Self-Care for Lumbar Spinal Stenosis

Lumbar spinal stenosis self-care strategies including regular exercise, posture changes, and adopting healthy habits can help relieve back pain caused by narrowing spaces in the spinal canal.

Lumbar spinal stenosis is a progressive condition that can get worse over time, so it's important to know what self-care strategies can be helpful as well as what things you should avoid doing that may worsen your condition.

Living With Lumbar Spinal Stenosis

Spinal stenosis is caused by a narrowing of your spinal canal. This narrowing can irritate the nerves that travel down your legs. Symptoms are typically worse when you walk. They often get better when you sit down or bend forward.

If you are living with lumbar spinal stenosis, the discomfort and difficulty of walking can be hard to bear. It is normal to want relief right away. Depending on the nature and severity of your condition, there are things you can do that may help reduce pain or slow the progression of the condition.

Exercise

Moderate, low-impact exercise (such as swimming, water exercise, walking, and cycling on level surfaces) as well as exercises to build abdominal and hip strength can support your spine.

In the past, many specialists prescribed only flexion exercises for people with spinal stenosis. Flexion exercises bend the spine forward. Bending forward increases the diameter of your spinal canal. Creating more space in your spinal canal takes pressure off the nerves in your spine.

Today, it is more common to include exercises that allow you to bend backward, too. One such movement is called a sustained standing lumbar extension. This exercise gently presses against your spinal discs, moving them away from your spinal canal and nerves to give them more room.

Work with your healthcare provider or physical therapist to develop an exercise program. They can show you how to do these exercises safely.

Practice Good Posture

To treat your condition, you must change the biomechanics of your spine—the way your spine moves. You can help do this by correcting your posture. Concentrate on standing and sitting up straight with shoulders back and use proper back support when sitting or driving. Sleeping on a firm mattress can also reduce discomfort.

Physical Therapy

A physical therapist can teach you exercises to improve your range of motion (ROM) and strength. They can also show you proper ways to lift objects and how to change your posture to help ease your symptoms.

Lifestyle Changes

One of the most important things you can do to reduce your symptoms is to maintain a healthy weight. Excess weight puts added pressure on the spine when walking and standing.

Home Remedies and Alternative Therapies

Simple home remedies like using an ice pack or heating pad, or taking a hot shower may provide some temporary pain relief.

Along with home remedies, massage and acupuncture may provide pain relief. Clinical trials are beginning to emerge with the majority demonstrating benefit from certain acupuncture techniques.

What Not to Do With Spinal Stenosis

Lumbar spinal stenosis is different from many other causes of back pain. It is a progressive condition that often gets worse if you do nothing.

"Progressive" doesn't mean there is nothing you can do. Exercising can help you move more freely. It can also decrease back and leg pain. Working to improve your strength and range of motion can help you walk better with less pain.

Taking an active role in your care is one of the best ways to manage your condition.

Don't Overuse NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used as a first-line treatment for spinal stenosis. While these anti-inflammatory medications can bring you some short-term relief, it's important to only take them as directed by your healthcare provider.

Side effects of NSAIDs include:

• Indigestion
• Stomach ulcers
• High blood pressure
• Fluid retention
• Allergic reactions

Chronic NSAID use may also increase the risk of kidney injury and heart problems.

Stop High Impact Exercise

High-impact exercises like running, jumping, and climbing can worsen spinal stenosis. These activities create repeated impacts on the spine. Even prolonged walks should be avoided because they can cause muscle fatigue, which can increase the strain on your lumbar spine.

Contact sports such as football, soccer, basketball, and martial arts also involve a lot of impact and can result in sudden trauma or further injury to the spine.

Spinal Stenosis Therapies

The right treatment for you depends on many factors: the severity of your spinal stenosis, which levels and how many levels of your spine are affected, your age, your overall health, and whether you are prepared to participate in post-operative rehabilitation.

Spinal Stenosis Medication

Your healthcare provider may prescribe medication to help treat the pain from spinal stenosis. Remember that these medications should only be used as directed and only when your symptoms are severe.

• Tricyclic antidepressants can help ease chronic pain.
• Anti-seizure drugs such as gabapentin can help with nerve pain.
• Opioids may be prescribed for severe pain, but these can be habit-forming. Talk to your healthcare provider about whether these medications are appropriate for your condition.
  

Spinal Stenosis Surgery

There are several surgical options for treating lumbar spinal stenosis, but these are usually only considered after more conservative therapies have been tried. These include:

• Laminectomy, which removes part of the vertebrae called the lamina to create more space in the spinal canal
• Foraminotomy, which enlarges the area where the nerve root leaves the spinal canal
• Spinal fusion, which connects and stabilizes the affected vertebrae
  

Surgery may be the best option in some situations. For some people, non-invasive treatment and surgery have similar long-term outcomes for lumbar spinal stenosis. For example, for some people, epidural steroid injections, in which medication is injected into your spine, can be a good treatment option.

Summary

Lumbar spinal stenosis is a progressive condition. If you don't take any action, it is likely to get worse over time. Talk to a physical therapist or another healthcare provider about different types of exercise you can do to build up your strength and mobility and slow the progression of the condition.

While anti-inflammatory medications may ease symptoms, in the long run, you may be better off changing your posture and the way you move.

Surgery is a good option for some people with lumbar spinal stenosis. But, for some people, physical therapy can often achieve good results with fewer risks.