Medically reviewed by Misty Seidenburg
Spinal stenosis due to age or injury is one of the most common causes of chronic pain, especially in older adults. By the age of 50, 95% of people have some degree of spinal degeneration.
If you are among that group, exercising with spinal stenosis may seem counterintuitive. But physical activity can improve strength, flexibility, and stability—if you do the right activities. Here, we discuss activities to avoid if you have spinal degeneration and explain the benefits of physical therapy for safe, supervised exercise.
Let’s examine the anatomy of the spine to understand how and why spinal stenosis causes pain, numbness, and weakness in the back, upper body, or lower body. The spinal canal is a tunnel-like structure that runs through each spine vertebrae. It houses the spinal cord and nerve roots that branch out from the cord to other parts of the body.
As we age, everyday wear and tear causes the spaces within the spinal canal to shrink, exerting pressure on the spinal cord and nearby nerve roots. The location and severity of symptoms can vary depending on the area of the spine affected.
While age-related degeneration is a leading cause of stenosis, these spinal changes can also happen as a result of herniated or bulging spinal discs, systemic conditions like arthritis and osteoarthritis, and spinal fractures.
Healthcare providers use a to describe the progression of the condition. The type and intensity of stenosis symptoms depend on many factors independent of the severity of the condition.
Possible signs of stenosis include:
Individuals with early-stage stenosis are often asymptomatic. Once symptoms develop, they typically worsen over time.
Cervical stenosis is a form of stenosis that occurs in the neck. This abnormal compression of the spinal cord and nerve roots near the neck has several possible contributing factors, including degenerative arthritis, rheumatoid arthritis, and ossification.
With ossification, the posterior longitudinal ligament that runs along the back of the cervical vertebrae and disc turns into bone, narrowing the spinal canal. A traumatic injury can also compress the spinal cord in the neck.
Cervical stenosis can cause all the symptoms mentioned above, as well as pain, weakness, or numbness in the upper extremities, and lead to a diagnosis called cervical myelopathy, in which you may experience both arm and leg symptoms.
If you are diagnosed with cervical stenosis, you should avoid certain habits and movements as much as possible to minimize further disc damage.
These activities include:
Like stenosis that affects other parts of the spine, conservative therapies are the first-line treatment for cervical stenosis. If nonoperative treatments are unsuccessful, surgery may be recommended for patients at risk of disability.
Prolonged bed rest and a sedentary lifestyle can increase the severity of back pain. That is why exercise is recommended for many people with spinal stenosis. In fact, research shows that exercise therapy can mitigate the need for surgery in some patients.
However, the activities below can aggravate symptoms and speed up the progression of stenosis, so they should be avoided unless otherwise instructed by your physical therapist and other providers.
Frequent, short walks are beneficial for symptomatic stenosis patients. Yet long, extended walks can lead to muscle fatigue, which strains the lower back or lumbar spine. This added strain can increase pain and accelerate degeneration.
The continual thumping of the feet on the ground during running causes repetitive, jolting impacts on compromised spinal structures. This can increase spinal compression and worsen stenosis symptoms.
Basketball, volleyball, skipping rope, and other activities that involve frequent jumping cause the spine to compress and decompress quickly, which is not ideal for those with a degenerative condition of the back. Jumping also causes the back muscles to contract to protect the spine, which can increase spinal stenosis pain.
People with spinal stenosis should avoid contact sports like football, soccer, basketball, and martial arts. Forceful impacts to the body and sudden twists and turns may increase the risk of back injuries and further irritation to spinal structures.
Back extension exercises, or hyperextensions, involve extending the back from a flexed position. Some people incorporate these movements into their fitness regimen to strengthen the lower back.
Usually, this is a fantastic exercise to strengthen the back and improve weak bones, such as osteoporosis. However, in people with spinal stenosis, back extensions past neutral should be avoided because they cause narrowing of the spinal canal and a worsening of pain and other symptoms.
Now that we have covered what to avoid with spinal stenosis, let’s explore how physical therapy helps patients manage pain and remain active, strong, and fit. Here are some treatments and techniques physical therapists utilize to improve patients’ symptoms and quality of life.
The benefits of exercise for patients with spinal stenosis include improved strength, balance, and coordination, increased flexibility and range of motion, and better posture and gait. Targeted exercise helps to ease pressure on spinal nerves and decrease stenosis pain.
Your physical therapist prescribes safe, gentle, low-impact activities and aerobic exercises to help you feel and move better. They also create an exercise plan for you to do at home to help you see results sooner. Strengthening exercises help support the back and build capacity to resume the activities you previously participated in.
You may also benefit from soft tissue mobilization and other hands-on manual therapies to increase mobility in stiff, painful joints. Stretching, joint manipulation, and other techniques also help relax the soft tissues around spinal canal openings to ease spinal cord and nerve constriction.
Physical therapists wear many hats. In addition to being movement experts, they are also educators. They teach patients how to navigate routine tasks safely while minimizing pain. They work with you to practice proper posture when sitting, standing, sleeping, and walking to protect the spine and reduce pain as you go about your day.
Lifestyle recommendations are another important aspect of physical therapy. You’ll learn the benefits of hydration and healthy eating to promote healing and reduce inflammation. Physical therapists empower you with self-management strategies to treat your symptoms at home and complement your hard work in the clinic.
Living with spinal stenosis doesn’t mean you have to give up exercise and all of the activities you enjoy. A personalized physical therapy program can offer long-lasting relief and improve how you feel and move.
Check with your healthcare provider and schedule a screening to determine if you are a candidate for physical therapy. Then, find a physical therapy clinic near you.
