Exercise Program for Spinal Stenosis

Exercise Program for Lumbar Spinal Stenosis

Photo of woman stretching her back on the couch.
Your PT can help you set up a home exercise program for lumbar spinal stenosis.. PhotoAlto/Milena Boniek/Getty Images

 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 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 in with your doctor to be sure that exercise is safe for your specific condition.

Sustained Lumbar Extension

Photo of the sanding back bend.
The standing back bend may help relive your spinal stenosis symptoms.. QxQ Images-Datacraft/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 benefit from bending backwards.  It is theorized that this position gently presses agains 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 backwards.  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.

Lumbar Flexion in Lying

Lumbar flexion in lying
Perform low back flexion by pulling your knees towards your chest.. Brett Sears, PT, 2013

To start your spinal stenosis lumbar flexion exercise progression, perform the flexion in lying exercise.  To do this, lie 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, and then release your knees back to the starting position.

Perform lumbar flexion in lying for 10 repetitions, and then move on to the next exercise.

Seated Lumbar Flexion

Seated lumbar flexion.
Seated low back flexion can help improve your spinal mobility and decrease low back pain..

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.

Standing Lumbar Flexion

Lumbar flexion in standing.
You can perform lumbar flexion in standing to improve your spinal mobility.. ©Brett Sears, PT, 2013

Standing lumbar flexion is a great exercise to treat your spinal stenosis.  To do the exercise, stand with your feet apart and slowly bend yourself forward, reaching towards the floor.  When you are fully bent 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.  

Hip and Core Strengthening

Photo of the ball bridge.
After performing a ball bridge, slowly bend your knees and allow the ball to roll towards your buttocks.. Brett Sears, PT, 2011

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, lie on your back with your knees bent.  Slowly roll your pelvis backwards as if your were flattening out your spine.  Hold this position for 3 seconds, and then 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.)

Aerobic Exercise

Photo of active older couple riding bicycles.
Riding a bicycle can help improve your aeorbic fitness level.. 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, but 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.)

Bottom Line

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 for your condition, and start your lumbar spinal stenosis home exercise program right away.

McKenzie, R., & May, S. (2003). The lumbar spine mechanical diagnosis and therapy. (2nd ed., Vol. One). Waikanae: Spinal Publications New Zealand.

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