What is spinal stenosis?

What is spinal stenosis?

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Spinal stenosis is a medical condition characterized by the narrowing of a passage or opening, mainly the spinal canal or neural foramina (openings through which nerves exit the spinal column). It can be congenital (present from birth) or acquired and can occur at any age. The narrowing may be caused by soft tissue structures, such as disc protrusion (bulging disc), fibrotic scars (scarring of tissue) or joint swelling, by bony narrowing as with osteophyte formation (bone spur), or by faulty posture. This narrowing can exert pressure on the spinal cord or nerve roots, leading to various symptoms.

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There are two primary types of spinal stenosis:

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1. Central stenosis: In central stenosis, the central canal of the spinal column narrows, compressing the spinal cord. This condition commonly occurs in the neck (cervical stenosis) or lower back (lumbar stenosis).
2. Foraminal stenosis: Foraminal stenosis refers to the narrowing of the neural foramina, which are passageways through which nerve roots exit the spinal column. This type of stenosis can occur at any level of the spine and typically affects one or more nerve roots.

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Common symptoms of stenosis

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The symptoms of spinal stenosis can vary depending on the location and severity of the compression. Common signs and symptoms include:

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1. Pain: Stenosis can cause burning or aching pain in the affected area of the spine, which may radiate to other parts of the body such as the arms, hands, buttocks, legs, thighs and feet. Pain may result from the stresses of excessive mobility and may also be a result of swelling and irritation of the affected structural segments.
2. Numbness or weakness: Compression of nerves can lead to sensations of numbness, tingling, or weakness in the extremities, such as the arms, hands, legs, or feet and may be more pronounced upon certain movements of the affected area.
3. Difficulty with balance or coordination: Severe spinal stenosis can interfere with nerve signaling and affect balance, resulting in unsteadiness while walking or clumsiness.
4. Decreased endurance for walking or physical activity: Individuals with spinal stenosis may experience leg pain, cramping, or fatigue with walking or prolonged physical activity. This symptom is often relieved with rest or by adopting a forward-leaning posture.

What causes stenosis?

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The narrowing of the spinal canal or neural foramina can be caused by various factors, that could be congenital (present from birth) or acquired including:

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1. Degenerative changes: Aging and wear-and-tear on the spine can result in the breakdown of spinal structures, such as intervertebral discs and facet joints. This can lead to the formation of bone spurs (osteophytes) and the thickening of ligaments, contributing to spinal stenosis.
2. Herniated discs: When the gel-like material within an intervertebral disc protrudes or herniates, it can cause compression of the spinal cord or nerve roots, leading to stenosis.
3. Spinal injuries: Trauma usually affects the spinal canal with a mechanical force that causes injuries to the spine, such as fractures or dislocations, which can result in spinal stenosis.
4. Congenital conditions: Some individuals are born with a narrower spinal canal or have conditions that predispose them to spinal stenosis.

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How can physical therapy help? 

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Physical therapy can be a beneficial component of the treatment plan for individuals with spinal stenosis. While physical therapy cannot reverse the narrowing of the spinal canal or neural foramina, it aims to manage symptoms, improve function, and enhance quality of life. Here are some ways in which physical therapy can help with stenosis:

1. Pain management: Physical therapists can utilize various modalities, such as heat or cold therapy, electrical stimulation, ultrasound, or manual therapy techniques, to help alleviate pain and discomfort associated with spinal stenosis. Traction may also be prescribed to the patient; it has the mechanical benefit of temporarily separating the vertebrae and may help reduce circulatory congestion and relieve pressure on the spine. They may also educate individuals on self-management strategies for pain relief.
2. Posture and body mechanics: Physical therapists can provide guidance on proper posture, body mechanics, and movement techniques to relieve pressure on the spinal cord or nerve roots. They may teach awareness and control of spinal alignment, as well as functional adaptations such as; stable spine lifting, pushing/pulling and reaching techniques. 
3. Strengthening exercises: Physical therapists can design specific exercises to strengthen the muscles that support the spine. Strengthening the core (abdominal) muscles, as well as the muscles of the back, and lower limbs, can improve stability and relieve pressure on the spinal structures. Strengthening exercises may include the use of resistance bands, and free weights  wherein the patient will start from a low load resistance and will progress to a more challenging exercise.
4. Flexibility and range of motion exercises: Decreased flexibility in joints and muscles may restrict the patient's ability to assume normal spinal alignment. Manual techniques and safe self-stretching techniques are utilized to increase muscle, joint and connective tissue mobility. 
5. Aerobic conditioning: Aerobic capacity is usually compromised on patients with spinal stenosis. The physical therapist will guide the patient in the initiation of or safe return to an aerobic conditioning program that does not exacerbate spinal symptoms. Low-impact aerobic exercises, such as walking, swimming, or cycling, can improve cardiovascular fitness and overall endurance without placing excessive stress on the spine. Aerobic conditioning can help individuals with stenosis manage weight, improve circulation, and enhance overall physical well-being.
6. Balance and coordination training: Physical therapists can incorporate exercises to improve balance and coordination, which are often affected in individuals with stenosis. These exercises may include spinal stabilization, standing balance exercises, proprioceptive training, and dynamic trunk and neck exercises to enhance stability and control during activities.
7. Education and home exercise program: Physical therapists can provide education about healthy exercise habits, the benefits of maintaining fitness level and safe body mechanics. They also encourage patients to engage in all activities and teach safe execution of their home exercise program to reinforce the intervention and for self-maintenance. 

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The specific treatment plan will vary depending on the individual's condition, age, spinal area affected, symptoms, and goals. It's important to work closely with a physical therapist who has experience in treating spinal stenosis to receive personalized care and guidance. They can tailor the exercise program and therapeutic interventions to suit the individual's needs and monitor progress throughout the treatment process.

It's recommended to consult with a healthcare professional, such as a doctor or physical therapist, to determine the most appropriate approach for managing spinal stenosis and to ensure safe and effective treatment.

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Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth.

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