Spinal stenosis is a narrowing of the spinal column that causes pressure on the spinal cord or narrows the openings where spinal nerves leave the spinal column. While there are many possible causes of spinal stenosis, all present with pain and limited mobility. Do not attempt any exercise without the approval of your physician. Do not perform any exercise without instruction from a licensed physical therapist.
Physical Therapist Recommendations
One of the issues with stabilization exercises in a patient suffering from spinal stenosis is compliance with exercise protocol. As even mild exercise can cause pain, often exercises are not performed, or the exercises are limited in scope. In a 2010 study published in the "Journal of Back and Musculoskeletal Rehabilitation" it was shown that physical therapists recommended stabilization exercises to 86 percent of patients. In the same study it was concluded that only 23 percent of patients reported doing regular strengthening exercise. So while a protocol may be recommended, it must be implemented for it to be effective.
Trends in Stabilization Exercises
In a 2003 study published in the journal of "Physical Medicine and Rehabilitation Clinics of North America," stabilization exercises were recommended as an alternative to surgery. Numerous studies have referenced the need for a comprehensive treatment program, including a 2005 study published in the "Archives of Physical Medicine and Rehabilitation." The team of researchers concluded that all physical treatment of spinal stenosis should be included in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation.
Results
Stabilization exercises have been shown to reduce back pain and improve posture in the majority of cases in which they were implemented. In a four-year followup study published in "Spine," all respondents who received dynamic stabilization exercise were happy with the results. All participants reported a decrease in back pain and no increase in spondylolisthesis. In a 2006 study in "Spine," all patients responded favorably to stabilization exercise and showed marked improvement in functionality after six weeks of physical therapy.
Exercises
While it is impossible to list all of the exercises that you should perform if you suffer from spinal stenosis, there are certain categories of exercises that should be part of your program. As each individual case is different, there are no two identical treatment protocols. Basic flexibility is a key component, and stretching of the hamstrings should be a regular part of of your program. Core work such as pelvic tilts and bridging exercises strengthen your abdominals and help stabilize your spine. Lying leg raises are sometimes used to strengthen the neutral spine and develop the hip flexors.
References
- PubMed Health: Spinal Stenosis
- "Journal of Back and Musculoskeletal Rehabilitation"; Physical Therapy Treatment Options for Lumbar Spinal Stenosis; C.C. Tomkins, et al.; 2010
- "Physical Medicine and Rehabilitation Clinics of North America"; Functional Rehabilitation for Degenerative Lumbar Spinal Stenosis; J.D. Rittenberg, et al.; February 2003
- "Archives of Physical Medicine and Rehabilitation."; Rehabilitation of Orthopedic and Rheumatologic Disorders; A.N. Vo, et al.; March 2005
- "Spine"; Minimum Four-year Follow-up of Spinal Stenosis with Degenerative Spondylolisthesis Treated with Decompression and Dynamic Stabilization; S. Schaeren; et al.; August 2008
- "Spine"; A Comparison Between Two Physical Therapy Treatment Programs for Patients with Lumbar Spinal Stenosis: a Randomized Clinical Trial; J.M Whitman, et al.; October 2006
