Medically reviewed by Misty Seidenburg
Spinal stenosis due to age or injury is one of the most common causes of chronic pain, especially in older adults. By the age of 50, 95% of people have some degree of spinal degeneration. If you are among that group, it may seem counterintuitive to exercise with spinal stenosis. But physical activity can improve strength, flexibility, and stability—if you are doing the right activities. Here, we discuss the exercises to avoid with spinal stenosis and explain the benefits of physical therapy for safe, supervised exercise.
To understand how and why spinal stenosis causes pain, numbness, weakness in the back, upper body, or lower body, let’s look at the anatomy of the spine.
The spinal canal is a tunnel-like structure that runs through each of the vertebrae of the spine. It houses the spinal cord and nerve roots that branch out from the cord to other parts of the body.
As we age, everyday wear and tear causes the spaces within the spinal canal to shrink, which in turn exerts pressure on the spinal cord and nearby nerve roots. The location and severity of symptoms can vary depending on the area of the spine affected.
While age-related degeneration is a leading cause of stenosis, these spinal changes can also happen as a result of: herniated or bulging spinal discs, systemic conditions like arthritis and osteoarthritis, and spinal fractures.
Prolonged bed rest and a sedentary lifestyle can actually increase the severity of back pain. That is why exercise is recommended for most individuals with spinal stenosis. In fact, research shows that exercise therapy can mitigate the need for surgery in some patients.
But some movements can cause further pain during an episode of symptoms. Here are the top activities to avoid if you have spinal stenosis:
Frequent, short walks are beneficial for those with stenosis who are symptomatic. Yet long, extended walks can lead to muscle fatigue which strains on the lower back, or lumbar spine. This added strain can increase pain and accelerate degeneration.
The continual thumping of the feet on the ground during running causes repetitive impact on the spine. It can increase compression on a sensitive back that can worse stenosis symptoms.
Basketball, volleyball, skipping rope, and other activities that involve frequent jumping cause the spine to compress and decompress quickly, which is not ideal for those with a degenerative condition of the back. Jumping also causes the back muscles to contract to protect the spine which can increase spinal stenosis pain.
People with spinal stenosis should avoid contact sports like football, soccer, basketball, and martial arts. Forceful impacts to the body and sudden twists and turns may increase the risk of back injuries and further damage to spinal structures.
Back extension exercises, or hyperextensions, are exercises that involve extending the back from a flexed position. Some people incorporate these movements into their fitness regimen to strengthen the lower back.
This is a fantastic exercise to strengthen the back and to improve weak bones, such as in osteoporosis. However, in people with spinal stenosis back extensions past neutral should be avoided because they cause narrowing of the spinal canal and a worsening of pain and other symptoms.
Now that we have covered what to avoid with spinal stenosis, let’s explore the ways physical therapy helps patients manage pain and remain active, strong, and fit. Here are some of the treatments and techniques physical therapists utilize to improve symptoms and quality of life for spinal stenosis patients.
The benefits of exercise for patients with spinal stenosis include improved strength, balance and coordination, increased flexibility and range of motion, and better posture and gait. Targeted exercise helps to ease pressure on spinal nerves and decrease stenosis pain.
Your physical therapist prescribes safe and gentle low-impact activities like aquatic therapy and other aerobic exercises to help you feel and move better. They also create an exercise plan for you to do at home to help you see results sooner. Strengthening exercises will help support the back and build capacity to do the activities you are missing out on.
Patients also benefit from massage and other hands-on manual therapies to increase mobility in stiff joints which can contribute to or occur due to spinal stenosis. Stretching, joint manipulation, and manual therapy techniques also help to relax the soft tissues around spinal canal openings to ease constriction of the spinal cord and spinal nerves.
Physical therapists wear many hats. In addition to being movement experts they are also educators. They teach patients how to navigate routine tasks safely while minimizing pain. They help patients practice proper posture when sitting, standing, sleeping, and walking to protect the spine and reduce pain.
Lifestyle recommendations are another important aspect of physical therapy. Patients learn the benefits of hydration and healthy eating to promote healing and reduce inflammation. Physical therapists empower patients with self-management strategies to treat their symptoms at home and complement their hard work in the clinic.
Living with spinal stenosis doesn’t mean you have to say no to exercise and all of the activities you enjoy. A personalized physical therapy program can offer long-lasting relief and improve the way you feel and move.
Check with your healthcare provider and schedule a screening to find if you are a candidate for physical therapy. Find a physical therapy clinic near you.