Demystifying Spinal Stenosis: A Comprehensive Guide to Understanding, Avoiding Risk Factors, and Non-Surgical Management

What is spinal stenosis?

Spinal stenosis is a health condition characterized by the narrowing of spaces within the spine, which can lead to pressure on the nerves that travel through it. This condition primarily manifests in two areas: the neck (cervical spine) and lower back (lumbar spine), causing symptoms like pain, numbness, and even mobility challenges. Most common in adults over 50, spinal stenosis is often a byproduct of the wear and tear linked to aging. However, it can also present in younger individuals due to congenital conditions or as a consequence of injury.

What are spinal stenosis exercises to avoid? 

Exercises form a crucial part of managing and preventing the exacerbation of spinal stenosis symptoms. Yet there are certain activities that individuals with this condition should steer clear of. High-impact exercises such as running or jumping can intensify symptoms as they put undue stress on the spinal cord.

Likewise, exercises involving twisting of the spine or heavy lifting can also strain the spine. Instead, gentle, low-impact activities like swimming, cycling, Pilates, or yoga are advisable as they strengthen the supporting muscles without burdening the spine.


Things to avoid with spinal stenosis

Beyond exercise, there are other lifestyle factors that those living with spinal stenosis should remain wary of. Extended periods of standing or walking, bending backwards, and maintaining poor posture can aggravate the condition. Regularly monitoring your body's response to various activities and adjusting habits accordingly is vital to managing spinal stenosis effectively.

What kind of walking problems do people with spinal stenosis have?

The narrowing of spinal spaces can cause distinctive walking problems. A common symptom experienced by people with this condition is known as "neurogenic claudication." This issue manifests as pain or cramping in the lower back and legs, which worsens when standing or walking and improves when sitting or leaning forward. Another related walking problem is foot drop, where an individual struggles to lift the front part of their foot, leading to frequent tripping.

How do you fix spinal stenosis without surgery?

Fortunately, there are numerous ways to manage spinal stenosis without resorting to surgery. Physical therapy is a cornerstone of managing this condition; it strengthens the muscles that support the back, improving overall stability.

Medical interventions such as pain relievers, anti-inflammatory drugs, and nerve desensitizers can alleviate pain and other symptoms. Additionally, epidural steroid injections have been successful in providing temporary relief for some patients. Complementary therapies, including massage therapy and acupuncture, have also shown promise in managing spinal stenosis symptoms.

Is spinal stenosis a permanent disability?

Spinal stenosis can significantly impair an individual's quality of life, but it doesn't always qualify as a permanent disability. The severity and progression of the condition vary greatly among patients, and in severe cases, spinal stenosis might be deemed a disability under the Social Security guidelines. However, a comprehensive evaluation by a medical professional is necessary for this classification.

Is spinal stenosis hereditary?

While the origins of spinal stenosis are multifaceted, a hereditary component does exist. A congenitally small spinal canal can make an individual more susceptible to spinal stenosis. However, most cases of spinal stenosis are linked to age-related degenerative changes like osteoarthritis or disc degeneration.

What is the difference between cervical and lumbar spinal stenosis?

The key difference between cervical and lumbar spinal stenosis lies in the location and the resultant symptoms. Cervical stenosis, occurring in the neck, can lead to symptoms like numbness, weakness, or tingling in a hand, arm, foot, or leg and can interfere with balance and coordination.

Lumbar stenosis, which is more common and located in the lower back, often causes pain or cramping in the legs, especially when standing or walking. Despite the differences, both types of stenosis stem from a common cause: a narrowing of the spaces within the spinal canal that puts undue pressure on the spinal cord or nerve roots. By understanding the nature and nuances of this condition, individuals can manage their symptoms and maintain an active lifestyle.


How is spinal stenosis diagnosed?

Spinal stenosis is diagnosed through a multi-step process, starting with a detailed history and physical examination by a healthcare provider. Patients often describe specific symptoms, such as pain in the neck or back, numbness or tingling in the arms or legs, or problems with walking or balance. During the physical examination, the doctor may test the patient's reflexes, strength, and sensation, and look for signs of neurogenic claudication, a hallmark of spinal stenosis.

After a physical examination, if the healthcare provider suspects spinal stenosis, they may order imaging tests for confirmation. These can include X-rays, which can reveal changes associated with osteoarthritis or bone spurs; computed tomography (CT) or CT myelograms, which can provide detailed cross-sectional images of the body and reveal herniated disks, bone spurs, or tumors; and magnetic resonance imaging (MRI), which can provide 3D images of the spine and detect damage to disks and ligaments, as well as the presence of tumors.


What does spinal stenosis look like on an MRI?

On an MRI, spinal stenosis appears as a narrowing of the open spaces within the spine. The spinal canal, where the spinal cord or nerve roots travel, may seem constricted. This constriction could be due to various factors, such as bulging discs, thickened ligament tissue, or bone spurs.

The pressure these structures place on the spinal cord or nerve roots may be visible, particularly if the scan is performed with contrast. While interpreting an MRI scan requires specialized training, these are some of the signs a trained radiologist or physician may note when diagnosing spinal stenosis.

What is congenital spinal stenosis?

Congenital spinal stenosis is a form of spinal stenosis that a person is born with. The term "congenital" means that the condition is present at birth. In this case, the individual inherits a smaller than normal spinal canal.

While they may not experience symptoms at a young age, the narrow spinal canal leaves less room for error, making these individuals more susceptible to developing symptoms of spinal stenosis earlier in life, especially if they experience any sort of degenerative changes or trauma to the spine. It's important to note that while congenital spinal stenosis increases the risk, it does not guarantee that the individual will develop symptomatic spinal stenosis.

Here are a few references that you might find helpful:

  1. Kalichman, L., Cole, R., Kim, D. H., Li, L., Suri, P., Guermazi, A., & Hunter, D. J. (2009). "Spinal stenosis prevalence and association with symptoms: The Framingham Study". The Spine Journal, 9(7), 545-550. Read here

This study provides a detailed look at the prevalence of spinal stenosis and its correlation with symptomatic manifestations, which underscores the importance of early detection and management.

  1. Schneider, M. J., Ammendolia, C., Murphy, D. R., Glick, R. M., Hile, E., Tudorascu, D. L., ... & Tomkins-Lane, C. (2019). "Comparison of non-surgical treatment methods for patients with lumbar spinal stenosis: protocol for a randomized controlled trial". Chiropractic & Manual Therapies, 27(1), 1-11. Read here

This randomized controlled trial gives an overview of the effectiveness of various non-surgical treatment methods for patients with lumbar spinal stenosis, which can be an excellent reference for the section on managing spinal stenosis without surgery.

The Mayo Clinic offers comprehensive information on spinal stenosis, its diagnosis, symptoms, causes, and treatment. You can link to their page on spinal stenosis here:

Click here to learn about sciatica and a herniated disc and how they are different than Spinal Stenosis…

If you are local to the Austin area and need help with Spinal Stenosis, please call 512-215-4227 now!

Co-Owner / Physical Therapist at CORE Therapy and Pilates
Stephen graduated with a Masters in Physical Therapy in 1998 from LSUMC in New Orleans and is a licensed physical therapist in Texas since 2004. Immediately interested in hands-on therapy, he began to study with Brian Mulligan and became certified in the Maitland Australian Approach in 2003. Stephen has since studied the fascial system through John F Barnes Myofascial Release. Stephen completed a comprehensive Pilates training in 2002 and the GYROTONIC Expansion System® in 2009. The combined treatment of manual therapy with mind-body awareness exercises using Pilates and Gyrotonic concepts was the start of his whole-body treatment approach.
Stephen Dunn