Spinal Stenosis? Try This Exercise First

Photo of the sanding back bend.
The standing back bend may help relive your spinal stenosis symptoms. QxQ Images-Datacraft/Getty Images

If you have been diagnosed with lumbar spinal stenosis, then you understand how your symptoms can limit your ability to walk or enjoy your normal activities.  Spinal stenosis, or a narrowing of your spinal canal that pinches on your nerves, typically causes back pain and pain or tingling in both legs when walking.  The symptoms are typically improved or abolished with rest.

If you develop spinal stenosis, you may benefit from physical therapy to help you improve your lumbar range of motion (ROM) and strength and to help manage your primary symptoms.

 Physical therapy for spinal stenosis had been shown to be just as effective for surgery for the condition, with fewer dangerous side effects.  Components of your physical therapy treatment program may include:

Exercise for spinal stenosis typically involves spinal flexion.  Why?  Because it is thought that flexing, or bending your spine forward, helps to open up and increase the diameter of your spinal canal.  This helps to take pressure off of the nerves that exit your spine and travel down your legs.

So is spinal extension, or bending backwards, completely out of the question if you have spinal stenosis?  Maybe not.

The Standing Back Extension Exercise

Check with your doctor before starting this or any other exercise.

If you have spinal stenosis, one exercise you should try first is the standing lumbar extension exercise.  Here is how you do it:

  1. Stand with your feet about shoulder width apart.
  2. Place both hands behind your back just above your hips.
  3. Slowly bend yourself backwards.  You can lean backwards against a kitchen counter for stability if necessary.
  1. Hold the bent back position for up to 60 seconds, and monitor your symptoms as you are bending backwards.
  2. After 60 seconds, return to the upright position.

While performing the standing lumbar extension exercise, monitor your symptoms.  Initially, you should feel increased back pain and leg pain or tingling.  As you hold the position, continuing monitoring your symptoms to see if these symptoms decrease or centralize to your back. A decrease  or centralization of your symptoms is a good sign and means that you should continue the exercise a few times a day to maintain your ROM and control of your symptoms.

If your symptoms continue to hurt in your low back and your legs continue to tingle, stop the exercise and proceed with your physical therapy flexion exercise program; standing lumbar extension is not an appropriate exercise for you.

The Mechanics of Standing Lumbar Extension

The standing lumbar extension exercise is typically used by physical therapists trained in the McKenzie Method of Mechanical Diagnosis and Therapy.

 There is a specific reason why this exercise is used with patients who have spinal stenosis.  Historically, all patients with lumbar spinal stenosis were prescribed lumbar flexion exercises to help open up the spinal canal and relieve pressure off of spinal nerves.  Many patients with spinal stenosis benefit from flexing their spine.

Some patients, though, benefit from bending backwards.  Lumbar extension places stress and pressure on the back side of your intervertebral discs, those soft, squishy shock absorbers in your spine.  By bending backwards and pressing against the discs, you may be able to slightly press them away from your spinal canal and nerves.  This can give your spinal nerves a little more room, and it may relieve your symptoms of spinal stenosis.

Bottom Line

Lumbar spinal stenosis can be a difficult diagnosis to manage. It can make walking challenging, and it can limit your ability to work or enjoy recreational activity.

If you have stenosis, you may be tempted to engage in only flexion-based exercises for your condition.  By performing standing lumbar extension, you may be able to quickly get pressure off your spinal nerves and rapidly reverse your symptoms.  This can allow you to get back to your normal activity quickly and safely.

Check in with your doctor to make sure you get an accurate diagnosis for your condition first, and then visit your physical therapist to learn the correct exercises to perform for your specific condition. Your PT can help you move better and feel better so you can get back to your normal, active lifestyle.

Source: 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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