Back pain can make all sorts of physical activities nigh unbearable. Whenever back pain flares-up considerably, our first instinct is to give ourselves a rest. While that is by no means a bad idea, it does become counterproductive at some point: our bodies tend to become shaped by what we do with them, and a lack of activity can often exacerbate causes of back pain, and make flare-ups more common rather than soothe them.
On the other hand, doing the wrong thing can greatly impact how back pain develops, and make a bad situation worse. In cases of spinal stenosis exercises, there is often a fine line between good activity and bad activity – but where good movement can greatly improve strength and stability, bad movement can lead to greater pain, and even surgery. Differentiating between the two is important.
What Is Spinal Stenosis?
Spinal stenosis refers to a significant narrowing of the spinal column. While some narrowing in the spinal column is normal, and part of the natural idiosyncrasies of the human body, any amount that begins to put pressure on the spinal cord itself can lead to flare-ups and significant pain, as well as a reduction in range of motion, lack of strength, and accompanying numbness.
Spinal stenosis can be caused by several issues, some of which are fixable through spinal stenosis exercises and a diligent lifestyle change, and some of which require a more invasive approach due to their irreversible nature. The spinal column itself is made up of bones called vertebrae, connected via spongy impact-absorbing discs, and small stabilizing facet joints. Other elements of the spinal column include ligaments, attaching to important muscles throughout the back and hips.
Changes in the bone itself, inflammation in the ligaments and discs, and injuries can all cause a narrowing of the spinal column, thereby compressing the nerves inside. If a radiologist and spine specialist has ruled out any kind of bony protrusion or removable growth, chances are that injury and/or inflammation contributed to your stenosis. It’s in such cases that certain activities can greatly help reduce pain and swelling – while others can serve to exacerbate it. Some spinal stenosis exercises and activities to consider avoiding or stopping altogether include (but not limited to):
1. Avoid Excessive Back Extension
One of the more common stretches we tend to engage in after a long period spent sitting or hunching over is the standing back extension, or more aptly, the standing lumbar extension. It involves standing up straight, putting your hands on your hips, and leaning back as far as you can. In a few cases, this type of compression on the back of the vertebrae may help make space for the spinal cord by pushing some inflamed tissue out of the way.
However, in most cases, it leads to worse symptoms and more pain. If you tend to experience more pain and numbness following a back extension, try to avoid that stretch – and more importantly, try to avoid any activity that causes your back to go into excessive extension, i.e. anything requiring you to bend over backward. The increased compression can make inflammation worse.
2. Avoid Long Walks or Running
Some spinal stenosis exercises are important, but too much – or the wrong kind – can be detrimental to your pain. While jogging and running are generally seen as an “easy” exercise and associated with low- or mild-impact, jogging and running usually qualify as high-impact exercise, especially if you don’t have access to a soft or loamy trail, but are instead forced to run on pavement.
The repeated trauma to the knees and spine is less than ideal. On the other hand, walking for long periods of time – or long distances, instead – can also exacerbate back pain. Consider starting with shorter, tolerable distances, and make modest increases in pace and distance without breaking into a jog.
3. Avoid Certain Stretches and Poses
The previously mentioned back extension exists in a variety of common poses and spinal stenosis exercises, including the cobra, the bridge, most lower back exercises involving hyperextension (such as the Superman), and more. While it is certainly a good idea to strengthen the muscles of the lower back, it is far better to avoid spinal flexion or extension when doing so. Instead, look at isometric exercises that revolve around stabilizing the back, and keeping it stiff against an outside force.
4. Avoid Loading a Rounded Back
Free weights can be a great boon to someone with back pain, provided they are working with a professional and have received prior clearance from their doctor. Certain exercises can greatly strengthen the muscles that support the spine and make it easier to maintain a healthier posture in a variety of activities and positions. Free weight exercises can also help you address unilateral imbalances in your body, such as uneven strength in the legs, hips, shoulders, and arms, which can translate into more back pain.
But when performed incorrectly, free weight exercises can easily lead to injury. One such example is any exercise requiring hip hinging, from bent over rows and flies to the deadlift. Any rounding in the back can greatly destabilize the muscles around the spine, and cause shearing forces to impact the spine, affecting the discs. Be sure to work your way up in difficulty and weight one step at a time, to avoid any excessive force on the back.
5. Avoid Too Much Bed Rest
It’s tempting to lay in bed whenever possible, but too much bed rest will only serve to atrophy your muscles and place further strain on your back and contribute to inflammation. Staying active can help you reduce pain and improve your quality of life, at the cost of a few minutes a day spent sweating and moving.
6. Avoid Contact Sports
While it’s good to get active, try to stick to sports that avoid sudden impact and contact. Martial arts, football, basketball, and soccer are just some examples of sports where healthy training can very quickly lead to a sudden tear or fracture, especially when you come into physical contact with others.
Spinal Stenosis Exercises and Activities to Do More Of
Spinal stenosis is a serious spinal condition that requires a medical diagnosis and a course of treatment. But when that course of treatment permits the use of physical therapy and exercise as a preferred alternative to something potentially more invasive, there are many options available to you depending on the nature and severity of your condition. Some things to consider include:
1. Consult a Physical Therapist
First and foremost, you should get in contact with a reputable physical therapist with a history of working with patients with back pain, especially spinal stenosis. They may be able to help you find spinal stenosis exercises or activities that suit your interests and circumstances.
2. Strengthen the Core and Hips
Building a strong base for the spine is important when approaching an exercise plan. Strengthening the muscles of the core and hips without compromising the integrity of the spine is key. Planks, side planks, unilateral carries, lunges, and gentle twists are just some examples of spinal stenosis exercises that could greatly improve strength without putting the spine in a position that might lead to more pain.
3. Consider Swimming and Water Exercise
Training in the water can help take the stress off the spine and joints, and it provides a way for some patients to get moving and get some endorphins flowing through them without putting undue stress on arthritic joints and a painful back. Spinal stenosis is a condition that requires medical treatment first and foremost but may be helped considerably by observing a few physical dos and don’ts.
