal stenosis?
A: Your physical therapist's overall purpose is to help you continue to participate in your daily activities and life roles. The therapist will design a treatment program based on both the findings of the evaluation and your personal goals. The treatment program likely will be a combination of exercises.
RELIEVE PAIN AND INCREASE MOVEMENT
Your therapist will design:
Special exercises to take pressure off the nerves to relieve pain
Stretching and flexibility exercises to improve mobility in the joints and muscles of your spine and your extremities, improving motion in a joint is often the key to pain relief
Strengthening exercises: strong trunk muscles provide support for your spinal joints, and strong arm and leg muscles help take some of the workload off your spinal joints
Aerobic exercise to increase tolerance for activities such as walking that might have been affected by the spinal stenosis
This might sound like a lot of exercise, but don't worry: research shows that the more exercise you can handle, the quicker you'll get rid of your pain and other symptoms.
Your physical therapist also might decide to use a combination of treatments:
Manual therapy to improve the mobility of stiff joints that may be contributing to your symptoms
A special harness-type device attached to a treadmill that helps to reduce pressure on the spinal nerves during walking
Posture education to help you learn to relieve pressure on the nerves by making simple changes in how you stand, walk, and sit
Special pain treatments, such as ice or electrical stimulation, for pain that is severe and not relieved by exercise or manual therapy
Chautauqua Physical & Occupational Therapy is celebrating 17 years of serving our community. We are located in the Riverwalk Center, are therapist owned and are the only outpatient clinic in the area to offer free consultations. Call us at 488-2322 or visit www.chautauquapt.com.