Exercises for Lumbar Spinal Stenosis

Staying active is one of the most important things you can do to manage lumbar spinal stenosis.

The key is to find exercises that you are able to do and enjoy, and that are gentle on your spine.

The Importance of Exercising

I cannot stress enough how important it is to put in the effort to stay as active and mobile as possible.

Still need convincing?

Here are 5 important reasons to stay active:

1. Exercise spurs blood flow to the painful area, and this blood brings oxygen and healing nutrients and helps wash away toxic metabolites.
2. Exercise strengthens the muscles that help hold up and move your spine, helping to take the pressure off your joints and discs, which in turn leads to a better healing environment.
3. Exercise maintains flexibility, which prevents muscles from becoming overly tight and pulling on your spine.
4. Exercise helps with maintaining a healthy weight. Excess weight can lead to worsening back pain and leg pain.
5. Getting up and moving gets your blood and endorphins flowing, which in turn helps reduce pain and improve physical symptoms.

In addition, regular exercise and movement will assist you with maintaining your balance.

Recommended Exercises for Lumbar Spinal Stenosis

An effective exercise program for people with lumbar spinal stenosis usually includes a combination of range of motion, strengthening, endurance, and stability related activities.

Patients often find that activities/exercises for lumbar stenosis that are done in a bending - forward position are more comfortable.

Recommended types of exercise that are gently on your lower back include:

• Biking. Some people find bicycle riding an enjoyable and rewarding activity as it places your back in a leaning-forward position. Stationary biking may be preferable as it is less jarring.
• Swimming. Swimming is relatively gentle on the spine and provides gentle resistance; however, it is important to swim with correct form so you don’t arch your back and stress your lower spine.
• Water Therapy. Exercising in a water therapy program, which is exercise done while partially submerged in a warm pool, is a good choice for anyone with spinal stenosis as the buoyancy of the water keeps pressure off the spine. The water in the pool provides gentle friction, so the exercise is very effective, and the warmth of the water is also soothing. Many people with both arthritis and spinal stenosis find this an excellent choice.
• Tai Chi. One particularly gentle form of exercise is Tai Chi. This type of exercise class focuses on slow, deliberate and flowing movements of the body. An added benefit of Tai Chi is it incorporates exercises that improve balance, and improved balance reduces the risk of accidental falling.

Walking is an Excellent Form of Low-Impact Exercise for Spinal Stenosis

A regular routine of exercise walking is an excellent form of low impact aerobic exercise, provided the spinal stenosis symptoms don’t make it too difficult for you to walk.

For some people who have severe symptoms such as drop foot, and/or have spinal stenosis with claudication, walking on a treadmill might be a good option. Patients can find a comfortable position and lean on the support bars while on the treadmill.

The treadmill can be set at a slight uphill incline while walking, and this is helpful because it naturally places the spine in a flexed (forward-leaning) position that opens up the spinal canal and relieves pressure on lumbar nerves.

Some physical therapists recommend walking backward (on a treadmill or with support) because it changes spinal mechanics and may reduce pain.

If you have spinal stenosis with arthritis, you may benefit from using a walker, cane or hiking pole to reduce the force on knees, hips, and the lower back by absorbing some of the shock from each step.

If walking is quite painful, or if the spinal stenosis is causing your legs to suddenly give out or become weak, it may be beneficial to walk for exercise while in a warm pool.  This can be done as part of a water therapy class or as water therapy with a physical therapist.

The above activities are at the smooth and repetitive end of the exercise spectrum.

One-on-One Physical Therapy Provides Customized Exercises

Perhaps the best way to engage in a controlled, progressive spinal stenosis exercise program is to work with a physical therapist, physiatrist or certified athletic trainer.

The one-on-one attention with a qualified professional provides you with an effective way to learn stretching and core strengthening exercises and make regular progress through:

• Learning to do exercises with correct form
• Targeting muscle groups that support the spine, such as the core muscles
• Monitoring progress and adjusting exercises as needed
• Providing oversight for safety

It is also valuable to work with an expert to help you stay committed to making progress toward your goals.

Here are standard exercises for sciatica from spinal stenosis.

Exercises to Avoid with Lumbar Spinal Stenosis

It’s important to avoid exercises that worsen nerve compression or increase pressure on the lower back. Remember to always listen to your body when exercising. If an exercise increases the pain, pick a different exercise and don’t just “work through” the pain.  Here are common exercises to avoid:

1. Hyperextension or Backward Bending Movements, such as cobra pose (yoga), back extensions, certain Pilates movements
2. Heavy Lifting (especially with poor form), such as deadlifts, squats with heavy weights, leg presses
3. High-Impact Activities, such as running, jumping, plyometrics, high-impact aerobics
4. Straight-Leg Exercises, such as straight-leg raises, full sit-ups, double leg lifts

It is a good idea to avoid any form of high impact forms of exercise such as jogging, any type of contact sport, or any exercise that requires excessive bending and twisting.

Most people find it is better to avoid long periods of walking, but note that regular shorter walks are tolerable.

Final Thoughts

Remember that the best exercise is one that will become part of one's daily routine. Planning to bicycle every day for one hour won't do any good if it isn't fun and doesn't become part of your routine. Pick a form of active exercise and stretching that is personally rewarding, fun and enjoyable.

Remember to always check with the doctor before starting any new exercise regimen. The doctor may also recommend a physical therapist to learn exercises that can then be incorporated into a daily exercise routine.

See Physical Therapy for Low Back Pain Relief

Don't exercise through pain and other symptoms. If the spinal stenosis symptoms are brought on by the activity, or worsen during or after the activity, stop and discuss it with the doctor.