LUMBAR CANAL STENOSIS EXERCISES, CAUSES, SYMPTOMS, TREATMENT, TYPES

LUMBAR CANAL STENOSIS

• Lumbar spinal stenosis (LSS) is a decrease in the dimensions of the central or lateral lower back (lumbar spinal) canal that occurs mostly due to chronic degenerative changes at the lower back motion segment. 

• It can be congenital or developmental and acquired.

• Normally the cross-section area of the lumbar canal is 150–200 mm2, decrease in cross-section area to less than 100 mm2.

• According to the area of narrowing lumbar canal stenosis can be of two types, central canal stenosis, and lateral canal stenosis

• However, the symptoms caused by both of them are almost similar.

• Narrowing of a neural foramen causes pain in the leg that is persistent, regardless of the position

CAUSES OF LUMBAR CANAL STENOSIS

• It can be congenital that is from birth due to some spinal structural deformities.

• Can be due to age-related degenerative changes

• Kyphosis

• Scoliosis

• Paget’s disease

• Rheumatoid arthritis

• Fracture spine

• DISH (diffuse idiopathic skeletal hyperostosis) syndrome.

• Spinal infections

• Iatrogenic causes, like hypertrophy of posterior bone graft, incomplete treatment of the stenotic condition, Post discectomy/laminectomy/fusion, etc.

EXAMPLES OF CAUSES OF STENOSIS

The symptoms of Lumbar canal stenosis occur due to a combination of mechanical compression and local inflammation.

SYMPTOMS OF LUMBAR CANAL STENOSIS

• Lower back pain in common

• Neurological claudication: that is complaining of pain in the buttocks and legs while walking and pain decreases with bending forward or sitting.

• Lower limb weakness

• Tingling or pricking numbness, or decreased sensation

• Difficulty in toe/heel walking

• Walking with bending forward and difficulty in lying flat or standing straight.

• Increase in pain while bending the trunk backward

• Has a problem with downhill walking but can walk uphill and do cycling with no problems.

TREATMENT OF LUMBAR CANAL STENOSIS

• Bed Rest is a must but not for a prolonged period

• activity modification

• NSAIDs

• narcotics 

• antidepressants 

• In severe cases surgery

• physical therapy

• Lumbar corset for back support

PHYSIOTHERAPY FOR LUMBAR CANAL STENOSIS

• Lumbar traction to relieve spasm

• Proper back ergonomics

• IFT (Interferential Therapy)

• Proper Back Exercises to improve strength, endurance, and tone

BACK EXERCISES FOR LUMBAR CANAL STENOSIS

LEVEL 1

• ISOMETRIC ADDUCTOR SQUEEZE EXERCISE

• SINGLE-LEG ELONGATION EXERCISE

• SUPINE PIRIFORMIS STRETCH EXERCISE

• SUPINE PELVIC TILT EXERCISE

• HAMSTRING STRETCH 1 EXERCISE

• BRIDGE EXERCISE

• SINGLE KNEE TO CHEST EXERCISE

• KNEES-TO-CHEST STRETCH EXERCISE

LEVEL 2 (start after 1 week only if improvement in felt)

• KNEELING SUPERMAN EXERCISE

• CLAM EXERCISE

• SINGLE-LEG BRIDGE EXERCISE

• FOUR-POINT SUPINE KNEE LIFT EXERCISE

• HIP FLEXOR STRETCH EXERCISE

• SEATED PIRIFORMIS STRETCH EXERCISE

AVOID BACK EXTENSION (BACKWARD BENDING) EXERCISES

If no improvement is noticed for more than 2 weeks consult your professional physical therapist for further evaluation.

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