4 Things to STOP Doing if You Have Lumbar Spinal Stenosis

Lifestyle and Exercise to Avoid

Photo of an overweight man with back pain.
If you have spinal stenosis, there are some things you should avoid doing. Universal Images Group/Getty Images

If you have lumbar spinal stenosis, you may be waiting and hoping it will go away. Or you may doing exercises but wonder if you are doing enough or the right kind. Finally, you may be wondering whether surgery should be considered. What should you avoid or stop doing at this time?

Living With Lumbar Spinal Stenosis

If you have lumbar spinal stenosis, your doctor has probably talked about things that you can do to manage your back and leg pain and improve your ability to walk.

Your physical therapist can teach you an exercise program to improve your spinal range of motion (ROM) and strength. He or she can also show you how to adjust your posture to help control your symptoms. You may have even started doing some of the common exercises for lumbar spinal stenosis.

Yet, when you are living with a back problem, learning what you should not do is often as important as learning what you should do. There are things you should stop doing if you have back pain in general, but lumbar spinal stenosis is a special condition. Spinal stenosis is a medical condition which has its own rules to follow, including things that you should do and things you should avoid to maximize your chances of successful management.

What Should You Stop Doing if You Have Lumbar Spinal Stenosis?

What should you avoid if you have lumbar spinal stenosis? Let's take a look at what you should stop doing today.

It's important that you also talk to your doctor and physical therapist to learn how to best manage your condition over the long term.

1. Stop Waiting For Symptoms to Go Away

If you have known other people with back pain, you may be waiting and hoping that your symptoms will just go away. But lumbar spinal stenosis behaves differently than many other causes of back pain.

Lumbar spinal stenosis is a progressive condition which generally worsens if you do nothing. It doesn't just go away.

Progressive, however, doesn't mean there is nothing you can do. Engaging in an exercise program often helps to improve mobility and decrease back and leg pain. Working to improve your strength and range of motion can help you walk better with less pain. 

As with other medical conditions, taking an active role in your spinal stenosis care is one of the best ways to manage your condition.

2. Stop Treating Only the Inflammation

Spinal stenosis is caused by a narrowing of your spinal canal, and this narrowing can irritate the nerves that travel down your legs. Symptoms are typically worse with walking and better with sitting down or bending forward. When your nerves become irritated, they may be inflamed, and taking anti-inflammatory medication can temporarily improve your condition. But relying solely on a medication to manage your spinal stenosis can lead to a worsening of your symptoms and progression of your mobility limitations.

To effectively treat your condition, you must change the biomechanics of your spine and improve the way your spine moves. This can be accomplished through exercise and postural correction.

3. Stop Doing Only Flexion Exercises

Historically, people with spinal stenosis were prescribed only flexion exercises that bend the spine forward. Why? Because this position causes an increase in your spinal canal diameter, and this is thought to take pressure off spinal nerves.

In addition to flexion exercises, however, people with lumbar spinal stenosis may also benefit from bending backward with an exercise called sustained standing lumbar extension. This exercise can gently press against your spinal discs, moving them away from your spinal canal and nerves to give them more room. Talk to your physical therapist about how spinal extension exercises are done and whether these may be of benefit to you.

4. Stop Thinking About Surgery

When you were first diagnosed, your doctor may have talked to you about the treatment options for lumbar spinal stenosis. Spinal surgery called a lumbar laminectomy may be helpful for some people with spinal stenosis. But studies now indicate that physical therapy may have similar long-term outcomes to surgery when compared for the treatment of lumbar spinal stenosis.

While the outcomes of the two approaches may be similar, the risks associated with surgery are usually significantly greater than those encountered while participating in an active physical therapy program. In fact, a 2017 review in the International Journal of Surgery again confirmed the equal efficacy of surgery and non-surgical approaches such as physical therapy but found a higher complication rate for those who underwent surgery.

Surgery may certainly be needed for some people with lumbar spinal stenosis, and when the condition reaches that point the benefits usually outweigh risks. But before your spinal stenosis reaches that point, if it ever does, stop worrying about surgery and engage in an active program to treat your spinal stenosis. More invasive options such as epidural steroid injections or surgery can be done at that time if needed.

Bottom Line on What to Avoid With Lumbar Spinal Stenosis

If you are living with lumbar spinal stenosis, stop hoping it will just go away. Spinal stenosis is a progressive condition, but symptoms can be improved with the right exercises. It's important to do these exercises and not just use anti-inflammatory medications alone. Using the right exercises is also important, and your physical therapist can guide you into the best flexion as well as sustained standing lumbar exercises for your particular symptoms and disease. Finally, unless you have exhausted your physical therapy options it's usually best to put surgery on the back burner and pursue the less invasive and equally effective physical therapy approaches.

Sources:

Delitto, A., Piva, S., Moore, C. et al. Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis. Annals of Internal Medicine. 2015. 162(7):465.

Ma, X., Zhao, X., Ma, J. et al. Effectiveness of Surgery Versus Conservative Treatment for Lumbar Spinal Stenosis: A System Review and Meta-Analysis of Randomized Controlled Trials. International Journal of Surgery. 2017. 44:329-338.

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