Spinal stenosis is a narrowing of the spinal canal, the space that contains the spinal cord. This is most often caused by degenerative changes that occur over time, just as with herniated discs, arthritis, compression fractures, etc. The stenosis, or narrowing of the space, can put pressure on the nerves that travel through the spine. The two most common places for this to occur are in the neck (cervical stenosis) and the low back (lumbar stenosis).
Most often stenosis can begin with little to no sign that anything is wrong, with progression of symptoms over time as the stenosis worsens. Due to the compression that occurs on the nerves where they leave the spinal canal, the most common symptoms include numbness, tingling, and weakness of the limbs. In some severe cases, organ function may be affected as well.
There are many treatment options for spinal stenosis depending on the severity of the case, such as pain-relieving medications, physical therapy, epidural steroid injections, and surgical decompression procedures. Surgery is usually reserved as a last resort, so physical therapy is the first, and often one of the most effective steps in finding relief from the direct compression on those nerves. With the appropriate movements and exercise regimen, much of that pressure can often be relieved. If you have some progressed symptoms and are dealing with the pain of the nerve compression, movement and exercise may be the last thing you want to do. However, it is often the best course of action. Getting through the first few minutes, and the first few sessions, is the hardest part. Once you’re past that, you’ll often start to see some immediate improvement.
While spinal stenosis can be painful, it is important to remain as active as possible to prevent worsening of your symptoms. Low impact exercises such as riding a stationary bike or swimming are often recommended by rehab physicians and physical therapists. Because the exact cause and nature of the stenosis may be unique for each patient, talk with your medical professionals about the best exercises for your specific type of stenosis.
Massage therapy, specifically Neuromuscular Therapy, may be another option to treat the pain associated with spinal stenosis. We target the primary spinal muscles associated around the stenotic area, but also the secondary muscles related to biomechanics of the affected area. While NMT itself can’t remove the direct compression within the structure of the spine, it can offer relief to the muscular pain, trigger points and adhesions that often occur as a side effect of that compression. And by decreasing the muscular tension around the structure of the spine, you also decrease compression on the other components of the vertebrae and nerves that exacerbate the primary pain from stenosis. To put it simply, your body tenses all the muscles in the area as a way to try to protect from further damage and to provide stability, like a splint. While this is well-intentioned protection, this can only add to the pain. Minimizing that tension and maintaining the muscle flexibility will often result in far less discomfort associated with the stenosis and a better quality of life.