If you’re over age 50 and starting to experience discomfort in your back and legs, you’re not alone. You may have spinal stenosis, a common back condition that can affect how you walk.
Your spine is made up of 33 interlocking bones called vertebrae. The cervical, thoracic, lumbar, and sacral bones have an opening called a foramen. These openings line up to form the protective spinal canal that surrounds your spinal cord.
“Stenosis” is the Greek word for narrowing. If you have spinal 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 the lower back, also known as the lumbar region.
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 cause spinal stenosis in two ways:
- The wearing down of vertebrae cartilage can pinch nerves.
- The vertebrae can develop bone spurs, which put pressure on nerves.
Other conditions that can cause spinal stenosis include:
- ankylosing spondylitis
- rheumatoid arthritis
- previous surgery
- spinal tumor
Your lumbar region is where your spinal cord ends in a collection of nerves that look like a horse’s tail, called the cauda equina. These nerves send and receive messages to and from your pelvic area and legs.
Stenosis of your spinal canal interrupts these messages. As a result, lumbar spinal stenosis can cause walking problems.
Contact your doctor right away if you have severe pain and difficulty standing up. You may have developed cauda equina syndrome, which puts stronger 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:
- disturbance or loss of bladder or bowel function
- numbness in your inner thighs, back of legs, genital area, or anal region
- severe pain or weakness in your legs that makes it difficult to stand up
If you have lumbar spinal stenosis, you may notice symptoms while walking or standing. These can include:
- lower back pressure when upright
- pain in your back, buttocks, or legs
- leg numbness, cramping, or tingling
- muscle weakness
- a weak foot that drops (slaps down) when you walk
You may feel relief from these symptoms when you lean forward, sit, or crouch, or while riding a bike or pushing a shopping cart. This is because a forward-leaning position reduces pressure on your nerves.
Walking is a good exercise for spinal stenosis. It’s low impact, and you control the pace and distance.
However, if walking triggers your symptoms, choose a different type of exercise. Discuss alternative movement options with your doctor.
If you’re able to walk without symptoms, incorporate this activity into your routine. Some ways to walk more include:
- taking out the family dog
- parking a few blocks away from your destination
- running short errands on foot
Spinal stenosis in your lumbar region can affect your feet and legs. Examples of this include:
- Foot drop. Nerve compression in your spine can cause weakness in your foot, causing it to slap the ground as you walk.
- Sciatica. This causes sharp 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 stand, walk, or bend your spine backward.
Exercise is important for spine health. As part of your spinal stenosis management strategy, exercise can:
- strengthen back muscles and connective tissue
- develop your core, which supports your spine
- increase delivery of oxygen and nutrients to tissues via blood flow
- reduce inflammation because of improved circulation
- maintain or increase your spine flexibility
- improve your range of motion
Try exercises that allow you to stretch and strengthen muscles while not putting pressure on your spine. Examples include:
- water aerobics
Pace yourself and stop doing any type of movement that causes pain. Schedule rest days between workouts.
Proper sleep is important for everyone, but even more so when you have a condition that can cause regular discomfort.
Lack of sleep can make your central nervous system more sensitive to pain, and
Insufficient sleep can also trigger inflammation and suppress the release of healing growth hormone.
Improve your sleep by:
- investing in a comfortable mattress
- keeping a consistent sleep schedule
- avoiding screens with blue light before bedtime
- practicing a midday caffeine cutoff
- getting regular exercise
Healthy food doesn’t just provide the nutrients you need. It also gives you the energy to exercise, which benefits your spine.
Stay hydrated and eat nutrient-dense food such as:
- whole grains
- lean proteins
- healthy fats
Stay away from highly refined food such as sugar and avoid smoking and excessive consumption of alcohol.
Use proper posture and correct lifting techniques to reduce your chance of back strain or injury.
Stand tall with your shoulders back and your weight evenly distributed through your feet. Hold your head above your neck and not tipped forward.
When you lift or bend, use your legs while keeping your back supported with your abdominal muscles. Hold the object you’re lifting close to your body.
Physical therapy is usually a good treatment option for spinal stenosis. Other treatments include medication for pain and inflammation or surgery as a last resort.
The goal of physical therapy for spinal stenosis is to:
- strengthen muscles in your core and legs
- improve your mobility
- maintain your ability to perform day to day activities
Your physical therapist can help you with:
- stretching recommendations
- learning how to keep your back safe
- proper use of devices like a back brace, cane, or walker
- correct posture and body mechanics
- advice about shoe inserts and splints
- hot and cold therapy
- suggestions for modifications to your home environment, such as ergonomics and cushions
Before you start any kind of treatment plan, discuss it with your doctor first to make sure it’s an appropriate option for you to try.