Spinal Stenosis Walking Issues: EP’s Sciatica Clinic

Spinal Stenosis Walking Issues: Stenosis means a narrowing. Spinal stenosis can happen in any spine region, but the neck and lower back are the most common locations. The spinal canal becomes narrower and can cause the nerves to become compressed, pinched, and irritated and can extend from the lumbar spine through the hips, buttocks, legs, and feet. Individuals with lumbar spinal stenosis may have difficulty walking caused by sensations of discomfort like numbness, electrical shocks, and pain, requiring the need to lean forward to relieve pressure and symptoms. Additionally, symptoms are likely to worsen the longer the walk. Chiropractic treatment can treat spinal stenosis because it corrects and re-aligns the spine, thus reducing pressure on the spinal cord, joints, and nerve roots.

Spinal Stenosis Walking Issues

The spine is made up of interlocking vertebrae. The regions are cervical, thoracic, lumbar, and sacral bones with a foramen opening. These openings form the protective tunnel/spinal canal surrounding the spinal cord. The spinal cord is a group of nerves that run through the tunnel. The narrowing suffocates the nerves supplying the lower extremities that can influence walking activity.

Symptoms

There may be no symptoms with early lumbar spinal stenosis. Most individuals develop symptoms gradually and may begin to notice them while walking or standing. These can include:

• Lower back pressure sensations when standing upright or walking.
• Leg numbness, tingling, weakness, burning, and/or cramping.
• Muscle weakness.
• Persistent pain in the back, hips, buttocks, or legs while walking.
• Difficulty lifting the top part of the foot – known as drop foot.
• Loss of sensation in the feet.
• A weak foot that drops/slaps down when walking.
• Loss of sexual ability.
• In more serious cases, severe numbness, bladder problems, and inability to stand.

Individuals begin to lean forward when symptoms start, bringing relief by reducing the pressure on the nerves. However, constantly leaning forward leads to other posture and health problems.

Diagnosis

A doctor or chiropractor will ask questions about symptoms and medical history and perform a complete physical examination to diagnose lumbar spinal stenosis. During the physical examination, a healthcare provider will look for signs, such as loss of sensation, weakness, and abnormal reflexes.

Tests:

• X-rays of the lumbar spine may show bone growths called spurs that push on spinal nerves and/or narrowing of the spinal canal.
• Imaging tests – A CT or MRI scan can provide a detailed look at the spinal canal and nerve structures.
• Other studies include – bone scans, myelogram, which is a CT scan that uses a color dye, and EMG, which is an electrical test of muscle activity.

Chiropractic Treatment

Chiropractic care combined with physical therapy is a tried-and-true treatment for spinal stenosis. A chiropractic treatment plan can include targeted and passive exercise programs. Targeted exercises involve strengthening the core and back muscles. Passive treatments include hot and cold therapy, massage, decompression, and electrical stimulation. The objective of chiropractic therapy is to:

• Strengthen muscles in the core and legs
• Correct posture and body mechanics.
• Improve mobility.
• Maintain ability to perform day-to-day activities.
• Recommend stretches.
• Educate on how to keep the spine and back muscles safe.
• Train on using devices like a back brace, cane, or walker properly.
• Advise about shoe inserts and splints.
• Suggest work and home environment modifications, such as ergonomics and cushions.

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Chiropractic Relief

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References

Conway, Justin, et al. “Walking assessment in people with lumbar spinal stenosis: capacity, performance, and self-report measures.” The spine journal: official North American Spine Society journal vol. 11,9 (2011): 816-23. doi:10.1016/j.spinee.2010.10.019

Lurie, Jon, and Christy Tomkins-Lane. “Management of lumbar spinal stenosis.” BMJ (Clinical research ed.) vol. 352 h6234. 4 Jan. 2016, doi:10.1136/bmj.h6234

Macedo, Luciana Gazzi, et al. “Physical therapy interventions for degenerative lumbar spinal stenosis: a systematic review.” Physical therapy vol. 93,12 (2013): 1646-60. doi:10.2522/ptj.20120379

Tomkins-Lane, Christy C et al. “Predictors of walking performance and walking capacity in people with lumbar spinal stenosis, low back pain, and asymptomatic controls.” Archives of physical medicine and rehabilitation vol. 93,4 (2012): 647-53. doi:10.1016/j.apmr.2011.09.023