4 WAYS TO SELF MANAGE LUMBAR SPINAL STENOSIS

Lumbar spinal stenosis (LSS) is a pathological process where bony, ligamentous, and synovial elements of the lower axial spine degenerate and overgrow, progressively compressing the neural and vascular elements in the spinal canal. This degenerative process may result in impingement on the nerve roots of the cauda equina 1. The compression can be asymptomatic if it is mild or can result in a variable combination of static back pain, radicular lower extremity pain, or radicular claudication.

Radicular pain
Patients with lumbar spinal stenosis might report leg pain predominantly in the buttock, thigh and the calf, altered sensation , numbness, tingling or weakness. During neurological assessment we may find dermatomal loss of sensation, myotomal loss of power, nerve mehanosensitivity or reflex loss. It affects people of all ages but most commonly seen in patients in their forties or fifties.

If you want to learn more about this topic, you can watch Adam Dobson's lecture here:

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4 WAYS TO SELF MANAGE LUMBAR SPINAL STENOSIS

1) Advice on walking 
It is absolutely safe to walk for patients with lumbar spinal stenosis. We do not want to be scaring patients and tell them they have to stop walking. If it is tolerable it is safe. Walking can also be done in water. Aquatic therapy is good option. The upward thrust exerted by water on a body virtually eliminates the effects of gravity and the body’s buoyancy reduces compression on the lower back, allowing for more pain free movement (Kaneda et al., 2007). 

2) Encourage bending programs
We should encourage bending in patients with LSS. Bending is good for symptoms, it’s good for flexibility and it forms a part of a lot of treatment strategies. It can be taught to be done everyday for example if walking is getting a bit uncomfortable, they can do bending or stretching and build on that as a routine.

3) General exercise program
Any exercise that patients can enjoy and they feel they can maintain. Swimming, gym anything that is safe to do, should be encouraged with patients.

4) Weight management
Although there is no evidence regarding weight management and lumbar spinal stenosis, it may help to reduce inflammation.
 

If you want to learn more about this topic, you can watch Adam Dobson's lecture here:

Click here

Sources:
1.Current concepts and recent advances in understanding and managing lumbar spine stenosis.
Carlos Bagley, Matthew Macallister, Luke Dosselman, Jessica Moreno, Salah G. Aoun, Tarek Y. El Ahmadieh
2. The effects of aquatic walking and jogging program on physical function and fall efficacy in patients with degenerative lumbar spinal stenosis
Jae-Hyun Lee  Eunsook Sung
3. ‘Lumbar Spinal stenosis’  lecture by Adam Dobson