A Non-Pharmaceutical Approach to Spinal Stenosis

In this week’s blog Dr. Wael dives into a condition we see often at the Rehab Grid: Spinal stenosis. If you're dealing with spinal stenosis, concerned about its progression, or seeking clarity on your condition, you're in the right place. Our chiropractors and physiotherapists are well-equipped to provide safe, non-pharmaceutical care to help you manage your concerns and regain your quality of life. In this blog, Dr. Wael explores the common causes of spinal stenosis and sheds light on the invaluable role that chiropractors and physiotherapists play in its management.

Spinal stenosis involves a gradual narrowing of the spinal canal. This can occur anywhere along the length of the spine, from the neck down to the low back. 

The spine is made up of building blocks called vertebrae. You can picture these as a stack of Lego pieces, one on top of another. Now, I’d like you to imagine a long tunnel passing through the center of these pieces, from the top to the bottom of this stack. This tunnel is known as the spinal canal. 

Inside this canal travels many important structures, one of which is  your spinal cord. The spinal cord transfers information that is necessary to complete some of the most basic human functions, such as lifting a single finger, to more complex functions such as regulating your bowel or bladder.

Certain problems such as arthritis and disc herniations can lead to stenosis or narrowing of the canal. This causes pressure to build up, which may irritate the spinal cord and surrounding tissues, leading to symptoms such as numbness, weakness, loss of strength, poor coordination, or trouble with bladder control. 

If you are working through spinal stenosis, worrying about it progressing, or seeking clarity on your condition you’ve come to the right place. Chiropractors and physiotherapists are well educated on this topic and can offer safe non-pharmaceutical care to help you with your concerns.   

Common Causes of Spinal Stenosis

Spinal stenosis is most commonly related to aging as most cases present in individuals fifty and older. That said, some cases have been reported in younger individuals due to trauma, congenital, or acquired aetiologies. Below are the main causes of spinal stenosis:

Aging

The natural aging process is one of the most common causes of spinal stenosis. As people age, the spinal structures, including the intervertebral discs and ligaments, tend to degenerate and thicken. This can reduce the space within the spinal canal and contribute to stenosis.

Herniated Discs

A herniated or bulging disc occurs when the soft, gel-like material inside a spinal disc protrudes outward and presses against the spinal canal. This can lead to stenosis by reducing the available space for the spinal cord and nerves.

Osteoarthritis

Osteoarthritis is a degenerative joint condition that can affect the facet joints in the spine. As the joints deteriorate, they can cause the formation of bone spurs (osteophytes), which can encroach upon the spinal canal and result in stenosis.

Congenital Factors

Some individuals may have a genetic predisposition to developing spinal stenosis due to factors like having a smaller-than-average spinal canal from birth.

Trauma or Injury

Spinal stenosis can also occur as a result of trauma or injury to the spine. This may involve fractures or dislocations of the vertebral bones, which can impinge on the spinal canal.

The Role of Chiropractors and Physiotherapist in the Management of Spinal Stenosis

Chiropractors and physiotherapists will work with you to help improve mobility, strength, endurance (especially when walking), and return to the activities you enjoy most. The specific approach may vary depending on the individual, the severity of the condition, and the location of the spinal stenosis. Here are some of the most common treatment options to discuss with your chiropractor or physiotherapist:

Manual Manipulation

Chiropractors and Physiotherapists often use spinal adjustments or manipulation techniques to improve spinal alignment and reduce pain. This can help alleviate pressure on the spinal cord and nerves in some cases.

Soft Tissue Therapy

Physiotherapists and Chirporactors may use soft tissue techniques, such as massage, myofascial release, or trigger point therapy, to address muscle tightness, spasms, and pain associated with spinal stenosis.

Mobilization

Both chiropractors and physiotherapists may use joint mobilization techniques to increase joint flexibility and reduce stiffness, potentially providing relief from spinal stenosis symptoms.

Acupuncture

Acupuncture may be used by some chiropractors or physiotherapists to help manage pain and improve overall well-being in individuals with spinal stenosis.

Strengthening Exercises

Physiotherapists and Chiropractors often prescribe specific exercises to strengthen the muscles supporting the spine. Strengthening the core and back muscles can help stabilize the spine and reduce stress on affected areas.

Stretching Exercises

Gentle stretching exercises can improve flexibility and reduce muscle tension, potentially relieving symptoms and increasing mobility.

Postural Training

Chiropractors and physiotherapists may provide guidance on proper posture and body mechanics to minimize strain on the spine and reduce the risk of exacerbating symptoms.

Education

Both healthcare providers can educate patients about spinal stenosis, its causes, and strategies to manage and prevent symptoms. They may also provide guidance on lifestyle modifications and ergonomics.

Activity Modification

Recommending modifications to daily activities and exercises to accommodate the condition and reduce pain and discomfort.

What to Expect on Your First Visit to the Rehab Grid

A clinician at the Rehab Grid will guide you through a focused examination. This includes a full history with the purpose of understanding your story and assessing for pathologies that may be worsening your symptoms. The clinician will then follow up with a thorough physical examination to assess your strength, mobility, walking capacity and screen for any red flags. A plan of management will be discussed and tailored to help you understand the nature of your concerns, the course of treatment recommended, and the range of therapeutic interventions that we can provide for you.