If you are over 50 and have aches and pains in your back and legs, you are not alone. You may have spinal stenosis, a common back condition that can affect your walking.
Your spine is made up of 33 interlocking bones called vertebrae. The neck, chest, lumbar, and sacrum bones have an opening called the foramen. These openings line up to form the protective spinal canal that surrounds your spinal cord.
“Stenosis” is the Greek word for constriction. If you have spinal canal stenosis, it means that parts of your spinal canal have narrowed and are putting pressure on your spinal nerves.
Spinal stenosis can occur anywhere on your spine, but the most common locations are the neck and lower back, also known as the lumbar spine.
The most common cause of spinal stenosis is osteoarthritis. This type of arthritis is caused by age-related wear and tear on the cartilage that protects your bones.
Osteoarthritis can lead to spinal stenosis in two ways:
- Spinal cartilage wear and tear can pinch nerves.
- The vertebrae can develop bone spurs that put pressure on the nerves.
Other conditions that can cause spinal stenosis include:
- Ankylosing spondylitis
- Rheumatoid arthritis
- previous operation
- Spinal tumor
In your lumbar region, your spinal cord ends in a collection of nerves that look like a ponytail called a cauda equina. These nerves send and receive messages to and from your pelvic area and legs.
A stenosis of your spinal canal interrupts these messages. As a result, lumbar spinal stenosis can lead to walking problems.
Contact your doctor right away if you experience severe pain and difficulty getting up. You may have developed cauda equina syndrome, which puts increased pressure on the nerves at the bottom of your spinal cord. If left untreated, this syndrome can cause permanent nerve damage.
Symptoms of cauda equina syndrome include:
- Disruption or loss of bladder or bowel function
- Numbness in the inner thighs, back of legs, genital area, or anal area
- severe pain or weakness in your legs making it difficult to stand up
If you have lumbar spinal stenosis, you may experience symptoms when you walk or stand. These can include:
- lower back pressure when upright
- Pain in the back, buttocks, or legs
- Numbness, cramping, or tingling in the legs
- Muscle weakness
- a weak foot that falls (hits down) while walking
You may get relief from these symptoms by leaning forward, sitting or crouching, riding a bike, or pushing a shopping cart. This is because a forward leaning position will reduce the pressure on your nerves.
Walking is good exercise for spinal stenosis. It has little impact and you control the pace and distance.
However, if walking triggers your symptoms, choose a different type of exercise. Discuss alternative exercise options with your doctor.
If you can walk without symptoms, incorporate this activity into your routine. Some ways to walk more are:
- get the family dog out
- Park a few blocks from your destination
- run short errands on foot
Spinal stenosis in your lumbar region can affect your feet and legs. Examples for this are:
- Foot fall. Nerve compression in your spine can cause weakness in your foot, causing it to hit the floor while you walk.
- Sciatica. This causes severe pain and weakness in your legs, usually one leg at a time.
- Neurogenic claudication. This is pain and numbness in your back or legs that you can feel when you are standing, walking, or bending your spine backwards.
Exercise is important for spine health. As part of your strategy for treating spinal stenosis, exercise can:
- Strengthen back muscles and connective tissue
- Develop your core that supports your spine
- Increases the delivery of oxygen and nutrients to tissues through blood flow
- anti-inflammatory through improved blood circulation
- maintain or increase your spinal flexibility
- Improve your freedom of movement
Try exercises that allow you to stretch and strengthen your muscles without putting pressure on your spine. Examples include:
- Aqua aerobics
- To go biking
Accelerate your pace and stop any type of movement that causes pain. Schedule rest days between training sessions.
Good sleep is important for everyone, but even more so if you have a medical condition that can cause discomfort on a regular basis.
Lack of sleep can make your central nervous system more sensitive to pain, and research from 2020 suggests that poor quality sleep is common in people with lumbar spine stenosis.
A lack of sleep can also trigger inflammation and suppress the release of the healing growth hormone.
Improve your sleep by:
- invest in a comfortable mattress
- Follow a consistent sleep schedule
- Avoid screens with blue light at bedtime
- Practicing a lunch break from caffeine
- regular exercise
Eating healthy doesn’t just provide the nutrients you need. It also gives you the energy to exercise, which will benefit your spine.
Stay hydrated and eat nutritious foods like:
- full grain
- lean proteins
- healthy fats
Avoid highly refined foods like sugar and avoid smoking and excessive alcohol consumption.
Use proper posture and lifting techniques to reduce the risk of back strain or injury.
Stand up straight with your shoulders hunched back and distribute your weight evenly across your feet. Keep your head above your neck and do not tilt it forward.
When you lift or bend, use your legs while supporting your back with your abs. Hold the object you are lifting close to your body.
Physiotherapy is usually a good treatment option for spinal stenosis. Other treatments include pain and inflammation medications or surgery as a last resort.
The goal of physical therapy for spinal stenosis is:
- strengthen the muscles in the trunk and legs
- improve your mobility
- maintain your ability to carry out everyday activities
Your physical therapist can help you with:
- Stretching recommendations
- Learn how to protect your back
- Correct use of devices such as back braces, walking sticks or walking aids
- correct posture and body mechanics
- Advice on insoles and splints
- Heat and cold therapy
- Suggestions for changes to your living environment, such as ergonomics and pillows
Before starting any treatment plan, discuss it with your doctor first to make sure this is a suitable option for you.