Back & Neck Pain Exercise Exercise Program for Spinal Stenosis By Brett Sears, PT facebook twitter linkedin Brett Sears, PT, MDT, is a physical therapist with over 15 years of experience in orthopedic and hospital-based therapy. Learn about our editorial process Brett Sears, PT Medically reviewed by Medically reviewed by Laura Campedelli, PT, DPT on March 15, 2020 linkedin Laura Campedelli, PT, DPT, is a physical therapist with experience in hospital-based acute care and outpatient therapy with both children and adults. Learn about our Medical Review Board Laura Campedelli, PT, DPT on March 15, 2020 Print If you have lumbar spinal stenosis, you may benefit from physical therapy to help treat your back pain and leg symptoms and to improve your overall mobility. Your physical therapist may use many different treatments and modalities to help you move better and feel better so you can enjoy your normal activities. One of the most important things you should do if you have spinal stenosis is to engage in a regular exercise program. Your exercise program should focus on changing the position of your spine to help take pressure off spinal nerves. This can decrease or abolish your pain and improve your ability to walk without pain. This step-by-step is an exercise program for spinal stenosis and is similar to one that your physical therapist may prescribe as a home exercise program for your condition. The exercise program focuses on restoring normal mobility to your spine and helping you return to optimal function and mobility. Before starting this, or any other, exercise program, check with your doctor to be sure that exercise is safe for your specific condition. 1 Sustained Lumbar Extension Patrik Giardino / Getty Images Many people with lumbar spinal stenosis benefit from lumbar flexion exercises that bend your spine forward, and many of the exercises in this program focus on flexion. But first, you should try sustained lumbar extension as recommended by the great physical therapist Robin McKenzie. Why? Lumbar flexion opens up your spine and takes pressure off of your spinal nerves. But a small subset of people with spinal stenosis benefits from bending backward. It is theorized that this position gently presses against the soft lumbar discs and nudges them away from your spinal canal. This can help give your lumbar nerves a little more room. To perform the exercise: Stand with your feet shoulder-width apart. Support your back and bend backward. Hold the position for about 60 seconds. This position may cause an increase in your back pain and leg pain or tingling. In some people, the symptoms subside within 60 seconds. If that happens, add the exercise to your lumbar spinal stenosis home program. If sustained lumbar extension causes an increase in your symptoms that does not abate in 60 seconds or so, then it is not for you and it should be eliminated from your home exercise program. Sustained Lumbar Extension Exercise 2 Lumbar Flexion in Lying Mitch Diamond/Photodisc/Getty Images To start your spinal stenosis lumbar flexion exercise progression, perform the flexion in lying exercise. To do this: Lay on your back with your knees bent. Slowly bring your knees up to your chest, and grab onto them with your hands. Hold this balled-up position for 2 seconds. Release your knees back to the starting position. Perform lumbar flexion in lying for 10 repetitions, and then move on to the next exercise. Williams Lying Low Back Flexion Exercise 3 Seated Lumbar Flexion Brent Sears Once you have completed lumbar flexion in supine, it is time to perform the bending exercise for your stenosis in a seated position. To perform lumbar flexion in sitting: Sit in a firm chair with both feet on the floor. Slowly bend yourself forward and reach towards the floor. Hold the fully bent position for 2 seconds. If you need to add more overpressure, grasp your ankles and give a gentle tug. After holding the position for 2 seconds, release and return to the full, upright seated position. Repeat the seated lumbar flexion exercise for 10 repetitions, and then move on to the next exercise. 4 Standing Lumbar Flexion Steve Prezant / Getty Images Standing lumbar flexion is a great exercise to treat your spinal stenosis. To do the exercise: Stand with your feet apart. Slowly bend yourself forward, reaching towards the floor. When you are fully bent, hold for 2 to 3 seconds. Slowly return to the upright standing position. Repeat the exercise 10 times. This exercise can be used to help eliminate your back and leg pain that may come on while you are out for a walk. Whenever your feel increased back pain or leg tingling when walking, simply bend yourself forward for a few repetitions to help alleviate your symptoms. Standing Back Flexion Exercise 5 Hip and Core Strengthening Brett Sears If you have spinal stenosis, you may benefit from core strengthening to help improve the way your muscles that support your spine work. The posterior pelvic tilt is a great exercise that works your abdominal and hip muscles while flexing your spine. To do the pelvic tilt: Lay on your back with your knees bent. Slowly roll your pelvis backward as if you were flattening out your spine. Hold this position for 3 seconds. Slowly return to the starting position. Repeat 10 times. Sometimes, hip strengthening may be in order to help you improve your walking ability if you have spinal stenosis. Start with basic straight leg raises, and then move on to advanced hip strengthening exercises. (Your physical therapist can help you decide which exercises are best for your specific condition.) 6 Aerobic Exercise Paul Bradbury/Getty Images Lumbar spinal stenosis is a progressive condition that comes on gradually. You may notice that since the onset of your symptoms, you have slowly decreased your activity level. This decrease in activity may take a toll on your overall aerobic fitness level. Once your spinal stenosis symptoms are under control, you can start to incorporate aerobic exercise into your routine. Walking is always a good idea for people with back pain. If your symptoms prevent you from walking any distance, you may want to consider bicycle riding to help improve your cardio-respiratory fitness level. Biking is a good choice because you are seated while riding, and this places your spine in a stenosis-friendly flexed position. A Word From Verywell If you have lumbar spinal stenosis, exercise should be one of your main tools to treat your symptoms and to prevent the progression of the disease. Visit your physical therapist to learn exercises specific to your condition, and start your lumbar spinal stenosis home exercise program right away. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Tomkins CC, Dimoff KH, Forman HS, et al. Physical therapy treatment options for lumbar spinal stenosis. J Back Musculoskelet Rehabil. 2010;23(1):31-7. doi:10.3233/BMR-2010-0245 Kuramoto A, Chang L, Graham J, Holmes S. Lumbar spinal stenosis with exacerbation of back pain with extension: a potential contraindication for supine MRI with sedation. J Neuroimaging. 2011;21(1):92-4. doi:10.1111/j.1552-6569.2009.00382.x Stewart DM, Gregory DE. The use of intermittent trunk flexion to alleviate low back pain during prolonged standing. J Electromyogr Kinesiol. 2016;27:46-51. doi:10.1016/j.jelekin.2016.01.007 Chen C, Lin Z, Zhang Y, Chen Z, Tang S. Does the effectiveness of core stability exercises correlate with the severity of spinal stenosis in patients with lumbar spinal stenosis?. Pak J Med Sci. 2017;33(3):631-634. doi:10.12669/pjms.333.12123 Vanti C, Andreatta S, Borghi S, Guccione AA, Pillastrini P, Bertozzi L. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials. Disabil Rehabil. 2019;41(6):622-632. doi:10.1080/09638288.2017.1410730 Additional Reading McKenzie, R., & May, S. (2003). The lumbar spine mechanical diagnosis and therapy. (2nd ed., Vol. One). Waikanae: Spinal Publications New Zealand.